Millfield 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 remained Good.

This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People at Millfield House lived lives that were rich and varied and tailored to their own wishes and preferences. This included supporting people to build social connections through engaging with their local community and developing new interests that brought people meaning and joy. One person told us “I feel valued and supported as staff are aware of my preferences and interests. The manager is trying to arrange a fishing trip for me”.

Additional key working structures were being introduced to formalise how aspirations and goals were reviewed with people to ensure the care they were given met their wishes. People had choice and control over what they wanted to do, including personalising their rooms to reflect their own interests. One person had a passion for trucks and was supported to attend local meet ups. Staff members described how they had learned from this person about trucks as a result and were supporting them to upload pictures to social media which allowed them to interact with others with the same passion.

Staff were also exploring longer term goals such as people going zip-wiring or going on a cruise, including linking people with peers from other services run by the provider who had the same interest. Staff supported people to have a varied choice of activities within the home, in addition to supporting people to access the community. For example, there had recently been a visit from a local alpaca handler. One relative explained to us “I think (person name) is happy, they have brought back more activities recently such as the alpaca visit.”

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.

People expressed they did not always receive continuity of care and fed back about the number of different staff working at Millfield House. There was a heavy reliance on bank staff working for other services operated by the same provider who did not have the same knowledge of people’s needs which provided some limitations to people’s care. For example, access to staff who could drive and take people to places they wanted to go. One person told us, “There is a huge turnaround of staff. It can be challenging as not many regular staff.” Staff we spoke to did not always have a consistent knowledge of how to support people, therefore we were not assured that people would receive the same care depending on which staff were supporting them.

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

There was detailed guidance in place on each person’s communication needs, so staff knew how to share information with them in a way that was accessible and empowered them to be involved in their health and care. Staff could confidently describe how they would communicate with each person they worked with, including using cues such as body language and facial expressions where people had greater difficulty doing so verbally. The service had worked with the local speech and language team (SALT) to develop picture boards and communication aids to give one person an alternative way of communicating when they struggled by other means. This was currently in the process of being implemented in practice, and feedback from people was that further work was needed to ensure this met the person’s needs. People felt comfortable communicating with staff openly and that information would be shared with them. One relative told us,” Staff get my relative laughing, talking and communicating. They are really proactive with this”.

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 loved ones told us they were involved in reviewing their care to ensure it continued to meet their needs. They expressed confidence in being able to approach the manager or staff team if something was wrong, and that there was always open communication with them. One relative told us “Since the new manager came in communication is much better. She is very supportive of me. It’s not just a job for her.” A person living at the service added “If I needed anything I could speak to the manager or my staff.”

There were regular surveys to seek the views of people and their loved ones on their care. The most recent survey received no responses, therefore this was being repeated to encourage people to share their views. There was a complaints policy in place although the service had not recently received any complaints.

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

We identified 6 people were living with a physical disability. However, the building was not always well suited to people’s mobility needs which meant there were limitations on how people could access their own home environment. We observed a delay of nearly an hour from when one person requested to go downstairs and reaching the main lounge. Staff had difficulties manoeuvring their wheelchair in a narrow corridor and becoming stuck. The kitchen was also not wheelchair accessible which placed limitations on people being able to participate in their own nutrition and hydration in the same way as those who did not have a physical disability.However there was a drink station to support people to remained hydrated.

People were supported to access regular health appointments to ensure that appropriate specialist advice was in place, including in response to people’s health needs deteriorating. They stated they were able to access care when they needed it and had buzzers in their rooms which were responded to quickly to meet any support needs.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People were supported by a passionate staff team who advocated for them to have control in their day to day lives and participate in their wider community as equals. We saw an example where a person’s ability to go out freely was limited by roadworks and difficulties with their mobility equipment. The manager had worked with relatives and the wheelchair provider to resolve these issues, and ensure the person was able to go out in a way that was safe for them.

The service ensured people were able to participate in social activities that were important meaningful to them. One person had recently been to London to see their favourite football club play and another had been supported to obtain a season ticket for a local ice hockey club. Other people were supported to put assistive digital technologies in place to give them independence and ability to pursue activities of their choice. One person told us “(The best thing about the service is) freedom. Given my limitations, there are no other places that have let me do this.”

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.

The staff worked with people collaboratively to support them to plan the future. This included helping people put in writing their wishes should their health deteriorate, such as how they would want to be cared for at end of life including any cultural, spiritual or personal wishes to maximise their dignity and control over this.