Archived: Mill View Care Home

Updated 26 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was brought forward due to concerns raised by the local authority commissioning team and the Clinical Commissioning Group (CCG) regarding some poor nursing practices within the home.

The inspection took place on 20 and 21 September 2017 and was unannounced. The inspection team comprised of an adult social care inspector, a medicines inspector, two specialist advisors who had professional experience in the areas of nursing and mental health and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. This person had experience of older people who used residential services

Prior to the inspection we looked at the information we held about the service in the form of notifications, safeguarding concerns, whistle blowing and complaints. We also received a provider information return (PIR) from the provider. This form asks the provider to give us some key information about what the service does well and any improvements they plan to make.

During the inspection we spoke with the registered manager, the quality manager, 13 staff, including nurses, care assistants and an activities coordinator and three visiting health professionals. We spoke with 15 people who used the service and six relatives. We looked at six staff files, 21 care files, meeting minutes, training records, health and safety records and audits held by the service. We observed three meal times on different houses to help us understand the experience of people who were unable to speak with us. We also attended a residents’ and relatives’ meeting.

Updated 26 October 2017

The inspection took place on 20 and 21 September 2017 and was unannounced.

Mill View is a care home providing nursing and personal care for up to 180 mainly older people within six houses. It is situated in Great Lever about half a mile from Bolton town centre. The home is situated in its own grounds with garden areas and car parking available at the front of the home.

There was an interim registered manager in place, who had been tasked with managing the home for six months and inducting a new manager within that six month period. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During the inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regard to medicines and maintaining records. You can see what action we told the provider to take at the back of the full version of the report.

People who used the service that we spoke with told us they felt safe. The recruitment procedure was robust and there were sufficient staff on each of the houses to meet the needs of the people who used the service.

There were appropriate safeguarding and whistle blowing policies in evidence. Safeguarding issues were addressed appropriately and staff undertook regular training in safeguarding.

General and individual risk assessments were in place and were up to date. Health and safety records were complete and up to date. Medicines systems were in place but we found there was some missing medication, gaps in topical medicines administration and unsafe storage of thickener powder.

There was a comprehensive induction programme and training was on-going for all staff. We saw evidence of staff supervision sessions which were undertaken on a regular basis.

The food and drinks were plentiful and nutritious. The environment was clean, bright, pleasant, tidy and clutter free. There were dementia friendly signs to help orientate people living with dementia around the home.

There were appropriate care plans and risk assessments included in the care files. However some recordings were not up to date and monthly evaluations of care plans had not always been completed as required.

Appropriate referrals were made to other agencies and we saw evidence that the home worked well in partnership with other agencies.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

People we spoke with told us they were cared for with kindness and compassion and staff were respectful to them. We observed care on the different houses over the two days of the inspection. We saw good, friendly interactions between staff and people who used the service.

There was a service user guide which included information about the services offered. We saw evidence within the care plans of involvement of people who used the service and their families in care planning and review.

People were supported to be comfortable and as pain free as possible when nearing the end of their lives.

There was evidence of activities occurring within the home. Activities included gardening club, musical bingo, manicures, arts and crafts, shopping at Bolton market, table top games, knit and natter, hymn singing and film club. We saw photographs of old Bolton, and old music and film stars to aid reminiscence.

Care plan files examined were easy to navigate through and contained clear, detailed care plans. There was a good level of person-centred information within the plans. However, several of the care plan monthly reviews were not up to date as per the home’s procedure.

Residents’ and relatives’ meetings were undertaken regularly. Customer feedback was also encouraged in each house and we saw the service had responded to some suggestions made. There was an appropriate complaints policy and procedure in place.

Regular meetings were taking place between the home and the CCG regarding issues previously identified on the nursing houses. There was an improvement plan in place and progress had been made with regard to all the concerns.

A number of audits and checks were undertaken on a regular basis. These were followed by action and improvement plans to address any issues identified.

We saw evidence of staff support via one to one meetings, group supervisions and regular staff meetings.