Background to this inspection
Updated
26 May 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 25 and 26 April 2017 and was unannounced on the first day and announced the second day. The inspection team consisted of one adult social care 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.
At the time of our inspection there were 39 people using the service. During our visit we spoke or spent time with 15 people who used the service and five visitors. We spoke with nine staff members and the registered manager. We spent time looking at documents and records related to people’s care and the management of the service. These included quality assurance processes, four staff recruitment files and training records. We looked at five people’s care plans and eight people’s medication records.
Before our inspection we reviewed all the information we held about the home including previous inspection reports and statutory notifications. Before the inspection providers are usually asked to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. On this occasion, we did not ask the provider to complete a PIR.
We also contacted the local authority contracts and safeguarding team and Healthwatch for any information they held Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Updated
26 May 2017
This inspection took place on 25 and 26 April 2017 and was unannounced on the first day and announced the second day. The last inspection took place on 29 March 2016 and at that time we found the home was in breach of Regulation regarding good governance. This inspection was carried out to see what improvements had been made since the last inspection. At this inspection we found the provider had made improvements in the required area and was no longer in breach of the regulatory requirements.
Mill Lodge Care Centre provides nursing care for up to 42 older people, including some who are living with dementia. There were 39 people living at the home when we visited. Accommodation is provided in single en-suite bedrooms in two separate units; one on the ground floor and the other on the first floor. Lift access is provided between the floors. There is a communal lounge and dining room on each floor as well as toilets and bathroom facilities. A central kitchen and laundry are located on the ground floor. There is secure parking as well as garden areas.
The home had 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.
People living in the home told us they felt safe and well cared for. We found there were enough staff to support people effectively. The staff were knowledgeable about the individual needs of people and knew how to recognise signs of abuse.
The registered manager and provider followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people. People were supported with their medicines in a safe way.
The premises and equipment were appropriately maintained and we noted safety checks were carried out regularly. Risks to people's health and safety had been identified, assessed and managed safely. However some staff did not always follow procedure when moving people in wheelchairs.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people's rights were protected and they were encouraged to make decisions for themselves.
People had their nutritional needs met and were offered a choice at every meal time. People were offered a varied diet and were provided with sufficient drinks and snacks. People with specific nutritional needs received support in line with their care plan. However one person was not receiving the meals they required to meet their cultural need.
Staff were able to maintain and develop their skills by on-going training. Staff spoken with told us they had access to a range of learning opportunities and said they were well supported by the registered manager and the provider.
We saw staff were caring, positive, encouraging and attentive when communicating and supporting people. Visitors were made welcome in the home and people were supported to maintain relationships with their friends and relatives.
Care records and risk assessments were person-centred and were an accurate reflection of the person's care and support needs. The care plans were written with the person so they were able to influence the delivery of their care. Care plans included people’s likes and preferences and were reviewed regularly to reflect changes to the person's needs and circumstances. People had good access to healthcare professionals.
People knew how to raise concerns and complaints if they needed and appropriate action was taken to address issues that were raised. People's views of the service were sought and responded to appropriately.
There was an open and friendly atmosphere in the home which showed the staff and registered manager had developed good relationships and knew people well. We observed staff treating people with respect whilst assisting them to maintain their independence.
People, relatives and staff spoken with had confidence in the registered manager and felt the home had clear leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people living in the home and their relatives.