Millfield House

Updated 2 February 2019

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 was a comprehensive inspection. The inspection took place on 16 January 2019 and was unannounced.

The inspection team consisted of one inspector. Before the inspection, we reviewed information the provider sent us in the Provider Information Return. This is information we require providers to send to 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 also reviewed other information we held about the service including notifications they had sent us. These are events that happen in the service that the provider is required to tell us about. We considered the last inspection report and information that had been sent to us by other agencies.

Prior to this inspection, we reviewed information that we held about the service, such as notifications. These are events that happen in the service that the provider is required to tell us about. We considered the last inspection report and information that had been sent to us by other agencies. We also contacted commissioners who had a contract with the service.

During the inspection, we spoke by telephone with three relatives of people who used the service, to obtain their views about how well the service was meeting people's needs and wishes. We spent time in the company of people using the service when they were in the communal areas. By observing the care they received we could determine whether or not they were comfortable with the support they were provided with.

There were two registered managers who job shared. We spoke with a registered manager, a team manager, shift leader and three care staff.

We reviewed a range of records about people's care and how the service was managed. This included looking at two people's care records and associated documents. We reviewed records of meetings, staff rotas and staff training records. We also reviewed the quality assurance audits the management team had completed.

Updated 2 February 2019

Millfield House 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.

Millfield House provides accommodation and support for eight younger adults who have a learning disability and who live with autism. It is a detached Edwardian House with accommodation for six people in the main house and with a two bedroomed self contained annex that provides accommodation for two people. The service is close to the centre of Colsterworth, Lincolnshire. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in March 2016, we rated the service good. It was rated good for safe, effective, caring and responsive and requires improvement in well led. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, the service was rated good in all five domains and good overall.

People were protected from abuse and avoidable harm, by staff who understood their responsibilities for this. Staff identified risks to people’s health and safety and managed the risks without unnecessarily restricting people’s freedom. Staffing levels were planned to provide agreed levels of support and sufficient staff were available to maintain safe levels of care.

Medicines were managed and administered safely and people received their medicines as prescribed. The premises and environment were well maintained and the required safety checks were completed. Infection prevention and control was effectively managed.

Staff reported incidents and accidents and the registered managers ensured they were reviewed and learning identified to minimise the risk of recurrence.

Care was delivered by staff who were well trained and knowledgeable about people’s care and support needs. The registered managers carried out observations of practice and staff were provided with regular supervision and an annual appraisal.

People were provided with a varied and nutritious diet. Most people had very good appetites, however, we discussed the advantages of using a structured nutritional risk assessment when people lost weight.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

The service remained caring. People were unable to express themselves verbally, however, we saw they were relaxed and comfortable with staff and had positive relationships with them. Relatives praised staff for their kindness and the way they cared about their family members. They spoke about the staff team’s patient and understanding approach.

People continued to receive care that was responsive to their individual needs and wishes. Staff communicated with them very well and offered them choices on an ongoing basis. People had access to a wide range of activities based on their interests and wishes. They led full and active lives. A relative told us they felt their family member had a fantastic quality of life which went beyond anything they could have expected for their family member.

The management team provided good leadership and support for staff. They made themselves available for people and their relatives and treated everyone with fairness and without discrimination. The views of staff and people using the service were actively sought and listened to. Quality audits were completed to monitor the quality of the service provided and promote continuous improvement.

Further information is in the detailed findings below