Milligan Road

Updated 3 October 2023

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 Health and Social Care Act 2008.

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

This inspection was completed by 2 inspectors 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.

Service and service type

Milligan Road 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. Milligan Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection, there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection and reviewed the last inspection report. 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.

We used all this information to plan our inspection.

During the inspection

Not everyone who lived at the home was able to share their views with us. As a result of this, we spent time observing interactions between people and the staff supporting them.

We spoke with 6 members of staff. This included the registered manager, deputy manager, regional manager, a senior support worker and two support workers.

We looked at a range of documents including 4 people's care plans and risk assessments, 3 staff recruitment records, training records, DoLS records and mental capacity assessments. We also reviewed audits, governance and medicines records. We conducted checks of the building, grounds and equipment.

Updated 3 October 2023

Overall Summary

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

Milligan Road is a residential care home providing personal care to 7 people with a learning disability and or autism at the time of the inspection. The service can support up to 8 people.

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

Right Support: Risk management and oversight had improved. People’s support plans had been reviewed and rewritten to ensure guidance for staff was detailed and up to date.

Improvements had been made to how incidents were recorded and responded to. Further action was required to ensure documentation and management oversight was consistently completed. incidents were analysed and there was evidence of lessons learnt and action taken to reduce reoccurrence. However, further action was required to ensure patterns and trends were fully considered and debrief meetings were routinely completed to support learning opportunities.

Improvements had been made to how medicines were managed and administered. People received their prescribed medicines as prescribed and safely. Staff had detailed guidance to support them to administer medicines safely. There had been a reduction in the use of prescribed 'as required' (PRN) medicines, used for agitation and heighten anxiety.

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.

Right Care: Improvements had been made to ensure people received care and support that met their individual care and support needs. People were protected from the risk of abuse and avoidable harm. Any restrictions and conditions imposed by DoLS authorisations, were documented, regularly reviewed and monitored.

People were supported to access health care services and support. Information was shared with external health care professionals in a person’s ongoing care. People received sufficient to eat and drink.

There were sufficient skilled and competent staff to meet people’s individual care and support needs. Staff clearly knew people well. People received opportunities to lead active and fulfilling lives, social inclusion and independence was promoted as fully as possible.

Right Culture: Improvements had been made since the last inspection and these were ongoing. Whilst sufficient actions had been completed to meet previous breaches in regulation, further time was required for new and improved systems and processes to become fully embedded and sustained.

The new management team had worked hard to make improvements; they were open and honest during the inspection and showed a commitment to further develop the service.

Staff were positive about the improvements made and felt well supported. Staff received ongoing training and opportunities to discuss their work, training and development needs.

Feedback from people and relatives were positive about how well staff met people’s individual care and support needs.

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 rated inspection for this service was requires improvement (published 11 March 2023). Breaches in regulations relating to safe care and treatment, safeguarding, consent and good governance were identified. The provider completed an action plan after the inspection to show what they would do and by when, to improve and meet the breaches in regulation related to consent. Warning Notices were served for the breach relating to safe care and treatment, safeguarding and governance.

At this inspection, we found sufficient improvements had been made, and previous breaches in regulation had been met.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has remained requires improvement based on the findings of this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Milligan Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.