CQC report explained · a residential care home
What the CQC found at Mill Green
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. There were enough staff, robust risk checks and safe systems for managing medicines.
- Effective?
- Outstanding
- Staff identified physical and mental health needs, including through non-verbal signs, and worked closely with health professionals. Support helped people improve their health, communication, independence and quality of life.
- Caring?
- Outstanding
- Staff treated people with kindness, compassion, dignity and respect. They used individual communication methods and involved people and families in decisions as much as possible.
- Responsive?
- Outstanding
- Support plans were highly personalised and regularly reviewed. People were helped to take part in activities they enjoyed, try new experiences and stay connected with their families and community.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership, an open culture and strong quality monitoring. Staff were supported to develop their skills and were encouraged to suggest improvements.
What inspectors found, July 2019
Rated Outstanding; inspectors found exceptionally effective, caring, responsive and well-led support, with safety rated Good.
This was an unannounced planned inspection on 9 May 2019. One inspector observed care, spoke with people, staff and the manager, and checked care records, medicines, staffing, complaints and quality checks. Feedback was also gathered from relatives and health and social care professionals.
The home supports up to six younger adults with learning disabilities and/or autism. Five people lived there at the inspection. Inspectors found detailed, individual support, skilled staff and strong attention to people's health, communication, independence and chosen activities.
The home was rated Outstanding overall. Effective, Caring, Responsive and Well-led were all rated Outstanding. Safe was rated Good, the same as at the previous inspection.
The report says legal requirements were met. It found safe medicines management, enough staff, good safeguarding and strong systems for managing risks and learning from incidents.
Understanding communication
Staff understood people's verbal and non-verbal communication well, including when people were in pain, unwell or anxious. Each person had an individual communication plan.
“Staff used different communication methods with each person and were able to interpret fluently what people wanted.” from the report
Health support
The home carefully investigated changes in people's behaviour and health. This helped identify health problems, reduce pain and support people to take part in activities again.
“This enabled each person to have a hugely improved quality of life, where their independence was promoted, and they were free from pain.” from the report
Personalised care
Care plans described people's risks, needs, preferences and goals in detail. Staff adapted support to help people make choices and develop greater independence.
“Care and support provided was highly personalised. There was a whole team approach to supporting each person individually.” from the report
Kind and respectful staff
Inspectors saw a caring culture where staff knew people well and respected their dignity, privacy and choices. Families and professionals also gave very positive feedback.
“People were treated with kindness, compassion and respect.” from the report
Strong leadership
The home had clear values, experienced leadership and well-established checks on care quality and safety. Staff were encouraged to learn, reflect and improve.
“Quality assurance measures were extremely robust and well embedded into everyday practice.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and record my relative's communication methods, including signs of pain, anxiety or illness?
- 02How would you support my relative to manage their medicines and review whether those medicines are working well?
- 03What activities and community opportunities could be offered to match my relative's interests and goals?
- 04How would you involve our family in care reviews, health decisions and best-interest decisions if needed?
- 05How would you support my relative if their needs became more complex, given that the home is not registered to provide nursing care?
This was an unannounced planned inspection that looked at all five CQC questions and both the premises and care provided; no one was receiving end-of-life care at the time. This explanation was written from the published report of 18 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, November 2016
Rated Good; inspectors found safe, kind and personalised care, with some limits on individual activities outside the home.
This was an unannounced inspection on 01 November 2016. One inspector spent time with all five people living at the home, observed care and communication, spoke with staff and relatives, and checked care records, medicines records, training, incidents and quality checks.
The home was rated Good overall. It was also rated Good for Safe, Effective, Caring, Responsive and Well-led. Inspectors found that staff understood people's needs, medicines were managed safely, risks were assessed, and people were supported with food, healthcare, communication and daily choices.
People appeared comfortable with staff and relatives said they had no safety concerns. Care was personalised and relationships were supported. However, opportunities for one-to-one activities outside the home could be expanded, and some staff supervision was not completed as often as the provider's policy required.
The report says the last inspection was on 06 March 2014 and found no concerns. Since then, the provider had introduced new quality checks and was reviewing activities. Refurbishment was also taking place, including two ensuite bathrooms.
People felt at ease
People appeared comfortable and happy around staff. Relatives told inspectors they had no concerns about their family members' safety.
“People appeared very happy and at ease in the presence of staff.” from the report
Skilled staff
Staff had training and experience relevant to people's learning disabilities, autism, communication needs and health conditions.
“Staff were sufficiently skilled and experienced to care and support people to have a good quality of life.” from the report
Personalised support
Support plans described people's communication, preferences, relationships, goals and abilities. Staff knew these details well.
“People received individualised care that was tailored to their needs.” from the report
Quality monitoring
The home used audits, surveys and an action plan to check standards and identify improvements.
“A range of quality assurance audits were completed by the registered manager and representatives of the provider.” from the report
Limited one-to-one outings
needs fixingStaffing levels sometimes meant that activities outside the home were mainly group activities. The provider had identified this but had not fully put the improvement in place.
“It is recommended that the registered provider reviews staffing to increase meaningful, individual activities outside of the home.” from the report
Consent for sensor device
needs fixingOne person's ability to consent to a night-time sensor motion device had not been assessed or recorded. The manager said this would be addressed immediately, and inspectors saw evidence of action during the inspection.
“Consideration and assessment of the person's ability to consent to this had not been completed.” from the report
Supervision records
minorSome staff had not received formal supervision as often as the provider's policy required. Staff nevertheless told inspectors they felt supported.
“Some staff had not received formal supervision at the required frequency as per the provider's policy.” from the report
One less engaged observation
minorOne staff member sat with their back to people and did not engage as much as other staff during one observation. Inspectors said this was not usual and the manager acted on the feedback.
“We did observe one member of staff who sat with their back to people in the lounge and did not engage to the same degree as other staff.” from the report
- 01What individual activities outside the home are now available, and how do you make sure staffing does not limit these opportunities?
- 02How do you assess and record a person's consent when using sensor or monitoring equipment at night?
- 03How often will staff receive formal supervision, and how do you check that it happens in line with your policy?
- 04How will the refurbishment affect people's routines, safety and privacy?
- 05How do you use people's communication, body language and facial expressions to check whether they are happy with their care?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating; the previous inspection on 06 March 2014 found no concerns. This explanation was written from the published report of 17 November 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Mill Green
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- July 2019Outstandingcurrent ratingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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