MIG House Residential Care Homes

MIG House Residential Care Homes is registered with the Care Quality Commission to provide accommodation and support with personal care to a maximum of 4 adults with learning disabilities. At the time of our inspection 4 people were living in the home.

People’s experience of the service and what we found:

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Staff focused and supported people with their strengths and promoted their independence so people could live a meaningful everyday life. People were supported by staff to pursue their interests and achieve personal goals.

The provider gave people care and support in a safe, clean, well-maintained environment that met their sensory and physical needs. People were supported to personalise their rooms. Staff supported people to access health and social care provisions in the community. People were able to take part in activities and pursue their interests in their home and local community.

Staff supported people to make decisions for themselves and followed the mental capacity and best interest process when required. Staff communicated with people in ways that met their individual needs. People were supported safely with their medicines in a way that promoted their independence. Staff supported people to participate in maintaining their own health and wellbeing.

Right Care

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. We saw people received kind and compassionate care and support and respected people’s privacy and dignity. 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; the policies and systems in the service supported this practice.

People were protected from the risks of abuse and neglect, as staff were trained to identify signs and were clear of their roles and responsibilities to protect people from harm. The provider responded to incidents and accidents appropriately and ensured that lessons were learnt, and appropriate referrals were completed, if required. Staff assessed people’s risks appropriately and supported people to achieve their goals without barriers preventing their outcomes.

Staff were recruited safely and had the right skills to meet people’s needs and keep them safe.

Right Culture

The registered manager and staff were motivated and focused on delivering a good service to the people they supported. People were encouraged to make daily choices on things that was important to them. The provider created a positive environment that helped people to achieve their personal goals. Staff knew and understood people well and were responsive to their needs.

Staff turnover was low, which supported people to receive consistent care from staff who knew them well. The service supported people to access independent advocates services when required. Staff supported people to see their families and friends.

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

The last rating for this service was Good (published 12 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

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

MIG House Residential Care Homes is a care home for four adults with learning disabilities. At the time of our inspection four people were living in the home.

The home 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 2008 and associated Regulations about how the service is run.

The service was last inspected in July 2015 when it was rated ‘good’. The service remained overall ‘good’ at this inspection.

People and relatives told us they felt safe at the home. Staff were knowledgeable about safeguarding adults from avoidable harm and abuse. The home responded to incidents in an appropriate way, ensuring lessons were learnt and appropriate referrals were made if required.

The service identified and mitigated risks faced by people in their daily lives. Measures in place to mitigate risk were clear for staff to follow and people were involved in processes designed to reduce the risk of harm.

There were enough staff on duty in the home. Staff were recruited in a way that ensured they were suitable to work in the home.

People were supported to take medicines by staff. There was clear information on people’s medicines, and people were as involved in the process as they were able to be. Staff carried out daily counts of medicines stocks and the registered manager completed monthly audits. This ensured medicines were managed in a safe way.

When new staff joined the service they completed a comprehensive induction. Staff received training to ensure they had the knowledge and skills required to meet people’s needs. The registered manager completed monthly supervision with staff and each staff member had a development plan in place. Staff were supported in their roles.

People were supported to make as many decisions as they were able. Where people made decisions that were unusual for them, this was recorded in a special book to keep track of people’s different choices. Where people lacked capacity to make specific decisions the service worked within the principles of the Mental Capacity Act 2005.

Staff were knowledgeable about people’s dietary needs and preferences. People were involved in choosing the menu options and records showed people were supported with a varied diet. People were supported to be involved in meal preparation.

People living in the home had a range of long term health conditions. Staff supported people to attend appointments with healthcare professionals and there were clear records of advice from healthcare professionals.

People and staff had developed strong, positive relationships with each other. There was a positive, friendly atmosphere in the home. Throughout the inspection people teased staff in a friendly manner. Staff interacted with people in a positive way that recognised and valued them as individuals.

Staff worked to promote people’s independence and respected their privacy. People told us staff respected their privacy and treated them with dignity and respect.

Care plans were highly personalised and goal focussed. People’s independence was promoted and they were supported to achieve specific goals and rewarded for achieving them. People, relatives and external professionals told us people had made excellent progress and developed their skills and abilities while living in the home.

Information about complaints, and house meetings were available in a format that was accessible to people living in the home. People were able to provide feedback about their experiences and the home acted on this feedback and made changes as a result.

The registered manager and provider completed a range of checks and audits to monitor and improve the quality of the service. The registered manager was committed to improving the quality of care. The home had a clear set of values that focussed on person centred care and developing people’s skills.

People's needs were assessed and care and treatment was planned. Care plans and risk assessments were regularly reviewed. People were aware of what was in their care plan and told us that their care and support was delivered in line with it. However we were concerned that people were being deprived of their liberty without the appropriate authorisation being in place.

There were safeguarding vulnerable adults and whistle-blowing policies in place which the staff were familiar with. Staff had been trained in safeguarding vulnerable people and had a good knowledge about safeguarding issues.

The service had effective recruitment and selection processes in place. We found that appropriate checks were carried out before staff were allowed to work with people using the service. We reviewed several records relating to people using the service, the staff, and management of the service and found the records were accurate, up to date and fit for purpose.

Medicines were handled appropriately. Staff knew people's allergies and had received up to date training on administration of medication. Staff worked according to the medicine policy and knew what to do if someone refused medication.

Staff received appropriate professional development and regular training, supervision and annual appraisals. Staff felt supported by management and had knowledge about the care needs of people they looked after.

Care plans were up to date and contained individualised risk assessments and support plans. Health action plans and 'My hospital passport' documentation were updated regularly.

People's, relatives and staff views were listened too and taken into account most of the time. One person said, 'I go to bed when I want. Staff let me chose what I eat or what I wear.' However one relative said staff listened but did not always rectify concerns in a timely manner. We asked management about this they showed us evidence that they usually responded to concerns in a timely manner.