Archived: Millard House

During this inspection we looked round; spoke with two relatives, three people who used the service, and five staff. We looked at two care plans and other records relating to the management of the business.

We considered our inspection findings to answer questions we always ask; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

Staff checked our identity and asked us to sign in the visitor's book which meant that there were systems in place to protect people from unauthorised access. We looked round the service and noted it was free from hazards. Cupboards containing chemicals were locked away and the medication trolley was locked when not in use which meant people were protected from harm.

We saw adequate numbers of staff on shift and agency staff were being used to cover staff vacancies. The same agency staff were employed to ensure consistency for people who used the service.

Risks to people's health and welfare were assessed and people's needs were kept under review to ensure appropriate steps were taken to reduce risks to people. For example when a person had a fall their care plan and risk assessment was automatically updated and the accident record stated what measures had been taken to reduce the risk.

The service assessed people's capacity to consent to care. Where a person lacked capacity appropriate measures were taken to ensure the service acted in the person's best interest and in accordance with the law. The manager told us that people made their own decisions where they were able to even if this meant their decision might be detrimental to their health. The benefits and risks were clearly explained to people and recorded. This meant people's wishes were respected and people as far as possible were protected from harm.

Is the service effective?

Care records told us what people's needs were and we saw staff engaging with people in a positive way, and promoting their independence and dignity. The service had good relationships with outside professionals, family members and independent advocates which ensured that people's needs were met. There was a robust and effective activities programme which meant that people's social needs were met.

Is the service caring?

Staff observed were caring for people in appropriate ways by offering them choice and providing support in an unhurried way. Throughout the morning relatives visited their loved ones and helped assist them. Staff were familiar with the needs of people who used the service and their relatives and there was lots of friendly chatter and laughter. This meant staff were caring to the people who used the service and their extended families.

Is the service responsive?

People's records were accurate because they were kept under review and amended when a person's needs changed. For example there was a care plan ready for use should a person develop a chest or urinary tract infection. This would record when the treatment started, when it finished and any special instruction for staff to promote the person's well-being.

People's records showed us that staff kept family members informed about changes to their relative's needs. The service contacted other health care professionals when there was a change in a person's health needs. This meant the service was responsive to people's changing needs.

We saw that there was a range of things for people to do during the day to keep them engaged and active. Regular resident/relative meetings were held at the service and we saw minutes for these. These told us what had been discussed at these meetings and how staff had acted on people's suggestions. There was a notice board in the service which told us what people had said and what the service had done as a result of people's feedback. This meant the service was responsive to people's needs.

Is the service well-led?

The manager has been registered for over four years and had a lot of relevant experience. They were supported by a deputy manager and shift leaders/seniors which meant there were always suitably experienced/qualified staff on shift. There were good staff induction and staff support processes in place which meant that poor practice could be easily identified and measures taken to improve staff performance. This ensured high standards of care were maintained. The service had robust audits and quality assurance systems which helped to identify what people thought about the service, where the service was performing well and where they needed to improve. This enabled the service to continuously improve and provide a good service to those using it.

We saw that people's care had been planned and was person centred. People were asked for their consent before they received care and treatment.

One person we spoke with said;"The staff here are very nice".

People at Millard House had bedrooms which were personalised with photographs and their own belongings. We observed the premises were well maintained and suitable for the service being delivered.

There were recruitment processes in place to ensure staff were suitable to fulfil their role.

There were systems in place to ensure people's comments and complaints were listened to and acted on.

We found that people were supported to access healthcare professionals and that people's personal care needs were being met. We received feedback that the service offers good food. Our observations confirmed that people received a good level of assistance at mealtimes. People's nutritional needs were being met.