12 September 2023
During an inspection looking at part of the service
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.