Mickle Hill

Updated 13 May 2023

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.

Inspection team

This inspection was completed by one inspector 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

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 21 March 2023 and ended on 17 April 2023. We visited the location’s office on 22 March 2023 and 12 April 2023.

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 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 used all this information to plan our inspection.

During the inspection

We spoke with 3 people receiving a service and 2 relatives. We spoke with 3 staff and the registered manager. We reviewed 3 care plans, medication records and records associated with the management and oversight of the service. We reviewed 3 staff files, associated training and support records and a range of policies and procedures used by staff as a point of reference to support them in their roles.

Updated 13 May 2023

About the service

Mickle Hill is a domiciliary care service which provides personal care to people in their own

bungalows and apartments within the purpose-built extra care housing scheme.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of inspection over 160 people were living at Mickle Hill and 3 people were receiving the regulated activity of personal care.

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

Governance checks to maintain and improve the quality of the service and maintain compliance with regulation were not always implemented effectively.

People received initial assessments of their needs and information was used to formulate care plans for staff to use as a point of reference when supporting people. However, information was not always completed consistently putting people at risk of harm. People’s views and preferences were recorded but people were not always aware of all their choices and some preferences were not met due to staffing restrictions.

Staff did not always have access to clear information to communicate with people. Information to ensure people received effective communication was not robustly completed or updated following guidance under the Accessible Information Standard.

The provider was actively recruiting staff with interim contingency plans in place to ensure people’s needs were met.

People told us they felt safe with the staff who supported them. Staff were clear on types of abuse to look out for and how to raise their concerns when required. Processes ensured any incidents were routinely investigated with outcomes and actions implemented.

Where people required support to take their medicines this was completed safely as prescribed. The provider worked closely with other health professionals and supported people with any required referrals to maintain their health and wellbeing.

Staff were safely recruited into their roles and were supported with a range of training and support to carry out their duties. This included observations of their practice and regular supervisions.

Staff had good access to personal protective equipment to manage the risks associated with the spread of infection including COVID-19 and adhered to government guidance to protect people.

People told us they were happy with the service they received. They told us they were confident in approaching staff and the registered manager with any concerns and that any feedback or suggestions would be responded to.

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 told us they felt a part of the community where they lived and enjoyed good access to a range of relevant activities.

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

Rating at last inspection

The last rating for the service under the previous provider was outstanding, published on 18 February 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed from outstanding to requires improvement based on the findings of this inspection. We have found evidence the provider needs to make improvements. Please see the safe, responsive, and well led sections of this full report.

Enforcement and Recommendations

We have identified a breach in relation to the governance of the service, provider oversight including risk management and record keeping.

We have made recommendations for the provider to review and improve their policy and practice for record keeping and care planning. We found no evidence during this inspection that people were at risk of harm from these concerns. The registered manager had started to implement a new electronic risk assessments process to ensure robust and up to date record keeping was in place.

Please see the action we have told the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mickle Hill on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.