Millenium Care Limited - 89 Fox Lane

Updated 23 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by notification of an allegation of abuse. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of abuse. This inspection examined those risks. This inspection was also prompted in part by the findings of an inspection of the provider’s other care home where we found unsafe care.

The inspection took place on 14 and 21 November 2018 and was unannounced. The inspection was carried out by one inspector.

Before the inspection we considered all the information we held about the provider including the Provider Information Return. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also considered notifications made by the provider since the last inspection.

During the inspection we spoke to three people living in the home who were able to speak with us. Two of those people were able to answer a few questions and one person was able to tell us their views. As most people were unable to speak with us we spent time observing in the communal rooms to observe people’s wellbeing, the way staff interacted with them and their experience of mealtimes. We observed two mealtimes.

We met the registered manager, two care staff and the operations manager. We looked at four people's care records including their care plans and risk assessments, seven people’s medicines administration records and two staff files including their recruitment records. We looked at staff training, supervision and appraisal records. We also looked at other paperwork related to

the management of the service including staff rotas, quality assurance, audits, menus, health and safety and fire records. After the inspection we contacted and had feedback from a relative or advocate for four people living in the home and a health and social care professional involved with people in the home.

Updated 23 January 2019

This inspection took place on 14 and 21 November 2018 and was unannounced. The previous inspection was in March 2018 when the home was assessed as meeting all legal requirements.

Millenium Care Limited- 89 Fox Lane is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home provides care and support for up to seven people with learning disabilities. At the time of this inspection there were seven people living in the home.

The home is a semi-detached house in Palmers Green, North London. There was a stairlift available but at the time of the inspection everybody was able to use stairs.

The care home was registered more than twenty years ago so before the development of "Registering the Right Support " and other best practice guidance. There was evidence that the service did support some of the values of Registering the Right Support. They supported the values of choice and inclusion which are two of the values underpinning Registering the Right Support so that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection on 8 and 20 March 2018 we rated the service good. At this inspection, on 14 and 21 November 2018, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff understood what safeguarding was and how to report any concerns about abuse.

We found some safety concerns in the home as there were no window restrictors to prevent falls from windows or covers on radiators to protect people from risk of burns. The provider reacted immediately to address these issues as soon as we raised them to ensure people were safe from harm.

People's personal risks were managed well though some risk assessments, personal emergency evacuation plans and care plans did not contain all the important information about the person.

Medicines were managed safely by trained staff who followed good practice.

Staff received regular supervision and training and an annual appraisal. Staff said they worked well as a team and were supported by the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People had support to eat a healthy balanced diet. Those with swallowing difficulties received the right support from staff with eating.

Staff knew people well and were able to understand their needs and wishes. People were able to follow their interests and took part in activities outside the home that they enjoyed.

Complaints were managed well. The homes had effective quality assurance systems in place including audits of medicines management and annual quality audits. There was evidence of continuous learning and improvement.

We have made three recommendations regarding risk assessments, evacuation plans and care plans containing sufficient information about the person; medicines and ensuring people’s communication needs are more detailed in care plans.