Archived: Mill View Care Home

Updated 18 January 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.

The inspection took place on 28 and 29 November 2016 and was unannounced. The inspection consisted of three adult care inspectors, a specialist professional advisor (SPA) who was a registered nurse and a pharmacy inspector.

Before the inspection the provider completed 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. We also reviewed information we held about the home in the form of notifications received from the service and concerns raised by HM Coroner with regard to training around assisting people with swallowing difficulties to eat.

Before our inspection we contacted Bolton local authority commissioning team to find out their experience of the service. We also contacted the local Healthwatch to see if they had any information about the service. Healthwatch England is the national consumer champion in health and care.

During the inspection we spoke with thirteen people who used the service, nine relatives, and nine staff members, including five carers, two house managers and two clinical service managers. We looked around the home and spent time observing care including the lunch time period in one of the houses. We reviewed records at the home including fifteen care files, nine staff personnel files, meeting minutes, training matrix and audits held by the service.

Updated 18 January 2017

Mill View is a care home providing nursing and personal care for up to 180 mainly older people within six houses. Each house caters for different needs including residential care, specialist dementia care and nursing. Mill View is situated about half a mile from Bolton town centre. The home is situated in its own grounds with garden areas and car parking available at the front of the home. At the time of the inspection there were 174 people living at the home.

The registered manager at the home had recently left their employment and a new manager had been employed by the service. They were in the process of registering with the Care Quality Commission. On the day of the inspection the new manager had been in post only a few days. 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.

The unannounced inspection took place on 28 and 29 November 2016. At the previous inspection on 15 and 16 June 2015 the service was given a rating of good overall. This inspection was brought forward due to concerns received from HM Coroner around an incident that had happened at the home. The concerns were around the lack of appropriate training in relation to assisting people with swallowing difficulties to eat. Information received from the provider and evidence gathered at the inspection demonstrated that the service had responded to the concerns appropriately. They had produced an action plan, updated staff guidance around assisting people to eat and included more specific instruction and guidance within the nutritional training for all staff.

There was a house manager for each of the six houses as well as two clinical service managers who oversaw the running of three houses each.

People told us they felt safe at the home. Appropriate individual and general risk assessments were in place and these were reviewed and updated on a regular basis.

Staffing levels were appropriate to meet the needs of the people who used the service. Staffing was based on the dependency levels of the people who used the service. Recruitment procedures were robust and the induction of new staff was thorough.

The premises were clean, tidy and warm with no malodours. The premises and equipment were maintained and serviced regularly to help ensure they remained fit for purpose.

There was an up to date safeguarding policy in place and staff were aware of how to recognise and report any safeguarding issues. Safeguarding issues were followed up appropriately by the home. We saw the home’s medication systems which helped ensure medicines were safely ordered, administered, stored and disposed of.

Staff had appropriate skills and training to ensure they were able to administer care effectively. Supervisions were undertaken regularly but recording needed to be more consistent.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and authorisation for Deprivation of Liberty Safeguards (DoLS) was sought appropriately.

People’s nutritional and hydration requirements needs were assessed and documented appropriately. Special diets were adhered to by the chef and people were given choice with regard to meals. Food and drink were plentiful throughout the day.

People told us they were treated with respect and kindness and we observed good interactions between staff and people who used the service. Visiting times were unrestricted and visitors told us they were made to feel welcome at all times.

People who used the service and their families were involved in care planning where appropriate. People’s wishes for when they were nearing the end of their lives were documented and their preferences adhered to if possible.

Care plans were person centred and included a range of health and personal information. This included people’s likes, dislikes and care needs. There was a varied programme of activities at the home and people’s preferences for how they liked to spend the day were supported.

Complaints were dealt with appropriately by the service and there were a number of forums for people to put forward suggestions and raise concerns.

The new manager at the home had not yet had time to become established. We were therefore unable to assess her leadership skills. People who used the service, visitors and staff reported that the management team were approachable. Staff meetings took place regularly.

A number of audits and checks were carried out by the home. Some were followed up appropriately but others lacked analysis and follow up actions.