Millwater

Updated 20 September 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector and 2 Experts 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.

Service and service type

Millwater is a care home without nursing. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection a registered manager was in post.

Notice of inspection

Our first inspection visit on 02 August 2023 was unannounced and was undertaken by the inspector and 1 Expert by Experience. Another Expert by Experience gathered feedback from people’s relatives via the telephone on 04 August. The inspector retuned to the service on 07 August 2023.

What we did before the inspection

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

During the inspection

We spoke with 4 people and 5 people's relatives to find out what it was like to live at the home. We spent time with people and observed the care and support they received in communal areas to help us understand the experiences of people who could not talk with us. We spoke with 9 members of staff including team leaders, support workers and the registered manager.

We reviewed a range of records which included 4 people's care records and 5 people's medication records. We reviewed the recruitment records for 3 staff members to make sure they had been recruited safely and we looked at a range of checks the management team completed to assure themselves people received a safe, good quality service.

Updated 20 September 2023

About the service

Millwater is a residential care home that provides accommodation and personal care for up to 19 people with learning disabilities and/or autism. The home is split into three separate units which share a court yard garden area. At the time of the inspection 13 people lived at the home.

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

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.

Right support

People’s care and support was personalised. The accommodation met people's needs and plans were in place to refurbish some areas of the building. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests, the policies and systems in the service supported this practice. People's independence was promoted and their right to privacy was respected.

Right Care

Some aspects of medicines management needed to be improved. People felt safe living at Millwater. Staff had been recruited safely and they completed training to help them carry out their roles effectively. Staff knew people well and people and staff had developed positive meaningful relationships. Risks had been assessed and care records contained information which helped staff to provide safe care. People had access to a range of healthcare professionals which supported them to remain healthy and well.

Right culture

The registered manager demonstrated a good understanding of their role and regulatory requirements. However, some of the provider's governance systems were not always effective. The culture at the service had improved since our last inspection. People were empowered and their feedback was welcomed and listened to. Staff felt valued and the registered manager had a good overview of the care and support provided to people. People were supported to maintain relationships that were important to them which had a positive impact on their lives. People followed their chosen religions and were supported to embrace their cultural traditions.

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 08 July 2019) and there were 2 breaches of the Regulations. At this inspection we found the provider remained in breach of 1 regulation.

The service remains rated requires improvement and we have found evidence the provider needs to make improvements. Please see the safe and well-led section of this full report. This is the second time the service has been rated requires improvement.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and was also prompted by a review of the information we held about this service.

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.

Enforcement

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.