The Mill House

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 changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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 make sure people’s care and treatment was effective because they did not consistently review people’s health, care, wellbeing and communication needs.

People’s care and support records contained inconsistencies in relation to the management or risks such as food consistencies to reduce the risk of choking, timing of repositioning to prevent the development or deterioration of pressure sores, fluid monitoring to prevent dehydration. This increased the risk of staff following incorrect guidance.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We identified inconsistencies in the completion of nationally recognised risk and assessment tools, which did not ensure corresponding risk scores were an accurate reflection of people’s individual care and support needs. People’s care and support records needed to contain clearer details in relation to the management of long term conditions such as diabetes, to ensure personalised information was in place, in line with nationally recognised best practice approaches.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they had good working relationships with external health and social care professionals, including the GP, to ensure people received timely access to appointments and specialist support. We observed the staff team to work collaboratively with people and their relatives.

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.

We received positive feedback regarding food quality and portions. People told us they received additional snacks and high calorie foods to aid maintaining or improve their weights. The service had systems in place for monitoring people’s overall health and wellbeing and ensure timely access to medical input was sourced. Our findings were supported by feedback received, this included, “With food they come into my relative’s room and give choices as to what they would like for lunch and also wait for an answer which is nice. Never feels rushed.” Another relative told us, “The food is delicious and is home cooked. [Relative] loves their food and is eating really well.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

We identified significant disparity between people’s care and support plans, and the service’s own risk register which should provide an accurate overview of people’s clinical needs and individual risk profiles within the service. We were not assured service leaders had a good oversight of people’s needs and outcomes within the service.

The provider did not always have good oversight of people’s individual rights around consent.

We identified a lack of mental capacity assessments in place for aspects of restrictive practices, such as the use of lap belts on wheelchairs. This did not demonstrate staff and leaders were adhering to the provider’s own policies which explicitly identified the need for these assessments to be in place. The service’s deprivation of liberty safeguards log was not being kept updated.