Background to this inspection
Updated
22 July 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Mickley Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service.
At the time of our inspection there was not a registered manager in post. The previous registered manager had left the service four months ago and the provider had appointed an interim manager to oversee improvements at the service until a new registered manager was appointed. The day after inspection the provider informed us a new manager had been appointed. They said the interim manager had agreed to stay on, until the new manager was established in the home, which would allow the interim manager to provide the new manager with a comprehensive handover.
Until a registered manager is appointed the provider is solely legally responsible for how the service is run and for the quality and safety of the care provided.
This inspection was unannounced. We inspected the service on 8 June 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service about their experience of the care provided. We spoke with 12 staff including the interim manager, clinical lead, registered nurse, a team leader, care staff, and other administrative, activity, maintenance, domestic and catering staff. We also spoke with the provider’s quality and compliance managers who were visiting the service on the day of our inspection.
We reviewed a range of records. This included three people’s care records and four medicine records. We looked at three staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service, including policies and procedures which we reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and the providers policy and procedures.
Updated
22 July 2022
About the service
Mickley Hall is a nursing home providing personal and nursing care to 40 people who have physical disabilities. At the time of inspection 26 people were receiving support.
People’s experience of using this service and what we found
The service had significantly improved since the previous inspection. People, stakeholders, health professionals and staff recognised the service had improved.
The management team conducted audits and checks to further ensure the quality and safety of services provided to people. The operation of the quality assurance processes had significantly improved and actions arising from audits were being recorded and progressed.
There had been significant improvements to ensure risks identified with people's health, medical and care needs had been assessed and documented. There was clear guidance on how to minimise the risk to keep people safe. People received their medicines safely and as prescribed. Systems and processes were in place to keep people safe.
The premises were clean and there was good infection control practice in place.
There was a friendly atmosphere at Mickley Hall, and we saw people looked well cared for.
Staff were recruited safely, and staffing levels and deployment of staff had improved to keep people safe and to meet their care needs. Staff were receiving appropriate training, which was relevant to their role and people's needs. Staff were supported by the management team and were receiving formal supervisions where they could discuss their on-going development needs.
People were supported to eat a healthy balanced diet. The dining area had been refurbished and was more ‘homely’ and the dining experience for people had improved. A range of meaningful activities were on offer to keep people occupied, according to their individual interests. Complaints and concerns were well managed.
People were supported and encouraged to achieve positive outcomes. The model of care helped to maximise people's choice, control and independence. People's own rooms were personalised. The care people received was more person-centred and promoted people's dignity.
Although we found significant improvements had been made since the last inspection, further time was required to ensure that new systems were fully embedded, and consistency of improved practice was evidenced.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Inadequate and there were multiple breaches of regulation (published 17 November 2021). The provider completed an action plan after the last inspection to show what they would do, and by when, to improve.
This service has been in Special Measures since November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
The overall rating for the service has changed from Inadequate to Good. This is based on the findings at this inspection.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mickley Hall on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.