Milehouse Lane

Updated 28 September 2017

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 took place on 9 and 16 August 2017 by one inspector. The inspection was unannounced.

Before the inspection, we reviewed the information we held about the service. This includes the Provider Information Return (PIR). This is a form that requires them to give some key information about the service, what the service does well and improvements they plan to make. However on this occasion a PIR had not been requested from the provider prior to the inspection taking place.

We also received feedback from health and social care professionals, stakeholders and reviewed the commissioner's report of their most recent inspection.

We used a number of different methods to help us understand the experiences of people who lived in the home. We spent time in the communal lounges, and also met with individual people in the privacy of their own rooms.

During the inspection we observed staff support people who used the service, we spoke with two people who used the service, five staff members, the manager, two representatives of the provider and three relatives to obtain their feedback on how people were supported to live their lives.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed care records relating to three people who used the service and other documents central to people's health and well-being. These included staff training records, medication records and quality monitoring audits.

Updated 28 September 2017

The inspection took place on 9 and 16 August 2017 and was unannounced. When we last inspected the service on 31 March 2016 we found breaches with regulations 11, 12 17 & 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had failed to manage people’s medicines safely and people were placed at risk due to staff not having a full understanding or knowledge with regard to how to obtain consent from people. We also found there was a lack of effective leadership and governance and deficiencies in the monitoring and auditing of the service placed people at risk of not receiving proper care and treatment. The staffing levels on the day of the inspection were also found to be inadequate to ensure people’s health and safety were maintained.

Following the comprehensive inspection, the provider wrote to us to tell us how they would make the required improvements to meet the legal requirements. At this inspection we found that the provider had made the necessary improvements and therefore improved the quality of the service provided at Milehouse Lane.

Milehouse Lane provides accommodation and personal care for up to seven people who have a learning disability and the home was fully occupied on the day we inspected.

Accommodation is provided over two floors. All bedrooms are for single occupancy and there are separate toilets and bathroom/shower facilities. There is a kitchen, communal areas, including a dining room, a lounge and a conservatory for people and their visitors to use.

There was a new manager in post who was in the process of applying to become the registered manager of the service. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The majority of people who lived at the home were unable to communicate verbally but we observed staff supporting people with a range of communication aids, which included signing and interpreting people’s body language with regards to meeting their needs and wishes. People welcomed us into their home and told us they felt safe and happy living at Milehouse Lane.

We found that people were supported to take their medicines by trained staff. We saw that staff followed safe practices and medicines were accurately documented and stock levels checked were correct.

People felt safe living at Milehouse lane. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated a thorough recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so.

We found that staff received regular one to one supervision and felt supported and valued. People received the support they needed to eat and drink sufficient quantities and their health needs were catered for with appropriate referrals made to external health professionals when needed.

Relatives complimented the staff team for being kind and caring. Staffs were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The manager had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. There was an effective system in place for people to raise complaints about the service they received.

There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the manager if they had a concern. The manager had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.