14 November 2017
During a routine inspection
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.