We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.About the service
Mill Lodge is a residential care home in a converted period building that was full at the time of the inspection, providing personal care to three younger adults all living with a learning disability and additional health needs.
People’s experience of using this service and what we found
Right Support
Mill Lodge is situated in a seaside resort with good public transport links meaning people had opportunities to fully engage with the local community. The model of care maximised people’s choice, control and independence and this was evidenced at this inspection.
Care plans showed people were fully involved in the support they received, and staffing arrangements meant people could be flexible in how they wished to spend their day. The provider’s values were embedded within the service meaning people were supported with life skills and seeking job opportunities. People’s relatives told us the service achieved positive outcomes for people that had improved the quality of their lives.
Right Care
People benefitted from being supported by staff who had been trained, supported and felt valued. Staff had the skills and training to provide person-centred care that met people’s needs and placed them at the heart of the care they received. Care plans showed discreet, respectful and dignified care was considered and our observations and discussions with people confirmed this was in place.
The risks to people had been identified, assessed and mitigated and the environment met people’s needs. Medicines were administered safely, and people received the health care they needed to keep them well. The service adhered to the Mental Capacity Act 2005 and consent was consistently sought. People’s hydration and nutritional needs were met, and people received a varied and nutritious diet of their choosing.
The relatives we spoke with told us the service was well-managed, communicative and effective. They shared examples of how the service had had a positive impact on their family members lives, all describing their family members as happy and fulfilled.
Whilst people received a dedicated, person-centred and meaningful service, the governance systems in place did require some improvement. For example, end of life care needs to be explored with people and they need to ensure consistent recruitment checks are in place. Additionally, audits need to be meaningful and the provider needs better oversight of the service in case of deterioration. Recommendations made by other stakeholders need to be actioned in a more timely manner.
Right Culture
The service had a positive, nurturing culture that placed the people who used it at the centre of it. People were encouraged to participate in activities, community events and to seek volunteering opportunities if they so wished. This was achieved by a provider ethos that supported and encouraged this with systems in place to achieve it. Staff told us they felt supported, listened to, valued and able to contribute to the care people received and the success of the service.
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 24 April 2019) and there were 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
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.