CQC report explained · a nursing home
What the CQC found at Millbridge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, effective safeguarding arrangements and safely managed medicines. Risks to people's health and wellbeing were assessed and emergency plans were in place.
- Effective?
- Good
- Staff had relevant training, supervision and competency checks. People had access to health professionals, and staff followed consent and best-interest processes.
- Caring?
- Good
- Staff were observed to be kind, respectful and attentive. People were offered choices, supported to remain independent and treated with dignity and privacy.
- Responsive?
- Good
- Care plans recorded people's preferences and staff knew how people liked to receive care. The home offered varied activities, supported communication needs and recorded end-of-life wishes.
- Well-led?
- Good
- Inspectors found the home well managed, with clear staff responsibilities and regular quality checks. People, relatives and staff were given opportunities to share their views.
What inspectors found, July 2019
Rated Good; inspectors found safe, kind and personalised care, with refurbishment still being completed.
This was an unannounced inspection on 11 June 2019. The inspection team spoke with people living at the home, relatives and staff. They also reviewed care records, medicines records and the home's quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practices, suitable care planning and good links with health professionals.
People were treated with kindness, dignity and respect. Staff supported people to make choices, take part in activities and receive care that reflected their preferences, including at the end of life.
The overall rating remained Good, the same as at the previous inspection published on 23 November 2016. One wing was closed for extensive renovation, which was nearing completion, and some worn flooring was due to be replaced.
Enough staff
Inspectors found staff responded promptly to call bells and people's needs. Staff had time to provide care without rushing.
“On the day of the inspection we saw that staff were quick to respond to people`s needs and answer call bells promptly.” from the report
Kind and respectful care
Staff used people's names, listened to them and supported their privacy, dignity and independence.
“We saw very caring interactions between care staff and people in the home.” from the report
Personalised support
Care plans recorded people's likes, dislikes and preferences. Staff could explain how they supported individuals in the way they preferred.
“Staff we spoke with could describe in detail the steps they took to support people, their preferences, life histories and how they liked to receive their care.” from the report
Good activities and relationships
People could join group activities, have one-to-one time and receive support to maintain relationships and attend appointments.
“There was a wide range of activities provided to people and these included exercises, musical entertainment, trips to local points of interest, card games or quizzes.” from the report
Learning and oversight
The home used incidents, audits and feedback to improve care. Staff said they felt supported and listened to by the manager.
“Accidents and incidents were used as an opportunity for learning and improving.” from the report
Some flooring needed replacement
minorSome existing floor coverings were worn and had a mild smell. The report said they were due to be replaced as part of the refurbishment.
“Some existing floor coverings were well worn and had some mild malodour but were all due to be replaced very soon once redecoration works were complete.” from the report
- 01Has the refurbishment of the closed wing now been completed, including replacement of the worn flooring?
- 02How will you assess and review my relative's individual risks, including mobility, nutrition and health conditions?
- 03How will you support my relative to make choices if they have difficulty communicating or lack capacity for a particular decision?
- 04What activities and one-to-one support would be available for my relative's interests and appointments?
- 05How would you record and follow my relative's wishes if they needed end-of-life care?
This was an unannounced comprehensive inspection covering all five CQC questions; the previous overall rating was Good. This explanation was written from the published report of 5 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.
What inspectors found, November 2016
Rated Good; inspectors found kind, personalised care, with some concerns about cleanliness, mealtime delays and privacy.
This was an unannounced inspection on 5 October 2016. Inspectors looked at four people's care in detail, reviewed care and medicine records, recruitment files, training records, rotas and quality checks. They spoke with people living at the home, staff, managers and a relative.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff overall, suitable risk assessments, safe medicine systems, trained staff and improved care records. People were treated kindly, involved in their care and supported to follow their interests.
There were still some day-to-day shortfalls. Inspectors found an unpleasant smell and cleanliness problems, a long wait for lunch, two occasions when privacy was not protected, and some reliance on one activities worker. The home had plans to address these issues, and no legal requirements were breached at this inspection.
Improved care records
Care records and risk assessments were up to date and reflected people's individual needs. Staff knew what action to take when risks changed.
“These risk assessments were up-to-date and included actions for staff to take, as well as the possible outcome if actions were not followed.” from the report
Kind and respectful care
Inspectors saw staff explain care, encourage independence and reassure people during transfers. People and relatives spoke positively about the care.
“Staff were kind and caring and gentle with people. We did not see any person that was rushed when receiving support from staff.” from the report
Safe medicines practice
Staff followed a clear process, checked whether people wanted their medicines and completed medicine records. Staff had training and regular competency checks.
“There were safe medicine administration systems in place and people received their medicines when required.” from the report
People's choices and interests
People were involved in care planning and supported to choose their routines, food, activities and religious interests. The home had improved its activities provision.
“People told us that they had access to activities and were encouraged to maintain their hobbies and interests.” from the report
Stronger management checks
The home had introduced and improved audits covering care, medicines, accidents, pressure care and safety. Managers used these checks to identify and address problems.
“There were effective monitoring and auditing processes in place to manage the quality of the home.” from the report
Cleanliness and unpleasant smell
needs fixingInspectors noticed an unpleasant smell in several parts of the home and cleanliness problems, particularly near the temporary kitchen. Managers had a plan to address this.
“When we arrived at the home we experienced an unpleasant odour in the hall way of the building.” from the report
Slow lunch service
needs fixingPeople came to the dining room at midday but food was not served until 1.05pm. One staff member was also supporting two people to eat at the same time.
“We saw that people started coming into the dining room for 12pm however did not receive food until 1.05pm.” from the report
Privacy was not always protected
needs fixingInspectors saw a bathroom door and a bedroom door left open while people were using them. Managers said this was below the expected standard.
“However we did see some instances where a person's dignity was not protected.” from the report
Activities depended on one worker
minorAn activity was cancelled when the activities worker was absent, and staff could not initially access the activities cupboard. Inspectors said more progress was needed so all staff could support social needs.
“Some progress was still needed to ensure that all staff could meet people's social need and not rely on the one activities co-ordinator.” from the report
Call bell waits
minorOne person said they sometimes had to wait after using the call bell. Staff also said they sometimes felt short staffed during holidays and sickness, although staffing had improved.
“I use the call bell and sometimes I have to wait.” from the report
New daily checklist not yet consistent
minorA new checklist showing the care people had received had sometimes not been completed. Managers said staff were still getting used to the process.
“We saw that this sometimes had not been completed.” from the report
- 01What has been done to remove the unpleasant smell and improve cleanliness, especially around the temporary kitchen?
- 02How do you make sure lunch is served promptly and that people who need help to eat are properly supported?
- 03How do you ensure bathroom and bedroom doors are closed so people's privacy is protected every time?
- 04What happens to activities when the activities worker is away, and can all staff access the activities equipment?
- 05What is the current call bell response time, and how do you cover staff absence during holidays and sickness?
This was an unannounced inspection of the overall service, but only the main building was in use and no one was receiving nursing care; 30 people were living there on the inspection day. This explanation was written from the published report of 23 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 Millbridge Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2015
Report published without a new overall rating.
- October 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 March 2011.
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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