CQC report explained · a residential care home
What the CQC found at Millfield House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found kind, person-centred care but repeated gaps in risk guidance and quality oversight.
This was an unannounced inspection on 27 October and 01 November 2022. One inspector spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
People and relatives said they were happy with the support. Staff knew people well, staffing was considered sufficient, and people received kind and personalised care. People were supported with their choices, communication, activities and relationships.
However, some care plans and risk assessments did not give enough detail about choking, epilepsy, diabetes or safe transfers. The same type of problem had been found at the previous inspection. The home was still in breach of the rules on safe care and treatment and good governance.
The overall rating was Requires Improvement. Safe and well-led were Requires Improvement, while responsive was Good. Caring and effective were not given separate ratings in this inspection.
Kind, respectful care
People received compassionate care, and staff understood their individual needs, privacy and dignity.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Choice and independence
People were supported to make choices, work towards goals, develop skills and take part in activities in the local area.
“The service (or staff) supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.” from the report
Reliable medicines systems
The medicines problems found at the previous inspection had been addressed. Counts matched the records and staff followed clearer procedures.
“At this inspection we found all medicine counts matched with MAR. There was a system in place to ensure medicine counts were completed daily.” from the report
Enough staff who know people well
Inspectors found enough staff, including for one-to-one activities and visits. Staff turnover was low, helping provide consistent care.
“Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.” from the report
Incomplete risk instructions
seriousCare plans and risk assessments did not always explain the actions staff should take to keep people safe. This affected risks including choking, epilepsy, diabetes and transfers, especially for new or agency staff.
“Care plans and risk assessments were not explicit to inform staff on actions to take to mitigate risks to choking, diabetes, epilepsy and when supporting people to transfer.” from the report
Repeated quality oversight problem
seriousThe home had identified a similar concern at the previous inspection but had not acted proactively enough to put the required guidance in place. Inspectors found a breach of good governance requirements.
“The registered persons had failed to effectively assess, monitor and improve the quality of the services provided.” from the report
- 01What has been changed in the care plans and risk assessments for choking, epilepsy, diabetes and transfers?
- 02How will you make sure new or agency staff receive clear instructions about each person's risks?
- 03What is the timetable for completing the action plan requested by CQC, and how will families be told about progress?
- 04How do you check that the updated risk guidance is being followed and remains accurate?
- 05How will feedback be collected separately for this home so that problems specific to it are identified?
This was an unannounced focused inspection covering Safe, Responsive and Well-led, with infection prevention and control also reviewed; Caring and Effective were not separately rated in this report. This explanation was written from the published report of 6 January 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, August 2019
Rated Requires Improvement; inspectors found kind, respectful care, but medicines, risk records and personalised planning were not always safe or up to date.
This was an unannounced inspection on 8 May 2019. One inspector spoke with people, staff and professionals, observed care, and checked care plans, medicine records, incident records, recruitment files, training and the provider's checks.
People told inspectors they felt safe and were positive about staff. Inspectors saw warm relationships, respectful care and support for people's independence. There were enough staff, staff were trained, and people were supported with food, healthcare, activities and communication.
The home did not always manage medicines safely. Some risk assessments and care plans gave incomplete or incorrect information. Accident records and daily care notes were not always complete, and some goals had not been reviewed. The overall rating was Requires Improvement. The home sent an action plan and evidence of improvements, and CQC said it would continue to monitor the service.
Kind relationships
People had trusting relationships with staff and were treated respectfully. Inspectors saw people chatting, laughing and interacting comfortably with staff.
“We observed warm relationships between people and staff, people chatted, laughed and interacted well together and with staff.” from the report
Staffing and recruitment
There were enough staff to meet people's needs, and recruitment checks helped ensure staff were suitable. People did not have to wait for support during the inspection.
“There were enough staff on duty to meet people's needs.” from the report
Staff skills
Staff received training linked to people's individual needs, including epilepsy, diabetes and stroke training. New staff had induction and competency checks.
“Staff had the training, skills and experience to provide the support people needed.” from the report
Community life
People were supported to take part in local activities and go to clubs, events, shops and cafes. A new activities coordinator was working to widen the choices available.
“People were encouraged to be a part of the local community; attending clubs and music events, visiting local shops and cafes.” from the report
Medicine safety
seriousA medicine record and the remaining stock did not match, suggesting a person may not have received the correct amount. Some handwritten medicine instructions were not checked by a second staff member, and there was no clear process for medicines taken out of the home.
“The provider had not ensured the proper and safe management of medicines.” from the report
Incomplete risk guidance
seriousSome risk assessments did not give staff enough accurate information to support people safely. Examples included seizure rescue medicine, PEG care, diabetes and catheter care.
“Risk assessments did not always give correct information for staff to follow and potentially did not provide enough guidance needed to keep people safe.” from the report
Incident records
needs fixingInspectors could not be confident that every accident or incident had been recorded. One injury shown on a body map had no matching incident report or investigation record.
“A system was in place to monitor accidents and incidents, but we could not be confident that all accidents and incidents were recorded.” from the report
Out-of-date goals
needs fixingSome goals dated from 2016 or 2017 and had not been reviewed. One person said their recorded goal did not reflect what they wanted to do.
“Some goals dated back to 2016/2017 and had not been reviewed or updated.” from the report
- 01What changes have you made to check medicine quantities against records and ensure handwritten instructions are double-signed?
- 02What is now the process for medicines people take out of the home, and are all night staff administering medicines trained and assessed as competent?
- 03Have the risk assessments for seizures, PEG care, diabetes and catheter care been corrected and reviewed by suitable professionals?
- 04How are people's goals and aspirations now reviewed, and how do you check that they reflect what each person wants?
- 05How do you make sure accidents, daily care and changes in people's support are fully recorded and checked by managers?
This was a planned, unannounced inspection covering all five CQC questions and both the premises and care provided; it was the first inspection since registration under the new provider name. This explanation was written from the published report of 1 August 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.
Every inspection of Millfield House
2 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2019Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018
Registered with the Care Quality Commission on 3 May 2018.
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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39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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