Archived: Millbrook House

Updated 7 June 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 team included two adult social care inspectors, a specialist nurse advisor and an expert with experience of dementia services.

Service and service type:

Millbrook House is a 'care home'. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with CQC. 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.

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:

The inspection was unannounced.

What we did:

We reviewed information we had received about the service since the service was registered. Due to a technical issue, the provider had not been asked to provide information in the form of a provider information return (PIR) in advance of this inspection. The provider was advised to share any information of relevance during the inspection.

People living at the home were unable to engage in conversations with us because of their health conditions. However, during the inspection we spoke with four relatives of people who lived in the home. We spoke with the registered manager, a deputy manager, a nurse, three care staff, representatives of the provider and an external healthcare professional.

We reviewed a range of records. This included five people's care records, five staff files and other records relating to the management of the home. We also completed observations of the care provided throughout the inspection.

Updated 7 June 2019

About the service:

Millbrook House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide care for a maximum of 60 people. At the time of this inspection 48 people were receiving care at the service.

People’s experience of using this service:

Medicines were not always managed safely in accordance with the relevant guidance. We made a recommendation regarding this.

Risk assessments were completed in relation to a range of health conditions and the environment. However, a small number of records relating to the management of risk had not been completed correctly or consistently. We made a recommendation regarding this.

The registered manager and provider completed regular safety and quality audits to measure performance and generate improvements. The issues identified during this inspection had not been identified by these audits. However, the response to address any issues and improve future practice was extensive and immediate.

Concerns identified at the previous inspection had been addressed and the service was no longer in breach of regulation.

Staff had been trained in adult safeguarding and understood their role in relation to keeping people safe. Staff had been safely recruited and deployed in sufficient numbers to meet people’s needs.

Staff were trained in relevant subjects and given support to do their job. Staff were aware of the relevant standards and guidance and used this effectively to assess people’s needs and plan their care.

Comments from relatives regarding the quality of food were mostly positive. People were given plenty to eat and drink and supported by staff where required.

Staff and managers worked effectively with healthcare professionals to ensure that people received the care they needed.

The design and flow of the building have been improved to make it more appropriate for people living with dementia.

Staff obtained consent for people's care and support. Staff understood the principles, of the MCA and people were supported wherever possible to make their own decisions.

Relatives told us that their family members were always treated well by staff and were involved in decisions about their care. We saw a number of examples where staff spoke to people with kindness and respect throughout the inspection.

Staff knew people’s personal histories and their likes and dislikes. They used this information to hold conversations and to engage people in activities.

Important information was made available in a range of accessible formats to help people understand and to promote their involvement.

Complaints were addressed in accordance with the provider’s policy and best-practice guidance. None of the people that we spoke with said that they had made a complaint recently. They each said that they would feel comfortable raising any issues with any member of staff.

Each of the people that we spoke with had a clearly defined role within the service and understood their role and responsibilities.

The provider placed continuous learning and improvement at the heart of their practice. Lessons learnt from incidents and accidents in other services were shared with managers and staff to improve practice.

Rating at last inspection:

Millbrook House was rated Requires Improvement at our last inspection. The report of the last inspection was published on 6 July 2018.

Why we inspected:

This inspection was scheduled and conducted in accordance with our methodology for Requires Improvement services to ensure that concerns identified at our last inspection had been addressed.

Follow up:

We will continue to monitor information and intelligence we receive about the service to ensure good quality care is provided to people. We will return to re inspect in line with our inspection timescales for Good services.

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