About the service Catherine Miller House is a residential care home providing personal and nursing care. There were 29 people aged 65 and over living at the service at the time of the inspection. The service can support up to 30 people.
People’s experience of using this service and what we found
Actions from a recent fire inspection had not been completed. Although people had not been harmed, there was a risk to people’s safety. The provider responded straight away to complete the outstanding actions.
We found paperwork was not always in place to support staff to help keep people safe. However, staff told us they knew how to support people. The registered manager took steps to put in place the paperwork required during the inspection.
The registered manager had not always notified the Commission of important events. They sent all required information after the inspection.
Quality assurance systems were not always effective. Checks had not identified the issues we found. The registered manager understood their responsibility to be open and honest when things had gone wrong. They welcomed our feedback and took immediate action in response to the issues we found. We felt confident the registered manager would continue to act and drive improvement at the service.
People felt safe living at the home and safeguarding procedures were in place to protect people from harm. Staff were safely recruited and enough staff with the right skills and experience were on duty during our inspection.
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’s needs were assessed before they moved in to the home to make sure it was the right place for them. Care plans contained person-centred information to help staff care for people in way that was personal to them. People and those closest to them had been included in care planning and reviews.
People and their loved ones spoke positively of the care that was provided. People were encouraged to be independent. Care was provided in privacy to respect people’s dignity. Staff had been given training to support people at the end of their lives and felt confident doing this.
The home environment was very clean and tidy. Plans were in place to paint people’s doors to make the home more dementia friendly and help people identify their rooms.
People did have access to activities, but these had been limited. A new activities co-ordinator had been employed to ensure people could enjoy the activates and outing they previously were able to take part in.
People and relatives confirmed they had access to health professionals when they needed them to maintain their health and wellbeing.
People, relatives and staff spoke highly of the registered manager and the culture they created and promoted. People and relatives confirmed they could talk to staff and the registered manager and felt able to raise concerns.
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 this service was good (published 15 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence the provider needs to make improvements. Please see the safe and well-led key sections of this full report.
Enforcement
We have identified a breach in relation to people’s safety.
We made a recommendation the provider ensures notifications are submitted when they are required to do so.
We made a recommendation the provider review best practice guidance for use of PRN and topical medicines, in regard to recording.
We made a recommendation the provider have appropriate systems in place to monitor whether staffing levels are sufficient to meet people’s needs.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.