The Mill House

Updated 3 April 2025

We completed assessment visits to The Mill House on 14 and 15 April 2025. This is a service for providing nursing and residential care to adults and older people living with dementia. At the time of our inspection the service was full at 45 people living at the service, with 3 people in hospital. At our last inspection completed in July 2019, the service was rated good overall, with requires improvement for safe.

At this inspection, we identified some areas of the service had deteriorated, and breaches of the regulations were identified in relation to the provision of safe care and treatment, and good governance. Where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.

We identified shortfalls in the quality and content of people’s care and support records, which increased the risk of inaccurate information being followed by staff, particularly unfamiliar staff such as agency. People were living with complex conditions and nursing care needs, and were not all able to make staff aware of their needs, or manage their safety independently.

We found areas of risk within the care environment the provider’s own audits and safety checks had not identified, including access to unsecured drink thickener, denture cleaning tablets and prescribed creams placing people, particularly those living with dementia at risk. Whilst the provider responded promptly to our inspection findings, changes within the care environment would not have happened without these concerns being brought to their attention. We identified shortfalls in the service’s oversight of people’s individual risk, and the wider impact this had on the assessed dependency levels and overall risk profile within the service.

As an outcome of our inspection, we made a referral to Norfolk Fire and Resue Service, who visited the service and gave advice to the provider and sourced their own assurances.

Updated 3 April 2025

People and their relatives provided positive feedback regarding the standards of care and support provided; however, we identified shortfalls in the oversight of the care environment, to protect people from the risk of harm. Improvements in relation to the management of medicines for people receiving these either covertly (hidden in food of fluid), or as required medicines (PRN) for constipation were identified. Corresponding care records needed improvements to ensure the guidance in place provided staff with clear timescales for escalation of concerns to the GP. Staff were not consistently completing required checks of people’s equipment, and repositioning them to prevent the development or deterioration in pressure sores; more needed to be done to support people to maintain their safety and welfare, in line with their assessed care needs and risks.

People unable to spend time out of bed told us they would like more time with staff on a 1 to 1 basis, to reduce the risk of isolation. Overall, people and their relatives spoke positively about the standards of care provided, and the food quality. People told us they enjoyed spending time in communal areas of the service and going out for trips and activities in the community.

People’s care and support records were not always an accurate reflection of their assessed needs and risks. Discrepancies contained within these documents increased the risk of people receiving poor care outcomes.

People and relatives told us they felt the staff were kind and compassionate and provided dignified care. Staff understood their roles and responsibilities in relation to providing people with emotional support, and tailored end of life care. Relatives told us they felt able to visit the service anytime and were welcomed by the staff team, they stated, “Everything they provide is good, and they look after [relative] extremely well.” Another relative stated, “The nursing and care staff are superb.”