Archived: Miramar

Updated 16 March 2019

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. 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 included an 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 mental health services.

Service and service type:

Miramar is a 'care home.' People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (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:

The inspection was unannounced.

What we did:

Prior to the inspection we reviewed all information we held about the home, such as details about incidents the provider must notify CQC about.For example, an investigation , for example a report into a serious incident in March 2018 where a person fell from a height, where a Velux window was not fitted with a window restrictor. The provider sent us 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 nine people to ask them about their experience of the care provided. We looked at three people’s care records and at their medicine records. We spent time in communal areas and observed staff interactions with people.

We spoke with the registered manager, the nominated individual, and with three care staff, kitchen staff and a housekeeper. We looked at three staff files around staff recruitment, supervision, appraisal and staff training records. We also looked at quality monitoring records relating to the management of the service such as audits and quality assurance reports. We sought feedback from commissioners, and health and social care professionals who worked with staff at the home and received a response from one of them.

Updated 16 March 2019

About the service: Miramar is a residential care home in Exmouth that provides accommodation with personal care for up to 14 people. This included people with mental health needs and living with addictions. When we visited, 13 people lived there, although one person was in hospital.

People’s experience of using this service:

¿ People were supported by staff that were caring, compassionate and treated them with dignity and respect.

¿ People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop positive, meaningful relationships with people.

¿ Risks of abuse to people were minimised because the service had robust safeguarding systems and processes. Staff demonstrated a good awareness of each person's safety needs and how to minimise risks for them.

¿ Regular health and safety checks were carried out. Environmental improvements, such as a stairlift to the second floor and a new shower had improved disabled access for people.

¿ People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. People’s health had improved because staff worked with a range of healthcare professionals and followed their advice.

¿ People were supported in the least restrictive way possible; the policies, systems and culture in the service supported this practice.

¿ People's concerns and complaints were listened and responded to. Accidents, incidents and complaints were used as opportunities to learn and improve the service.

¿ People, staff and professionals gave us positive feedback about the quality of people's care. They said the registered manager was approachable, listened and acted on feedback. Quality monitoring systems included audits, observation of staff practice and regular checks of the environment with examples of continuous improvements made in response to findings.

Rating at last inspection: Good. (last report published 6 April 2017)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The inspection was brought forward by a few months to check safety improvements identified in 2018 had been implemented. At this inspection, the service remained rated Good overall.

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

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