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 remained Good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care plans had been recently reviewed with people, their relatives and professionals involved in their care and support. Full assessments of people’s needs had been undertaken. Initial care plans were developed involving people and their relatives when they started living at the service. Care plans were reviewed as staff got to know people better or their needs changed. A summary of a person's life history and medical conditions were recorded in care plans. For example, when people had reduced mobility, the service had systems to monitor and prevent pressure sores. Records showed that regular reviews of people’s skin integrity were recorded. This meant staff had information and knowledge about people and how to meet their needs. The provider had recently strengthened and improved their care planning systems.

The service always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Care plans included detailed information about people’s preferences and how to support them to achieve their identified goals. People and their relatives were positive about the care and support people received. A relative told us, “[Relative] sees a nurse practitioner every week and we discuss any problems. All the managers have discussed care concerns with me, [relative] is prone to urinary tract infections (UTI’s), but [staff] have it sorted. I believe they are all well trained.” The service had recently improved their systems and processes for supporting people with their nutritional and hydration needs. They had conducted research into how people living with dementia could be encouraged to eat and drink more. They had upgraded all of their plates and cutlery to be dementia friendly and had a varied menu which was both visually appealing and reflective of seasonal ingredients. The service had created a ‘Nutritional Needs Chart’ which included each person’s picture, a description of their nutrition needs and anything staff needed to be aware of, such as whether they were required a modified diet or had an allergy. These were kept in both dining rooms and the kitchen. We found not all staff were aware of these, however the regional hospitality manager and the executive chef dementia hospitality lead were going to ensure this was rectified. The hospitality team were also trialling an initiative based on new research into offering staff and people decaffeinated drinks in the afternoon which had shown an increase in sleep for people. This showed the provider was aware of industry specific research and innovative techniques to improve people’s quality of life.

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.
A member of staff told us, “Every morning, the nurses give us the handover, then we as senior carers discuss how we're going to manage the floor. We work together as a team". We saw regular visits from a GP who did a weekly round. We also saw regular involvement with social workers. We saw evidence people’s mental capacity was reviewed and appropriate referrals were made for Deprivation of Liberty Safeguards (DoLS).
 

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.

There was a choice of food available to people considering their individual preferences. A relative told us, “The food is great now, it’s much improved, there’s a new chef now.” People were provided with opportunities to attend a number of activities in the service, and they had access to health professionals. A person told us, “The staff arrange a doctor when I need one. I’ve seen the doctor three times” A relative told us, “[Relative] had a seizure before Christmas, a doctor came and looked after [them].”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff engaged with people in discussions about their care and support needs. This meant people were able to express their views and provide feedback on their care. This approach made it possible for staff to understand what mattered to people and develop care and support plans that were consistent with people’s expectations. Care and treatment had been planned and delivered in a way which ensured people's safety and welfare. Each person had a care plan which detailed the service they received and their needs. We looked at 5 people's care plans and found each one showed staff how to provide individualised care and treatment.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s care plans clearly documented consent to care and treatment, including where individuals were unable to provide a physical signature. Where people lacked capacity, decisions were made in line with the principles of the Mental Capacity Act (MCA), ensuring their rights were upheld. People told us they felt their choices were respected and understood. One person told us, “Staff definitely treat me with dignity and respect.” Staff demonstrated a good understanding of informed consent, particularly in relation to personal care, and we observed multiple examples of staff promoting people’s choice, and independence. Staff received appropriate training on the MCA and DoLS.