CQC report explained · a nursing home
What the CQC found at Mill View Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2023
Requires Improvement; inspectors found positive care but unsafe medicines management and weaknesses in staffing and oversight.
This was an unannounced focused inspection on 16 and 17 August 2023. Inspectors spoke with 24 people, 8 relatives and 20 staff. They reviewed care records, risk assessments, medicines records and the home's monitoring systems.
People generally said they felt safe and spoke positively about the care and staff. The home was clean, infection control was effective, safeguarding processes were followed, and accidents and falls were recorded and reviewed.
Inspectors found medicines were not always given as prescribed. Some medicines were unavailable, stock records did not always match the electronic records, and thickened fluids were not recorded accurately. Staff were also very busy, with limited time for activities.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three question ratings were not inspected and carried over from the previous comprehensive inspection.
Kind and caring staff
People and relatives generally spoke positively about the care and staff. They said staff were approachable and caring.
“I couldn't be happier. The staff are kind and caring.” from the report
Clean environment
Inspectors found the home clean and found effective cleaning and infection control arrangements.
“The home was clean with effective cleaning and infection control processes in place.” from the report
Safeguarding and risk management
Safeguarding concerns were reported correctly. Risk assessments, safety checks, and reviews of accidents and falls were in place.
“Accidents, incidents and falls had been documented on the providers electronic monitoring system, which included actions taken and outcomes.” from the report
Positive communication
Relatives said they were listened to and kept informed about accidents and changes to care. Meetings had become more consistent.
“If anything goes wrong, such as [relative] has an accident, they ring me up and keep me informed.” from the report
Medicines were not always safe
seriousSome medicines were not given at the prescribed time, some were unavailable, and stock records did not always match the electronic records. Thickened fluids were also not recorded accurately, so inspectors could not be sure they were given or consumed safely.
“Medicines were not always managed safely. We found some medicines had not been administered as prescribed.” from the report
Staff time and activities
needs fixingThe staffing system did not include all the tasks staff were expected to do. Inspectors saw limited activities and heard that staff often did not have enough time to provide them.
“Activities are minimal, they are left for us, but not enough time to do them as there's always another care task to do” from the report
Quality checks missed problems
needs fixingThe home's audits had not identified the medicines and activity shortfalls. Inspectors also found gaps in some monitoring charts.
“Although the majority of issues we identified on inspection were already included on the SIP, the issues with medicines management and the lack of activities had not been identified.” from the report
Feedback was not followed up clearly
minorThe home collected people's views but did not have a system to tell people and relatives what action had been taken in response.
“There was currently no system in place for providing feedback to people and relatives on what actions had been taken to address any issues or act on suggestions.” from the report
- 01What changes have been made to ensure time-specific medicines are given at the correct times?
- 02How do you check that medicines are available and that stock matches the electronic medicines records?
- 03How are thickened fluids now recorded, and how do you check they are given safely?
- 04How many staff and activity staff are available on each unit, and how will residents receive regular activities?
- 05How will you identify problems through internal audits and report back to residents and relatives about their feedback?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 20 September 2023 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.
What inspectors found, January 2022
Rated Good; inspectors found safe, kind and personalised care, but some records and medicines processes needed improvement.
The inspection took place on 23 and 26 November 2021. Inspectors spoke with people living at the home, relatives, staff and other professionals. They observed care and checked care records, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe and well treated. Inspectors found that staff understood people's needs, supported their choices and provided personalised care.
There were some areas to improve. Some CQC notifications had not been sent on time, although this was corrected immediately. Medicines were administered safely but one medicines round took a long time. Records were being moved to a new electronic system, causing some gaps and overdue risk assessments.
People felt safe
People and relatives said they felt safe. Inspectors found robust safeguarding systems and staff who understood how to report concerns.
“There were robust systems in place to help safeguard people from the risk of abuse.” from the report
Kind and respectful care
Staff treated people with compassion, dignity and respect. They supported people to use their glasses, hearing aids and walking equipment.
“We observed staff treating people with respect in all units throughout the inspection.” from the report
Personalised support
Care records included people's histories, likes and dislikes. Staff were observed to know people well and involve them in decisions about their care.
“Care files contained a range of person-centred information.” from the report
Staff training
New staff received a thorough induction and training continued during their employment. Training records showed a high level of completion.
“Staff were well supported with a thorough induction and continued training programme.” from the report
Clean and suitable environment
The premises were clean, well maintained and spacious. Signage and memory boxes helped people living with dementia recognise areas and rooms.
“The premises were clean, odour free and well maintained.” from the report
Late CQC notifications
needs fixingSome incidents that should have been reported to CQC had not been notified on time. This was corrected immediately, but the provider was told to submit notifications promptly in future.
“There had been an issue with some CQC notifications not being submitted in a timely manner.” from the report
Medicines rounds took too long
needs fixingMedicines were administered safely, but the medicines round observed took a long time. Inspectors recommended better planning of medicines rounds.
“We recommend this is reviewed to ensure medicines rounds are planned effectively.” from the report
Records were not fully transferred
needs fixingThe move from paper records to an electronic system led to gaps and some overdue risk assessments. Staff could provide the information when asked and were working to complete the new records.
“The service was in the process of transitioning between a paper care planning system and electronic system and there were some gaps on the electronic system.” from the report
Some staffing vacancies
minorThere were staff shortages on some units. The home was recruiting and used regular agency staff, with inspectors finding that people's needs were being met at the time.
“There were staff shortages on some units and the service was actively recruiting to fill these roles.” from the report
- 01How have you made sure all CQC notifications are now submitted on time?
- 02How long do medicines rounds usually take, and what have you changed to make them more effective?
- 03Have all care plans and risk assessments now been transferred and updated on the electronic system?
- 04How do you check that food and fluid charts contain complete and accurate details?
- 05How are you addressing staff vacancies, family communication and the range of activities available?
The inspection looked at all five CQC key questions and included infection prevention and control checks; it was prompted in part by concerns about falls and infection outbreaks. This explanation was written from the published report of 1 January 2022 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 View Care Home
4 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022GoodSafe: GoodWell-led: Good
- July 2021Inspected but not ratedSafe: Inspected but not rated
- December 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017
Registered with the Care Quality Commission on 30 November 2017.
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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