Mitchell House Nursing Home

Updated 25 June 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

This inspection was completed by two inspectors on the first day of the inspection, and one inspector on the second day.

Service and service type

Mitchell House Nursing Home 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. Mitchell House Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection the manager was in the process of registering with us.

Notice of inspection

This inspection was unannounced.

What we did before the 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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with one person who lived at the home, who was able to communicate with us and five relatives of people who lived at the home. We spoke with seven members of staff, which included the manager, a nurse, senior carers, support workers, a cook, the domestic supervisor and the activity coordinator. We observed staff interaction with people who lived at the home. We reviewed several records included people’s care and medication records, audits, policies and procedures, staff files and staff training matrix.

Updated 25 June 2022

About the service

Mitchell House Nursing Home is a residential care home providing personal and nursing care to up to 45 people across four units. The service provides support to people with complex physical and mental health needs. At the time of our inspection there were seven people using the service.

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

There were improvements to the assessing and monitoring of people’s risks, but we found guidance for staff was not consistently in place and still required some improvement. The provider had made improvements to the management of people’s medicines, further oversight was required to ensure people received their medicines safely.

Some improvements were made to the detail in people’s care plans, but some information still required further updates. Improvements had also been made to the personalisation of people’s care plans; however, they did not always reflect people’s day to day life. There were improvements to the quality assurance process in place, but they were still not robust enough to always identify any required improvements.

The provider had made improvements to their infection, prevention and control systems. The manager had developed an effective system to review any accidents and incidents and to ensure actions were taken to reduce the risk of reoccurrence. The manager had also implemented an effective system to safeguard people from the risk of harm. People were now supported by permanent members of staff.

We found improvements were made and people were now 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.

Staff now had the right training to meet people’s needs. People were supported to eat and drink to maintain a healthy diet. People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment.

People were now involved in their care and supported to express their views. People’s right to confidentiality was respected, and their privacy, dignity and independence was respected and promoted. People were supported and treated well, with their equality and diversity respected.

People were supported to take part in activities which were of interest to them on a one to one basis. There was a system to record, monitor and respond to complaints. People’s care plans contained details of the care they required in an emergency situation.

Staff shared a positive culture which provided good outcomes for people. Staff were encouraged to be open and honest when things went wrong. People, their relatives and staff were provided with the opportunity to feedback on the service. The provider worked in partnership with others.

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 inadequate (published 04 May 2022) and there were breaches of regulation. The provider completed a weekly action plan after the last inspection to show what they would do and by when to improve.

At this inspection whilst we found improvements had been made and the provider was no longer in breach of some regulations, we found the provider remained in breach of one regulation.

This service has been in Special Measures since 11 January 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.

Since our inspection the manager had reviewed their current systems to make changes, identify any areas for improvement and mitigate any risks.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mitchell House Nursing Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.