The Millfield

Updated 28 February 2019

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 consisted of an adult social care 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. Our expert by experience had knowledge of nursing care of older adults and people who have dementia.

Service and service type:

The Millfield 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 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:

This inspection was unannounced on the first day and we announced our visit for the second day.

What we did:

•Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public, local authorities and clinical commissioning groups (CCGs).

•We asked the service to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

•We spoke with three relatives, 11 service users, two health care professionals, four staff members and the registered manager.

•We reviewed six people's care records, seven staff personnel files, audits and other records about the management of the service.

•We requested additional evidence to be sent to us after our inspection. This was received and the information was used as part of our inspection.

Updated 28 February 2019

About the service: The Millfield is a residential care home that provides personal care and accommodation for up to 45 people. The home is situated close to the town centre of Keswick and at the time of this inspection there were 43 people living here. The accommodation also includes a designated 10 bed unit for people living with dementia.

People’s experience of using this service:

There were sufficient numbers of suitably qualified staff to meet people’s needs in a timely manner. People and their relatives told us there were always enough staff available to assist them. One person told us, “There always seems enough staff.” Staff had completed training that enabled them to deliver good care and support to people effectively.

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. Medications were stored and managed safely and people received their medicines as they had been prescribed.

People’s individual preferences for food and drink were catered for and this also included people’s specific health and dietary requirements. Staff gave the right level of support to those who required extra help in eating and drinking. One person told us, “The food is good, very good and you get a good choice.” We observed the dining experience it was pleasant, sociable and very personalised.

Care provided to people respected their privacy, dignity and promoted their independence. It was clear from our observations that staff knew people's needs well. Kind and friendly interactions were observed taking place. One person told us, “It’s excellent here it really is, the girls [staff] are very kind, they spoil me really.” Another person told us, “The staff are really kind. They look after me very well, they seem to know what I want before I do.”

The service remained at the heart of the local community with strong links including the local school whose pupils visited the home regularly. The activities coordinator told us, “People from the town are very involved in the home, we get lots of input and help.” There was a varied and individualised activity programme in place that ensured people lived a fulfilled life of their choosing.

Staff were motivated and proud of the service. One staff member said, “We do work hard but this place is so much better to work in than some others, we are all family here.” There was a particularly strong emphasis on continuous development and improvement of the service with staff gaining additional qualifications and the implementation of electronic care records.

A variety of audits were in place that demonstrated the service was monitored and safe for people to live in. Feedback about the service was consistently good especially from health professionals we spoke with. One health professional said, “They [staff] work exceptionally hard with people they have referred to us. They follow our instructions and it shows in that those people no longer require our service.”

More information is in the full report.

Rating at last inspection:

GOOD (The date last report published was 19 July 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remains Good.

Follow up:

Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.