22 March 2023
During a routine inspection
Mickle Hill is a domiciliary care service which provides personal care to people in their own
bungalows and apartments within the purpose-built extra care housing scheme.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
At the time of inspection over 160 people were living at Mickle Hill and 3 people were receiving the regulated activity of personal care.
People’s experience of using this service and what we found
Governance checks to maintain and improve the quality of the service and maintain compliance with regulation were not always implemented effectively.
People received initial assessments of their needs and information was used to formulate care plans for staff to use as a point of reference when supporting people. However, information was not always completed consistently putting people at risk of harm. People’s views and preferences were recorded but people were not always aware of all their choices and some preferences were not met due to staffing restrictions.
Staff did not always have access to clear information to communicate with people. Information to ensure people received effective communication was not robustly completed or updated following guidance under the Accessible Information Standard.
The provider was actively recruiting staff with interim contingency plans in place to ensure people’s needs were met.
People told us they felt safe with the staff who supported them. Staff were clear on types of abuse to look out for and how to raise their concerns when required. Processes ensured any incidents were routinely investigated with outcomes and actions implemented.
Where people required support to take their medicines this was completed safely as prescribed. The provider worked closely with other health professionals and supported people with any required referrals to maintain their health and wellbeing.
Staff were safely recruited into their roles and were supported with a range of training and support to carry out their duties. This included observations of their practice and regular supervisions.
Staff had good access to personal protective equipment to manage the risks associated with the spread of infection including COVID-19 and adhered to government guidance to protect people.
People told us they were happy with the service they received. They told us they were confident in approaching staff and the registered manager with any concerns and that any feedback or suggestions would be responded to.
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 told us they felt a part of the community where they lived and enjoyed good access to a range of relevant activities.
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 the service under the previous provider was outstanding, published on 18 February 2020.
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed from outstanding to requires improvement based on the findings of this inspection. We have found evidence the provider needs to make improvements. Please see the safe, responsive, and well led sections of this full report.
Enforcement and Recommendations
We have identified a breach in relation to the governance of the service, provider oversight including risk management and record keeping.
We have made recommendations for the provider to review and improve their policy and practice for record keeping and care planning. We found no evidence during this inspection that people were at risk of harm from these concerns. The registered manager had started to implement a new electronic risk assessments process to ensure robust and up to date record keeping was in place.
Please see the action we have told the provider to take at the end of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mickle Hill on our website at www.cqc.org.uk.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.