Mill House

Updated 25 May 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two inspectors 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.

Service and service type

Mill House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Mill House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection there was not a registered manager in post. This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four relatives about their experience of the care provided. We spoke with 15 members of staff including the director of quality, regional manager, interim home manager, newly appointed home manager, clinical lead, head of hospitality, activity co-ordinator, care assistants, a chef, agency care workers, maintenance person, head housekeeper and administrator.

We reviewed a range of records. This included three people's care records and medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Following the site visit we reviewed the information the provider sent to us via e-mail and we continued to seek clarification from the provider to validate evidence found.

Updated 25 May 2022

About the service

Mill House is a care home providing personal and nursing care for up to 45 people aged 65 and over. At the time of the inspection there were 24 people living at Mill House across two floors, each of which had separate adapted facilities.

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

A new manager had been appointed and planned to register with CQC. The existing interim manager had a clear vision for the service and spoke positively about the changes they needed to make. This was being handed over to the new manager who was taking over the service. The provider had organised additional support for the service whilst the new management team settled, and they were working together to complete their service improvement plan.

We found some improvements were needed to ensure some people's risk assessments and risk management plans were accurate and updated; for example, people's risk of choking needed to be reviewed and updated as their needs changed. This would ensure that staff had up to date care records to refer to when supporting people. The provider had identified this as an area that required improvement through their own quality monitoring. Some time was needed for the manager to settle within the role and to complete their improvement plan before we could judge it to be effective in bringing about the required improvements.

People’s relatives told us people felt safe living at Mill House. The provider was monitoring and reviewing the staffing levels to ensure sufficient numbers of staff remained deployed to meet people's needs.

People were supported to receive their medicines safely and as prescribed.

Staff understood their responsibility to report concerns and poor practices.

We observed staff were kind and caring and treated people with dignity and respect.

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

People had access to a range of activities and events organised by the service's activities team.

Staff provided mixed feedback about the service and felt the changes in management over time had a detrimental impact on the moral of the team.

The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.

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

Rating at last inspection

The last rating for this service was Good (report published 23 July 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.