CQC report explained · a residential care home
What the CQC found at Millenium Care Limited - 89 Fox Lane
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Staff understood safeguarding and managed people's risks, but inspectors found no window restrictors at first and unsafe unprotected radiators. Some risk assessments, evacuation plans and medicines guidance were not personalised enough.
- Effective?
- Good
- Staff had relevant training and supervision. People received suitable food, support with swallowing difficulties and help from health professionals.
- Caring?
- Good
- Staff were kind, patient and respectful. They understood people's behaviour and communication and supported independence, privacy and personal choices.
- Responsive?
- Good
- People could follow their interests, go out and choose their routines. However, care plans did not give enough detail about communication, personal care and behaviour support.
- Well-led?
- Good
- The manager and staff worked well together. Audits, meetings and feedback systems were used to identify and make improvements.
What inspectors found, January 2019
Rated Good overall, but Safe Requires Improvement because inspectors found environmental risks and incomplete safety information.
The inspection was unannounced and took place on 14 and 21 November 2018. One inspector spoke with people, staff, relatives and professionals, observed care and meals, and checked care records, medicines, staff files and management records. The inspection was prompted partly by an allegation of abuse, but the criminal investigation meant inspectors did not examine that incident itself.
The home supported seven people with learning disabilities. Inspectors found staff were kind, knew people well and supported their choices, health, meals and activities. Medicines were given by trained staff, staffing levels were suitable, and complaints and quality checks were managed well.
The overall rating stayed Good, as did Effective, Caring, Responsive and Well-led. Safe fell to Requires Improvement. Inspectors found missing window restrictors and radiator covers, and some risk assessments, evacuation plans, care plans and medicines guidance did not contain enough personalised information. The provider acted immediately on the window and radiator concerns, and inspectors made three recommendations for improvement.
Kind, respectful support
Staff understood people as individuals, interpreted their behaviour and supported their dignity, privacy and independence.
“Staff interacted with people in a person-centred way and treated each person as an individual.” from the report
Good support with food and health
People received food suited to their needs, including support for swallowing difficulties. Staff worked with health professionals and attended appointments with people.
“Three people were assessed as being at risk of choking and staff supported them to eat foods suitable for their needs” from the report
Activities and choice
People could attend day services, social clubs, work at a garden centre or stay at home and choose their own activities.
“People had the choice to attend a range of social clubs and staff supported them to go out to local places they liked to go.” from the report
Teamwork and oversight
Staff felt supported and worked as a team. Regular audits identified issues and checked whether improvements had been made.
“There was evidence that the audits were effective at identifying areas for improvement and checking that the improvements were made.” from the report
Window and radiator safety
seriousAt the start of the inspection there were no window restrictors and some radiators were uncovered. These created risks of falls and burns, although the provider acted during the inspection.
“We found that there was a risk of people sustaining burns from unprotected hot radiators.” from the report
Incomplete risk and evacuation information
needs fixingSome records did not contain important personal details, including information about visual impairment and epilepsy. Behaviour guidance was also too general in places.
“We found that these did not all contain enough information about the person as they did not contain the fact that one person had a visual impairment” from the report
Medicines guidance
needs fixingMedicines were administered safely, but some medicine profiles and as-needed medicine instructions did not explain each person's condition, signs or required steps clearly enough.
“These did not give detail for staff on what signs to look out for each individual or what steps to follow before giving them the medicine.” from the report
Communication and care plans
needs fixingCare plans did not give enough personalised information about how people communicated or how they wanted support with personal care. The report says this had not appeared to harm people because staff knew them well.
“There was a lack of written guidance about how staff should communicate with somebody who was deaf or somebody who had no speech or signs.” from the report
- 01Have all window restrictors and radiator covers now been fitted, and how are these safety checks recorded?
- 02Have risk assessments and personal emergency evacuation plans been rewritten with each person's specific health, communication and safety needs?
- 03How are as-needed medicines assessed, and do the instructions explain the individual signs to look for before giving them?
- 04How would staff communicate with someone who has no speech or signs, or someone who is deaf?
- 05How do current care plans describe the exact support each person wants with personal care and behaviour?
This was an unannounced inspection of the whole service, including all five areas; the inspection was also prompted by safeguarding-related information, but it did not examine the circumstances of the allegation because of a criminal investigation. This explanation was written from the published report of 23 January 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, June 2018
Rated Good; inspectors found safe, kind and personalised care, with no serious risks or concerns.
This was a comprehensive, unannounced inspection. Inspectors visited on 8 March 2018 and later spoke by telephone with relatives and staff on 20 March 2018. They observed care, spoke with people, staff and a relative, and checked care plans, medicines records, staff files and quality checks.
The home supported seven people with significant learning disabilities and complex needs. Inspectors found that people were kept safe, received their medicines on time, and had detailed risk assessments. Staff were trained and supported, and people had access to healthcare, suitable food and activities.
Inspectors saw warm and calm interactions. Care plans described people's needs, communication and preferences in detail. The home had systems to check the quality of care and deal with any issues.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This was the same rating as at the previous inspection on 27 February 2015.
Detailed risk planning
Risk assessments explained people's risks and the steps staff should take to reduce them. Staff had extra training where a person's needs required it.
“People had detailed risk assessments that noted the risk and control measures in place to minimise the risk.” from the report
Kind and calm care
Inspectors saw staff respond calmly when someone became distressed. People appeared comfortable with staff, who knew them well.
“Throughout the inspection we observed a calm, warm and gentle atmosphere where people were relaxed and engaged.” from the report
Personalised support
Care plans described people's communication, history, preferences and what helped them have a good day. People were supported to take part in activities and outings.
“Care plans were person centred and contained detailed information that enabled staff to understand the person and how to work effectively with them.” from the report
Medicines managed safely
Records showed people received their medicines regularly and on time. Staff had medicines training that was refreshed each year.
“Medicine Administration records (MAR) showed that people were receiving their medicines regularly and on time.” from the report
Checks on quality
The home carried out regular checks on medicines, care plans, risks, infection control, safety and the environment. Actions were recorded and followed up.
“There were systems in place to ensure the quality of the home and the care and support provided to people.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative to communicate choices and express concerns if they cannot speak verbally?
- 02How would you manage my relative's specific risks, including any need for specialist training?
- 03What activities, outings and day-to-day choices would be available for my relative?
- 04How would you involve our family in care reviews and decisions if my relative lacks capacity?
- 05How do you check that medicines, care plans and risk assessments remain accurate and up to date?
This was a comprehensive inspection covering all five CQC questions, with an unannounced visit on 8 March 2018 and telephone calls on 20 March 2018. This explanation was written from the published report of 2 June 2018 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 Millenium Care Limited - 89 Fox Lane
3 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Millenium Care Limited - 89 Fox Lane →
- June 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Millenium Care Limited - 89 Fox Lane →
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 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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