We carried out a review of the data available to us about Millgate House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Millgate House, you can give feedback on this service.
People’s experience of using this service:
• The service met the characteristics of 'Good' in all of the five key questions.
• Staff were recruited safely but we noted in one case the need to improve some pre-recruitment checks.
• Although the service was following the principles of the Mental Capacity Act 2005, we have made a recommendation around the need to complete documented capacity and consent records.
• We have made a further recommendation in relation to the management of checks and audits so that they are effective in picking up some of the issues seen at the inspection.
• Risks to people’s health and safety were managed safely.
• Care records were up to date and reflected people’s current health care needs.
• People who used the service could not tell us of their experiences but their relatives told us that their loved ones were looked after and were happy with the care and support that was provided.
• People were protected against abuse, neglect and discrimination through good safeguarding processes.
• Staff we spoke with were positive about their roles and wanted to do the best for people.
• Staff we spoke with knew people well. They had developed good relationships with people.
• People who used the service clearly enjoyed the presence and attention from staff.
• More information is contained in the full report.
Rating at last inspection: At our last inspection the service was rated good overall. Our last report was published on 6 July 2016.
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
The last inspection of this service took place on 6 February 2014 when the service was found to be compliant with all regulations inspected.
Millgate House is part of an organisation that is a registered charity, overseen by a trustee management committee. It is a care home without nursing care that can accommodate eight young adults with learning and physical disabilities on a short term basis. Showers, bathrooms and bedrooms were designed to meet the needs of people with a learning or physical disability. It is also registered to provide personal care to younger people with disabilities living in the community in their own homes. Millgate House is situated just off the main road between Bacup and Rochdale and either town is easily accessible.
The registration requirements for the provider stated the home should have a registered manager in place. The service was managed by 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.
During this inspection we found the service was meeting the current regulations.
People/relatives using the service told us they felt safe and well cared for. They considered there were enough staff to support them when they needed any help. The registered manager followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people. We found there were enough staff deployed to support people effectively.
The staff we spoke with were knowledgeable about the individual needs of the people and knew how to recognise signs of abuse. Arrangements were in place to make sure staff were trained and supervised at all times.
Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained to do this safely.
Risks to people’s health and safety had been identified, assessed and managed safely.
We found the premises to be clean and hygienic and appropriately maintained. Regular health and safety checks were carried out and equipment used was appropriately maintained.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.
People using the service had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. Care files contained a profile of people’s needs that set out what was important to each person.
People’s care and support was kept under review, and people were given additional support when they required this. Relevant health and social care professionals provided advice and support when people’s needs had changed.
We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. Care plans were written with sensitivity to reflect and to ensure basic rights such as dignity, privacy, choice, and rights were considered at all times.
Activities were varied and appropriate to individual needs.
People were provided with a nutritionally balanced diet that provided them with sufficient food and drink that catered for their dietary and cultural needs.
People/relatives told us they were confident to raise any issue of concern with the registered manager and that it would be taken seriously.
People/relatives and staff considered the management of the service was very good and they had confidence in the registered manager. There were systems in place to monitor the quality of the service to ensure people received a good service that supported their health, welfare and well-being.
We found people felt the support workers treated them properly and with respect. They also felt they had choices that encouraged their independence. They had been involved in the setting up and planning of their service.
Families felt the care and support met the service users' needs and that the service was reliable and flexible. They said the support workers didn't miss visits and visited at the time they expected. One relative said, "The service is fantastic; they are all really friendly and caring". Another said, "It's going really well". Individual's had small groups of support workers who were known to them. People appreciated this consistency.
Service users had a knowledge of safeguarding matters appropriate for their understanding and abilities. The families were confident about what to do if they had concerns. The service had the right policies and procedures to help protect people.
We saw there was a good staff training programme, including the induction for new staff, and good staff support systems. This meant staff felt confident and competent and well supported in their work. There were suitable systems in place for monitoring service quality so the service could be changed and developed as necessary.
We spoke with some staff, including the manager. They told us that respect for service users' rights underpinned the service, and told us how Millgate ensured this worked in practice, such as through staff training and supervision, and family carers and service users being represented on the organisation's (trustee) management committee.
Staff told us there was a good staff training and support programme that helped staff to feel competent, valued and skilled. There were also good systems to find out what service users and families thought about Millgate House and to use these views in the development of the service.
Staff told us that respect and involvement of service users underpinned the service, and also told us how this occurred in practice, such as about staff training, and that family carers and service users were represented on the organisation's trustee management committee.
Staff also told us how they assessed people's needs and looked after them. We were also told that there was a good staff training and support programme that helped staff to feel competent, valued and skilled. There were also good systems to find out what service users and families thought about Millgate House and to use these views in the development of the service.