Archived: Mill Hayes Residential Home

Updated 1 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Mill Hayes is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with one person and we observed the interactions between staff and people throughout the day. We reviewed two people’s care plans and looked at the medicine records for all five people. We spoke with six members of staff including the registered manager, operations manager, support staff and the maintenance person. We looked at one staff file and various other records the home used on a regular basis to assist them in managing the service. These include audit reports, checklists, and training records

After the inspection

After the inspection we spoke with the local authority and the mental health trust which supports the service. We discussed evidence found on the day and the incident which triggered this inspection to take place.

Updated 1 October 2019

About the service

Mill Hayes is a residential care home providing personal care to five people under 65 at the time of the inspection. The service can support up to seven people with diagnosed learning disabilities, autistic spectrum disorder and mental health needs. The building has been configured to meet the needs of people with complex behaviour. People at the home have their own bedroom with additional lounge space. As well as access to a shared lounge, conservatory and large kitchen. People have access to outside space and the building is close to local amenities.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Risks to people’s safety were assessed and no areas of concern were identified within the environment. People were protected from the risk of infection and the building was being repaired when damaged.

People were protected from harm by staff who understood and felt confident to speak up. People were supported by enough staff and who when recruited were subject to a probationary period.

People’s medicine was stored securely and administered by trained staff. Medicine errors were investigated and action taken where necessary

Lessons were learnt when things went wrong, and information shared as required. The service tried to continually improve and work in partnership with others.

People were supported to achieve positive outcomes and have new experiences. People accessed the community and were supported to build new relationships.

Staff were clear about their role and responsibilities and worked well as a team. People were engaged with and helped to develop a service that was less restrictive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 June2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted in part by a notification of a specific incident. Following which a person using the service could have experienced significant harm. This incident is subject to further investigation by other parties. As a result, the inspection did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about unsafe medicine management.

We undertook a focused inspection to review the Key Questions of Safe and Well-led only. We reviewed the information we held about the service and no areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection. We found the service has improved. However, the overall rating for the service has remained as requires improvement. This is based on the findings from the previous inspection being included.

We found no evidence during this inspection that people were at risk of harm.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mill Hayes Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.