Archived: Millhouse

Updated 6 December 2018

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 16 November 2018 and was announced.

The provider was given 48 hours' notice because the location provides support to people in their own homes and we needed to be sure that someone would be in.

This inspection was carried out by one inspector and one 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.

Before the inspection we checked the information we held about the service. We looked at any notifications received and reviewed any information received from the public. 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 contacted the local authority to seek their views about the service. They told us they had no current concerns.

During the inspection we spoke with two people who used the service over the telephone. We also visited three people at home and a relative. We spoke with the registered manager, deputy manager, operations director, a senior carer and three care staff.

We reviewed four people's care records, looked at three staff files and reviewed records relating to the management of medicines, training and how the registered persons’ monitored the quality of the service.

Updated 6 December 2018

The inspection took place on 14 and 16 November 2018 and was announced.

Millhouse SOS Homecare Limited, provides personal care for people aged 55 and over. This service provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. There were 14 people receiving personal care when we inspected.

At our last inspection we rated the service good. At this comprehensive inspection we have rated the service 'good' overall but rated the safe question as ‘requires improvement. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was in place. A 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 were very positive about the support they received from the service.

Staffing levels were sufficient to provide safe care and people were supported by a small and familiar staff team. Recruitment checks had ensured they were suitable to work with vulnerable adults. We noted that records relating to reference checks could be more robust.

We found some shortfalls relating to medication records, which did not always contain sufficient detail. Records relating to risk did not always reflect the action that had been taken to mitigate risk. Where necessary people had equipment needed. Where we found concerns with records the registered manager was aware of them and had an action plan in place to address them.

Staff were trained and received ongoing support from the registered manager. However, work was being undertaken to ensure that staff supervisions and spot checks were carried out as frequently as required.

People's needs continued to be assessed before they started using the service and were reviewed to develop their care plans. People received appropriate support to meet their nutritional needs.

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

The service promoted a culture of dignified and respectful care. People told us that were treated by staff who were kind and caring. They were involved in decisions about their care and the development and reviews of care plans. People had close and effective relationships with staff due to the small staff team.

People received care and support that was personal to their needs and was responsive to their changing needs. Each person had a care plan and in some cases. we found they lacked person centred details. However, staff were knowledgeable and had sufficient guidance to meet people’s individual needs.

People had regular contact with the management team, and reported no difficulties in raising any concerns about the service if necessary.

People were positive about the way the service was managed. The service continued to monitor and assess the quality of the service they were providing to people. Internal audits had highlighted some areas for improvement. We recommend the provider continues to monitor and evaluate the existing quality improvement initiatives until improvements are shown to be sustained and embedded in practice.

Staff said they felt supported but raised some concerns about the accessibility of the management team at times. The registered manager told us they would address this.

Further information is in the detailed findings below.