Mill Lodge

Updated 19 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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector and a member of the CQC medicines team carried out the inspection.

Service and service type

Mill Lodge 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 Lodge is a care home without nursing care. 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.

What we did before 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.

Information received as part of a recent Direct Monitoring Approach (DMA) assessment was also used to plan the inspection.

This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We communicated with two people who used the service about their experience of the care provided. Both people were unable to speak with us but used different ways of communication including facial expressions, body language and signing that was individual to them; the registered manager assisted us to communicate who we spoke with as part of this inspection.

We reviewed a range of records. This included the care and medication records for three people. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were also viewed and included quality assurance records, servicing and maintenance checks and staff rotas.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and additional quality assurance records. We spoke with one relative and received written feedback from two others. A healthcare professional also provided us with written feedback. We spoke with an additional three staff members and we met with a person who used the service via a video conference who provided us with feedback on the service they received.

Updated 19 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Mill Lodge is a residential care home in a converted period building that was full at the time of the inspection, providing personal care to three younger adults all living with a learning disability and additional health needs.

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

Right Support

Mill Lodge is situated in a seaside resort with good public transport links meaning people had opportunities to fully engage with the local community. The model of care maximised people’s choice, control and independence and this was evidenced at this inspection.

Care plans showed people were fully involved in the support they received, and staffing arrangements meant people could be flexible in how they wished to spend their day. The provider’s values were embedded within the service meaning people were supported with life skills and seeking job opportunities. People’s relatives told us the service achieved positive outcomes for people that had improved the quality of their lives.

Right Care

People benefitted from being supported by staff who had been trained, supported and felt valued. Staff had the skills and training to provide person-centred care that met people’s needs and placed them at the heart of the care they received. Care plans showed discreet, respectful and dignified care was considered and our observations and discussions with people confirmed this was in place.

The risks to people had been identified, assessed and mitigated and the environment met people’s needs. Medicines were administered safely, and people received the health care they needed to keep them well. The service adhered to the Mental Capacity Act 2005 and consent was consistently sought. People’s hydration and nutritional needs were met, and people received a varied and nutritious diet of their choosing.

The relatives we spoke with told us the service was well-managed, communicative and effective. They shared examples of how the service had had a positive impact on their family members lives, all describing their family members as happy and fulfilled.

Whilst people received a dedicated, person-centred and meaningful service, the governance systems in place did require some improvement. For example, end of life care needs to be explored with people and they need to ensure consistent recruitment checks are in place. Additionally, audits need to be meaningful and the provider needs better oversight of the service in case of deterioration. Recommendations made by other stakeholders need to be actioned in a more timely manner.

Right Culture

The service had a positive, nurturing culture that placed the people who used it at the centre of it. People were encouraged to participate in activities, community events and to seek volunteering opportunities if they so wished. This was achieved by a provider ethos that supported and encouraged this with systems in place to achieve it. Staff told us they felt supported, listened to, valued and able to contribute to the care people received and the success of the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 April 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.