Archived: Mill House

Updated 13 August 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. 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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Mill 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 manager registered with the Care Quality Commission. 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.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We also spoke with the registered manager and two senior care workers. We reviewed a range of records. This included two people’s care records, medicines records, staff induction records and selected policies and procedures. We also reviewed a variety of records relating to the safety of the premises and management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also looked at staff training records and staff recruitment information. We spoke with one care staff and one senior care staff. We also spoke with three community health and social care professionals about their experiences of care provided.

Updated 13 August 2019

About the service

Mill House is a residential care home providing personal care for up to four people with learning disabilities. At the time of our inspection, there were three people living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Upon taking over the service, the provider taken steps to identify and address significant risks to people’s health and safety at the home. However, their quality assurance systems and processes had not enabled them to fully responded to identified risks associated with the fire and electrical safety of the premises. These risks had been highlighted through an independent electrical inspection and fire risk assessment commissioned on the premises, and inspections by the provider’s health and safety manager. Some essential works had been done, but others were being negotiated with the owners of the property. Although we found no evidence people had been harmed, this placed people at an increased risk of harm.

Staff understood how to identify and report any abuse involving the people who lived at the home. The risks associated with people’s individual care and health needs had been assessed, recorded and addressed. The provider adhered to safe recruitment practices. Staffing levels at the home enabled people’s care needs to be met safely. The provider monitored any accidents or incidents involving the people who lived at the home. People were protected from the risk of infections.

People’s individual needs were assessed and kept under review, in order to meet these effectively. Staff had ongoing training and good management support to enable them to succeed in their roles. People had enough to eat and drink and were supported to make choices about their meals. Staff worked effectively with a range of community health and social care professionals to achieve positive outcomes for people. 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.

Staff supported people in a caring and compassionate manner. People were encouraged to express their views about the care they received. People were treated with dignity and respect at all times.

People’s care plans were individual to them, and were read and followed by staff. People had support to participate in a range of social and recreational activities they enjoyed. People knew how to raise any concerns about their care. People’s wishes and choices about their end of life care were explored with them, in order that these could be addressed at the appropriate time.

The provider and registered manager promoted a positive and inclusive culture within the service, based upon open communication with others. Staff felt valued and well-supported in their work.

Staff understood the need to promote equality and diversity in their work and consider people’s protected characteristics.

Rating at last inspection

The last rating for this service was Good (published 25 August 2016). Since this rating was awarded the registered provider of the service has changed.

Why we inspected

This was a planned inspection based on the change in registered provider of the service.

Enforcement

We have identified a breach in relation to the safety of the premises where people lived 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 safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.