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Inspection Summary


Overall summary & rating

Good

Updated 4 September 2019

About the service

The Mill House is a residential and nursing home providing personal and nursing care to 45 people aged 65 and over at the time of the inspection. At the time of our inspection, there were 36 people using the service.

People’s experience of using this service and what we found

Medicines were administered safely by competent staff but records and storage of medicines did not always support safe administration. Some poor infection control practice was observed. Most of the time people received care in a timely way by staff who had been recruited safely however some concerns were raised about staffing numbers. People were kept safe from abuse and from risk of harm. People’s needs were assessed and staff took the necessary steps to promote their safety and wellbeing. Lessons were learnt from accidents and near misses, which were routinely reported, recorded and monitored.

Staff were well trained and regularly supervised. People were supported to eat and drink and their dietary needs were met. People were given choices with their meals. Emerging and existing health care needs were identified and managed well and people were supported to access external health professionals. Some improvements to the communication with the local GP surgery was needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by very caring and kind staff, who treated people as individuals and showed a genuine interest in them. People were supported to communicate their wishes and preferences about their care and to be involved in health and care decisions. People were treated with dignity and respect and staff sought to ensure people stayed as independent as possible.

People’s care planning was personalised and effective. There were examples of positive outcomes and people and relatives were happy with the care provided. The service supported people to avoid isolation and undertake activities of interest to them. People’s communication needs were met and end of life care planning was good. The manager dealt appropriately with and ensured the service learnt lessons from complaints.

The manager led and managed the service with enthusiasm and professionalism. They had instilled a caring and positive culture since their appointment and staff had responded well to this. People and relatives praised the staff and the manager and spoke of their contentment with the service. There was a clear drive for improvement and a willingness to ensure views from people, staff and reletiaves were reflected in plans to develop the service. Governance of the service was generally strong. Some improvements to the auditing of the recently introduced electronic care record system is required. Staff will benefit from further training on the new electronic care record system so that its functionality can be maximised.

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 February 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection areas

Safe

Requires improvement

Updated 4 September 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 4 September 2019

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 4 September 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 4 September 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Good

Updated 4 September 2019

The service was well-led.

Details are in our well-Led findings below.