Mill Green

Updated 18 July 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Mill Green is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Mill Green is not registered to provide nursing care.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed records we held on the service. This included notifications. Notifications are specific events that the provider is required to tell us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spent time with the five people using the service, observing the care they received. We also spoke with three staff and the registered manager.

We looked at:

• Five people’s care records

• Medicines administration records

• Staff recruitment, induction, supervision and training records.

• Staff rotas

• Records of accidents, incidents and complaints

• Audits and quality assurance reports.

After the inspection

The registered manager sent us contact details for people’s relatives and health/social care professionals who had supported people at Mill Green. We used this information to contact six relatives and 11 social care and health professionals including people’s GP and other specialists involved in their care. We received feedback from two relatives and four professionals.

Updated 18 July 2019

About the service

Mill Green provides accommodation and support for younger adults living with a learning disability and/or autism. Some people also were living with a physical disability.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The care home was registered to provide support for a maximum of six people, which is in line with best practice guidance. The service was an adapted two storey house in a residential street where people had easy access to local amenities. At the time of this inspection there were five people living at the home.

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

The service was led by an outstanding registered manager who was dedicated to the health and wellbeing of people living at Mill Green. She had worked tirelessly to identify each person’s risks, needs and preferences including investigation into the impact of health issues on people’s physical and mental wellbeing. She, and staff, had ensured they collected data to help provide information to health professionals which had led to diagnoses and health interventions. This enabled each person to have a hugely improved quality of life, where their independence was promoted, and they were free from pain. Best practice standards and professional research was used to implement high quality, effective care. Medicines were received, administered and recorded in line with best practice. Feedback from health professionals was extremely positive and described the registered manager and staff in glowing terms. For example, one professional commented “…staff are always striving to improve the quality of care being provided.”

The registered manager and senior managers fostered a culture of openness and professional challenge. This ensured all staff understood and were motivated to meet the high standards of quality expected of them. Staff and the registered manager had been recognised both within the provider organisation and the county council as providing exceptional care. They had been nominated for and been successful in achieving awards as the best performing team and as a finalist for the best registered manager in the county.

There was a consistent staff team, many of whom were very long-serving and knew people very well. Staff showed exceptionally caring, thoughtful and compassionate care to each person. Staff used different communication methods with each person and were able to interpret fluently what people wanted. This meant that the people living at Mill Green, some of who had little or no verbal communication, were very well understood and supported. Each person had a highly individualised communication and support plan taking into consideration all their communication methods. Support plans described the risks, needs and preferences and how staff should work with each person to ensure the person was able to lead as fulfilled and independent life as possible. New ideas for activities were explored and trialled to keep people occupied in a meaningful and enjoyable way. A professional commented that the care “…provided at Mill Green is personalised to meet physical, mental, emotional and social needs. They promote independence and autonomy.”

There were sufficient staff, who knew people very well, to support people safely both in the home and in the local community. Staff supported people to get involved in their preferred activities, individually and as a group. Staff knew how to keep people safe both from the risk of abuse and from assessed risks. Medicines were administered by staff who were well trained and competent. There were robust systems to ensure medicines were received, stored, administered, recorded and returned safely.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Staff understood and had taken appropriate actions to ensure people were supported in line with the Mental Capacity Act (2005).

People, and their families, were involved as much as possible in their care and support which helped to give them choice and control in their lives. People were encouraged to join in activities and be part of the local community, regardless of any physical or learning disability they had. Activities reflected people’s preferences. People’s families spoke very highly of the quality of care and of the approach of the registered manager and staff in supporting their relative. All the relatives and professionals we received feedback from, held the service in very high regard. Health professionals praised the service describing the positive outcomes and benefits to people living at Mill Green due to the way staff advocated for each person using evidence to support their proposals.

Quality assurance measures were extremely robust and well embedded into everyday practice. Staff reviewed the quality and safety of care delivered in an in-depth way on a regular basis. Staff performance was closely monitored in a supportive way. Staff undertook training to ensure their knowledge and skills remained current.

Rating at last inspection

Good (Inspected and report published in November 2016)

Why we inspected

This was a planned inspection in line with the rating at the last inspection.

Follow up

We will continue to monitor the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect sooner.

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