Mill View Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Although assessments were completed prior to people’s admission to the home, it was not always clear how much people and/or relatives had been involved in this process.

We found the quality and quantity of information to be variable. Some of the assessment and care records we viewed were detailed. However, in others we found sections for documenting background information, likes and dislikes and other key information about the person, contained limited information. For example, one person’s ‘how and when to support me’ section just stated, “whenever I need.” Internal governance processes completed by the provider had identified the completion of care documentation within the first 72 hours of admission was variable and inconsistent across units, issues included incomplete information and a lack of detail. This was in line with our findings.

The provider did not always plan and deliver people’s care and treatment with them, and in line with legislation and current evidence-based good practice and standards.

The mealtime experience for people was not always positive. The provider had identified mealtimes were unstructured and at times chaotic, and had introduced systems to help better organise these. However, whilst these systems were being used, we found further work was required. The process for plating and serving meals was very slow. Some people who had already been sat for up to 20 minutes waiting for food to arrive, had to wait another 10 to 15 minutes to be served. Some people had eaten their starter and were ready for their main before others had received any food. Due to how staff had been allocated, and how busy they were, there was no-one consistently available to encourage or support people to eat. We observed people sat with untouched food in front of them. When prompted to eat by staff walking past, they started to eat but stopped as soon as the staff had continued on. A relative we spoke with had observed similar, they told us, “I have noticed at mealtimes no one was encouraging residents to eat or drink. If there are four staff on duty, one is usually plating up and one is serving meals around the room before joining the other two supporting people in rooms. There is no one supervising or supporting those sitting at the tables.”

The provider documented people’s food and fluid intake. After identifying issues with the completion of these, the provider had held coaching sessions with staff to drive improvements. Overall, we found food charts were being completed to a satisfactory standard. However, fluid charts indicated some people had not always been offered the designated amount of fluid per day. People’s care plans did not instruct staff on actions to take, if people had not drank enough.

The provider had worked closely with the kitchen to improve the quality and variety of meals provided, including the provision of modified diets. Menus were considered for their nutritional value and to ensure a balanced diet was offered. Overall, people told us they were happy with the meals provided and received a choice of options. From reviewing records, we did note one person was being offered a limited diet, which they often refused. Food logs showed they were more likely to eat food culturally relevant to them. However, this was only being provided by their family. We discussed this with the provider who agreed to look into what was provided to his person.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access medical professionals as and when required. People and relative’s feedback supported our findings, Comments included, “My wife had a fall about 12 months ago and was taken to hospital but came back the same day”, “A podiatrist visits the home, and a GP will come if needed” and “Mum had an issue recently and the GP was called out and prescribed antibiotics.”

We noted examples of people being referred to specialists, such as the bowel and bladder service, Speech and Language Therapists and dieticians. Following a spate of unplanned weight loss within the home, the provider had taken steps to address people’s nutritional intake. We found the interventions used had been successful, with the majority of people gaining weight.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Although the provider told people about their rights around consent, they did not always respect their rights when delivering care and treatment. This mostly related to record keeping. Care records contained information about people’s ability to consent to their care and treatment. Where people lacked capacity, the best interest process had been followed. This involves staff, professionals and those closest to or legally responsible for the person, meeting to discuss any decisions which need to be made and agreeing what is in the person’s best interest. From reviewing this documentation, it was apparent the provider and care staff were mindful of the fact capacity and ability to consent was decision specific. A best interest meeting had been completed for each decision which needed to be made such as, consent to care, consent to share information, use of certain equipment.

However, we found on one unit, the best interest process had not been completed fully or correctly. The sections specifically for documenting why any decision made was in the person’s best interest were all blank. From checking the providers audit and monitoring systems, this issue had not been identified by management or the provider. Documentation on the other 3 units was of an acceptable standard, with all sections completed. The provider agreed to review training and support processes for the completion of this documentation.