CQC report explained · a residential care home
What the CQC found at 52 Mill Lane
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing, equipment, fire safety and infection control were managed safely. Incidents and accidents were reviewed, and safeguarding concerns were reported appropriately.
- Effective?
- Good
- Staff had relevant training and understood their responsibilities around consent and the Mental Capacity Act. People received support with nutrition, hydration, health appointments and adapted equipment.
- Caring?
- Good
- Staff knew people well, were kind and respected privacy, dignity and independence. Staff used individual communication methods to help people express their views and make choices.
- Responsive?
- Good
- Care was personalised and reflected people's interests, routines and preferences. Plans were reviewed when needs changed, families were involved and concerns were dealt with promptly.
- Well-led?
- Good
- The home had quality checks, action plans and clear leadership. Staff described open communication, positive teamwork and good links with health professionals and community services.
What inspectors found, January 2019
Rated Good; inspectors found safe, kind and personalised care, with all four breaches from the previous inspection resolved.
Inspectors visited on 15 November 2018. The visit was announced. They observed care, reviewed records and spoke with staff, the manager and a relative. They also looked closely at support for people's oral health.
The home supported up to five adults with severe learning disabilities and physical needs. Inspectors found that risks were managed, medicines were given safely and there were enough suitably trained staff. People were supported with food, drink, health appointments and communication.
Staff knew people well and treated them with kindness, dignity and respect. Care was tailored to people's choices, interests and abilities. The home had good systems for checking quality and making improvements.
The overall rating was Good, as were all five areas inspected: Safe, Effective, Caring, Responsive and Well-led. The previous inspection in August 2017 rated the service Requires Improvement and found four breaches. Inspectors said the provider had followed its action plan and met those breaches.
Detailed safety planning
Care plans gave staff clear instructions for managing complex health risks, including pressure sores, epilepsy and enteral feeding.
“Assessments and care plans were comprehensive and provided clear guidance for staff in how to achieve good outcomes for people.” from the report
Kind and respectful staff
Inspectors saw staff offering reassurance and responding to people's comfort, privacy and dignity. A relative also described people as happy at the home.
“We observed staff treating people with respect, offering gentle reassurance in a kind manner.” from the report
Personalised daily life
People were supported to take part in activities linked to their interests, such as music, gardening, swimming and community visits.
“People were supported to lead full lives that reflected their interests and preferences.” from the report
Support for communication and independence
Staff used communication passports, pictures, objects, signs and other individual methods. They helped people do as much as possible for themselves.
“Staff used a number of methods to break down barriers to communication.” from the report
Manager was not aware of the Accessible Information Standard
minorThe registered manager was not aware of this standard. However, inspectors said staff practice complied with it and people's communication needs were recorded and supported.
“The registered manager was not aware of the AIS, however staff practice complied with the standard.” from the report
- 01How will you assess and manage my relative's specific health risks, and how often will the care plan be reviewed?
- 02How will staff communicate with my relative and support them to make choices about care, food and activities?
- 03How do you make sure staff remain trained and competent to support complex needs, medicines and specialist equipment?
- 04How will you involve our family in reviews and tell us about changes in needs or care?
- 05What quality checks are currently being carried out, and how are any concerns turned into improvements?
This was an announced inspection of the overall service, including accommodation and care, with a detailed review of oral health support; inspectors observed two people, reviewed four care records and spoke with one relative and staff. This explanation was written from the published report of 17 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, December 2017
Rated Requires Improvement; inspectors found kind, personalised care, but identified safety, consent and management failures.
The inspection took place on 21 August 2017 and was announced. Two inspectors observed care, reviewed records and spoke with staff, a relative, the manager and a health professional. They looked closely at three people's care and reviewed records for all five people living at the home.
The home was caring and responsive. Staff knew people well, treated them with kindness and supported their choices, health needs, activities and relationships. Care records were detailed and personalised. There were enough staff, and staff had relevant training and supervision.
However, the home was not consistently safe, effective or well-led. Some risks were not assessed clearly. Possible safeguarding concerns were not reported correctly. Consent and legal safeguards were not handled properly during a temporary move or when medicines were given covertly. Management checks had not found these problems.
The overall rating was Requires Improvement. Safe, effective and well-led were rated Requires Improvement, while caring and responsive were rated Good. The provider was told to take action on five regulatory breaches, and CQC said it would check that action was taken.
Kind and respectful staff
Staff knew people well and used different ways to communicate with them. Inspectors saw people appearing relaxed and comfortable with staff.
“People were supported by staff who were caring, kind and compassionate.” from the report
Personalised care
Care plans included people's history, preferences, dislikes, communication methods and signs of distress or happiness. Staff updated plans when people's needs changed.
“Care plans were detailed and comprehensive.” from the report
Activities and community life
People were supported to go out regularly, follow their interests and take part in activities such as swimming, music groups, aromatherapy and sensory sessions.
“People were supported to lead full lives and to access the local community.” from the report
Staffing and training
Rotas showed consistent staffing, and inspectors saw that people did not have to wait for care. Staff had training relevant to people's complex needs and received supervision.
“There were enough staff to care for them safely.” from the report
Food and health care
People's eating, drinking and health needs were assessed and supported. Staff followed specialist guidance, kept health records and contacted health professionals when needed.
“People were supported to have enough to eat and drink.” from the report
Risks and equipment
seriousSome risks linked to enteral feeding equipment had not been assessed clearly. Unclear guidance contributed to a tube connector problem that caused stomach acid to burn someone's skin.
“This had resulted in leakage from the tube causing stomach acid to burn the person’s skin.” from the report
Safeguarding reporting
seriousSeveral incidents that might have involved neglect or harm were not identified as possible safeguarding concerns. The correct external alerts were not sent.
“Incidents had not been identified as possible safeguarding concerns and local safeguarding procedures had not been followed.” from the report
Consent and lawful restrictions
seriousThe home did not always follow conditions attached to legal safeguards. During a temporary move, people were deprived of their liberty for more than 28 days without proper authorisation.
“This meant that people were deprived of their liberty without lawful authorisation.” from the report
Covert medicines
seriousSome medicines were given in drinks or through feeding tubes without records showing that capacity and best-interest decisions had been properly considered.
“Peoples' capacity to consent to having their medicines had not been assessed and documented” from the report
Weak management checks
needs fixingAudits did not identify missing risk assessments, incomplete medicine guidance or possible safeguarding concerns. This meant important problems were not found promptly.
“Management systems were not always effective in identifying shortfalls and driving improvements.” from the report
Missing statutory notification
seriousThe provider did not notify CQC about people's temporary move during renovation work.
“The provider had failed to submit a statutory notification about people's temporary move from the home” from the report
- 01What has been done to make sure every person's risks, including risks linked to feeding equipment, are fully assessed and clearly explained to staff?
- 02How do you now identify and report possible safeguarding concerns to the local authority?
- 03How do you check that all Deprivation of Liberty Safeguards conditions are followed and that any temporary move is lawfully authorised?
- 04For anyone receiving medicines covertly, where are the capacity assessments and best-interest decisions recorded?
- 05What changes have been made to audits so they identify missing care guidance, risk assessments and statutory notifications promptly?
This was an announced inspection covering all five key questions, including observations of care, detailed reviews of three people and records for all five people living at the home. This explanation was written from the published report of 1 December 2017 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 52 Mill Lane
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- January 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 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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46 live-in carers within about an hour of Brighton and Hove
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 £1,020 to £1,280 a week. 37 can care for a couple. 10 years' experience on average.
“Lottie showed incredible patience and empathy, adapting her routine to fit in with Mum's moods. Most importantly, Lottie's cheerful manner helped Mum to get some enjoyment out of life.”
“He was infinitely patient with them and got on very well with us to the extent that we now regard him as a personal friend.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.