Millstream House

Updated 22 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using similar services.

Service and service type:

Millstream House 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 service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

Notice of inspection:

This was a comprehensive inspection, which took place on 19 and 20 February 2019 and was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection in February 2018. This included details about incidents the provider must notify us about, such as abuse or when a person dies. We assessed the information we require providers to send us at least once annually 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 six people using the service, one visiting relative, three care staff, the cook and the registered manager. We also spoke with the operations manager. We also requested feedback from a range of healthcare professionals involved in the service. We did not receive any feedback.

We reviewed a range of records. This included three people's care records and medicines records. We also looked at four staff files including their recruitment, supervision and training records. We reviewed records relating to the management of the service and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and surveys they completed to share their views.

Updated 22 March 2019

About the service: Millstream House provides care and support for up to 22 people who have a diagnosis of Huntington's Disease and acquired brain injury. The home is set out over three floors, with lift access throughout. Some people had mobility difficulties, sensory impairments and some received their care in bed. At the time of our inspection, 20 people were using the service.

People’s experience of using this service: The service had improved since we last inspected it. Everyone we spoke with was positive in their feedback. Comments included; “I feel safe living here, yes very safe. The staff and other people living here make me feel safe”, “The staff make me feel good. I like them” and “I would give it 9/10 [when 10 is excellent and 1 is poor]. The best thing is that all the people are friendly. I wouldn’t change anything.”

People were safe at Millstream House. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices. One person said, “I feel safe here because the staff are all very good.”

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them. They felt a part of their local community and were supported to use local resources to their advantage.

Staff understood the importance of promoting people’s choices and provided the support people required while promoting and maintaining independence. This enabled people to achieve positive outcomes and promoted a good quality of life.

People were involved in the running of the service and were consulted on key issues that may affect them.

People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.

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

Rating at last inspection: Requires Improvement (Report published 14 March 2018).

Why we inspected: At our last inspection, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach was in relation to our finding, which showed that records keeping had not improved in the service. We also made recommendations in relation to inadequate medicine administration record keeping and that the provider and manager seek advice and support, for the organising of stakeholders’ meetings within the service.

We asked the registered provider to take action to meet the regulations. We received an action plan on 05 April 2018, which stated that the registered provider would take action to meet the regulations by 30 August 2018.

At this inspection, we found that improvements had been made in relation to the requirement made above and the recommendations.

Follow up: We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.