The Mill House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people’s needs were not always met.

This service scored 61 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We identified the need for greater value to be placed on the level of detail in people’s care and support plans to make them individual, personalised documents, reflecting their needs, wishes and preferences. This was particularly important where people were living with dementia or conditions impacting on their abilities to express their wishes independently.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

We identified the need for greater consideration to be given to people’s dependency levels in relation to which bedroom they were given. Some people with limited mobility were at risk of social isolation, due to environmental limitations impacting on ease of access within the service. Some people told us they would appreciate more 1 to 1 time with staff, when they were unable to spend time in communal areas of the service.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff recognised people’s individual communication methods, and we observed them to tailor their approaches accordingly. Information was displayed in varying formats to assist people with decision making.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives were encouraged to be involved in attending meetings to discuss forthcoming activities, and ensure they were kept updated with any changes happening within the service. Leaders told us they were trying different approaches to improve attendance at relative meetings, as uptake was often low.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Outcomes from a recent serious incident at the service identified the need for improvements around staff proactively sourcing emergency healthcare and knowing how to respond effectively in urgent situations. Overall, people were supported to access services for specialist equipment, received regular medication reviews, foot and nail care to ensure their overall health, comfort and wellbeing needs were met.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We identified the need for people’s lived care experiences, along with their care records to be meaningfully reviewed, and people’s feedback sourced. Some people were at risk of social isolation within the service, with the need to tailor approaches to activities to make these more inclusive for those people spending most of their time in bed.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff spoke with compassion in relation to ensuring end of life care provision was tailored to meet people’s individual wishes and preferences, working collaboratively with external health care professionals to provide good pain management to achieve a comfortable and dignified death.