21 Mill Lane

Updated 14 December 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector.

Service and service type

21 Mill Lane 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. 21 Mill Lane is 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 not a registered manager in post. A new manager had been in post for 5 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced. Inspection activity started on 10 November 2022 and ended on 11 November 2022. We visited the service on both days.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

We spoke with 1 relative about their experience of the care provided. We spoke with 4 members of staff including the manager, team leader, a support worker and an agency member of staff. We also spoke with the area manager responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records, including 2 people’s care plans, 3 staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.

Updated 14 December 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

21 Mill Lane is a residential care home providing personal care to 2 people at the time of the inspection. The service can support up to 4 people.

People’s experience of using this service and what we found

Right Support:

21 Mill Lane is in local residential area. There was nothing outside to show it was a care home. The building was a similar size to other properties with a large garden to the rear, which people had access to. People who used services, their families and other professionals had been consulted on the refurbishment of the premises. This had ensured the layout of the interior, decoration and furnishings supported the needs of people with a learning disability or autistic people.

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. Staff worked well with the providers positive behaviour support (PBS) team to ensure people received the right level of support to manage signs of distress and or frustration. Staff knew people well and were quick to notice changes in their behaviour and take swift action to provide the appropriate care and support to diffuse incidents quickly.

People were supported by a consistent staff team, who showed a genuine interest in their well-being and quality of life. They were kind, caring and nurturing and as a result we saw people were at ease, happy, engaged and stimulated.

People were supported to access healthcare services to promote their wellbeing and help them to live healthy lives. People received support to eat and drink enough to maintain a balanced diet and were involved in choosing their meals to meet their cultural and dietary needs.

Right Care:

People’s care plans were personalised, covering all aspects of their current and longer-term needs. Staff spoke knowledgably about tailoring support for people to meet their individual needs, goals and aspirations and how these could be achieved. People’s positive behaviour support (PBS) plans had been developed in conjunction with staff and the providers PBS team to ensure staff know how best to support each person. Staff had been provided with training tailored to meet the specific needs of people using the service in line with recognised models of care for people with a learning disability or autistic people. This ensured people were receiving person-centred care which promoted their dignity, privacy and human rights.

The service had enough staff to keep people safe and to enable them to take part in leisure and social activities, when they wanted. The numbers and skills of staff matched the needs of people using the service. Systems were in place to safely recruit new staff.

Staff understood people’s individual communication styles and we saw they had developed a good rapport with them. People were supported to develop and maintain relationships, follow interests and take part in hobbies and activities that were socially and culturally relevant to them.

Systems were in place to ensure people’s medicines and infection; prevention and control measures were managed safely. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had training on how to recognise and report abuse. The manager worked well with other agencies to safeguard people. Investigations into incidents had been used as an opportunity to learn lessons, change practice and drive improvement.

Right Culture:

The provider had recognised people were at higher risk of the service developing a closed culture where they were highly dependent on staff to meet their basic needs. A new manager had been recruited and had been in post for 5 months. They had worked hard to instil a transparent, open and honest culture between people, those important to them, staff and managers. The manager was visible in the service, approachable and took a genuine interest in what people, staff, family and other professionals had to say. They worked directly with staff and led by example. Staff were motivated and had confidence in the manager.

Staff were aware of the company values to provide passionate, kind and resilient care. The attitudes and behaviours of the manager and staff ensured people received person centred care which sought to protect and promote their rights. Staff understood their role in making sure people were always put first.

The service had effective governance arrangements in place to assess the quality and safety of the service. These were used to identify and drive improvement. Concerns and complaints were taken seriously, investigated and the outcomes used to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was previously known as Little Millfields and registered under TLC Care Homes Limited. The last rating for the service under the previous provider was rated requires improvement (published on 14 May 2019.)

Little Millfields was reregistered under TLC CARE HOMES CLACTON RESIDENTIAL LIMITED but closed in July 2020. The service reopened as 21 Mill Lane and was registered with CQC on 20 May 2021 and this will be their first inspection.

Why we inspected

We undertook this inspection to assess the service was applying the principles of Right support, right care, right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.