Background to this inspection
Updated
9 January 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by 2 inspectors on both days. On the second day of the inspection, a regulatory coordinator joined us to gather feedback from people and their relatives.
Service and service type
Mill View is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Mill View a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion which gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
During the inspection, we spoke with the registered manager, a deputy manager, 3 team leaders, a care quality advisor, 7 care assistants, a housekeeper, a handy person, an administrator, a receptionist, and the district manager. We spoke with 10 people who lived at this home and 3 relatives. We looked at multiple medication records and care plans for 3 people. We looked at quality assurance records whilst we were on site and following the inspection.
Updated
9 January 2024
About the service
Mill View is a purpose built care home providing residential care for up to 50 people across 2 floors. On day 1 of our inspection, 41 people were living in the home and on day 2, this number was 40.
People’s experience of using this service and what we found
On day 1 of our inspection, we identified some staffing pressures which meant not all people had their care needs met in a timely way. On day 2, staffing levels increased and this improved. People told us there were enough staff to meet their needs in a timely way. Rotas showed shifts were fully covered. Recruitment practice was safe.
We have made a recommendation about reviewing people’s dependency levels as this did not accurately reflect the care needs of all people living in the home.
Hot water temperature checks in bedrooms and communal spaces had not been checked since July 2023. This was identified on day 2 of our inspection and immediately dealt with. Some lifting equipment needed for bathing was faulty and parts were on order. Risks to people were assessed, monitored and reviewed. Staff understood these risks and how to support people safely.
Some issues were identified regarding infection control on day 1 of our inspection. By day 2, these had largely been resolved and following the inspection, the registered manager advised of further action taken.
The management of medicines was safe. Some additional detail to PRN (for medicines given as required) protocols was added immediately following our inspection.
People and relatives consistently told us they felt safe with the care provided. Staff showed an understanding of their safeguarding responsibilities and described appropriate action they would take to report allegations of abuse.
Records showed complaints were well managed. People and relatives felt able to report concerns or complaints and noted they were encouraged to raise issues by the management team.
Quality assurance systems were in place and had identified issues which were acted on. The registered manager and district manager carried out their own quality checks. The registered manager told us they were going to introduce monthly risk meetings to look at themes and trends from accidents and incidents.
Feedback from people and relatives about the care provided was very complimentary. People felt included in their care planning and through resident meetings. The home was in the process of switching from paper to electronic care records by early in 2024, and preparations were being made for this at the time of the inspection.
The management team were committed to continuously improve the service. They were responsive to our feedback and took immediate action where 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. We observed personalised care being delivered by way of choices offered to people by staff. People were encouraged to be in control of their day to day routines and care records support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was outstanding (published 27 September 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from outstanding to good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.