Archived: Millbeck House

Updated 28 December 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 14 and 15 November 2017. The first day of our visit was unannounced. The inspection was carried out by one 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. Their area of expertise was older people.

Prior to our inspection, the provider had completed a Provider Information Return [PIR]. This is a form that asks them to give some key information about the service, what the service does well and improvements they plan to make. We looked at the PIR before our visit and took this into account when we made judgements in this report. We also reviewed other information that we held about the service such as notifications. These detail events which happened at the service that the provider is required to tell us about.

We contacted the commissioners of the service to obtain their views about the care provided. We also contacted Healthwatch Nottinghamshire who are the local consumer champion for people using adult social care services to see if they had any feedback about the service. We used this information to inform our inspection planning.

At the time of our inspection there were 25 people living at the service. We were able to speak with four people living there and three relatives. We also spoke with the registered manager, the deputy manager, two senior care workers, the cook, the domestic, four support workers and a visiting healthcare professional. We were also able to talk with the interim branch manager who was visiting on the second day of our visit.

We observed support being provided in the communal areas of the service. This was so we could understand people’s experiences. By observing the care received, we could determine whether or not they were comfortable with the support they were provided with.

We reviewed a range of records about people’s care and how the service was managed. This included three people’s plans of care. We also looked at associated documents including risk assessments. We looked at records of meetings, recruitment checks carried out for three support workers and the quality assurance audits the management team had completed.

Updated 28 December 2017

We inspected Millbeck House on 14 and 15 November 2017. The first day of our visit was unannounced. This meant the staff and the provider did not know we would be visiting.

Millbeck House is located in Arnold, Nottinghamshire. The service provides care and accommodation for up to 32 older people with age related needs, including dementia and physical disability. Accommodation is provided on two floors with a number of communal areas and enclosed gardens available for people to use. On the day of our inspection there were 25 people living at the service. At the last inspection in March 2015, the service was rated Good. At this inspection we found that the service remained Good, though there was a deterioration in Safe.

The service 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 did not always receive their medicines as prescribed by their doctor. Whilst there was a protocol in place for staff to follow when supporting people to take homely remedies such as paracetamol for pain relief, these were not in place for people who had medicines prescribed as and when required.

People using the service told us they felt safe living at Millbeck House. Relatives we spoke with agreed they were safe living there. People were kept safe from avoidable harm because the staff team understood their responsibilities. They knew what to look out for if they suspected that someone was at risk of harm and knew who to report their concerns too.

The risks associated with people’s care and support had been assessed and reviewed.

Appropriate pre-employment checks had been carried out on new members of staff to make sure they were safe and suitable to work there. An induction into the service had been provided and on-going training was being delivered. This enabled the staff team to gain the skills and knowledge they needed in order to meet people's needs. Whilst people’s needs were being met by the numbers of staff deployed at the service, there were times when people were left to sit and occupy themselves, or simply sleep.

People were provided with a clean and comfortable place to live. An on-going refurbishment plan was in place and improvements to the service were evident. There were appropriate spaces to enable people to either spend time with others, or on their own.

People’s needs had, whenever possible been assessed prior to them moving into the service to make sure they could be met by the staff team. Where people had arrived in an emergency, such as from hospital, as much information as possible had been obtained beforehand.

People told us the meals served at Millbeck House were good. Their dietary requirements had been assessed and a balanced diet was being provided. Monitoring records used to monitor people’s fluid intake did not always reflect that people were offered drinks in between the structured times provided.

People were supported to maintain good health. They had access to relevant healthcare services such as doctors and community nurses and they received on-going healthcare support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us the staff team were kind and caring and treated them with respect. Observations made during our visit confirmed this. We observed the staff team treating people in a friendly, caring and considerate manner. They knocked on people’s bedroom doors before entering and if someone declined their offer of help, this was respected.

People were supported in a way they preferred because plans of care had been developed with them and with people who knew them well. The staff team knew the needs of the people they were supporting because the necessary information had been included within their plan of care.

People knew who to talk to if they had a concern of any kind. A formal complaints process was in place and this was displayed. People were confident that any concerns they had would be taken seriously and acted upon. Complaints received by the registered manager had been appropriately managed and resolved.

The provider had an end of life policy in place and this showed the staff team how to provide high quality care for people as they approach the end of life.

Staff members felt supported by the management team and told us there was always someone available to talk with should they need guidance or support. The views of the people using the service were sought. This was through meetings and the use of surveys. Systems were in place to monitor the quality of the service being provided and a business continuity plan was available to be used in the event of an emergency or untoward event.

Further information is in the detailed findings below.