Archived: Millicent Preston House

Millicent Preston House provides extra care housing and has 34 flats. The service provided accommodation and daytime support. Evening support was provided by an external service. People who were assessed as needing support with personal care and/or medicines had staff support.

Each flat had its own bedroom, living room, kitchen and bathroom area. Some people had their own garden on the ground floor. There were communal areas where people could sit and watch television or relax.

There was a registered manager at the service. 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.

People were kept safe in the service as the service provided people with a pendent to call staff and they had call bells in their flats. Staff carried a mobile and cordless telephone at all times when on site so they could respond to calls from people in their flat.

Medicines were administered safely and people who took medicines had up to date risk assessments informing staff of possible side effects to be aware of.

Safe recruitment was followed as staff references and a criminal records checks were carried out before employment commenced.

Care was provided by staff who had up to date skills and knowledge and long term experience in giving care. Regular training was provided to staff and they had their medicines competence observed by management as part of supervisions and one to ones.

Staff understood the principles of the Mental Capacity Act and the need to assess peoples capacity on a regular basis. People had capacity in the service and nobody was restricted under Deprivation of Liberty Safeguards. Staff asked people for consent before giving care and before administering medicines.

People were cared for by kind and compassionate staff who took the time to listen to people and we observe them help people in the service.

Care plans were person centred and provided personal information about people so that staff could get to know the person as an individual. Families were involved in their relatives care and provided information to the service to help ensure care was personalised. Risk assessments with management plans were up to date and reviewed regularly.

People told us they would like to see more activities at the service but these would require personal funding from people. However we did see that the extra care coordinator had worked to bring in different activities to the service such as a library service, fish and chip night, bingo and the local school visits.

Staff and people had regular meetings where they discussed what was happening in the service. Feedback was regularly requested from people at the service, staff and health professionals. The registered manager performed audits of the service to ensure the care provided was of good quality and records we viewed showed that action from audits were completed so that the service improved.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with seven people using the service, three staff supporting them, the area manager and from looking at a selection of records.

Is the service safe?

Staff were recruited via a thorough selection system ensuring staff had the skills required to keep people safe. The home was clean throughout and this was maintained by domestic staff, who were well-led by a supervisor. Staff we spoke with were aware of the Mental Capacity Act [MCA 2005] and of deprivation of Liberty Safeguards [DoLS], which ensured people who lacked mental capacity would be kept safe from harm.

Systems were in place which ensured the home was continually reviewing safety measures. There were systems in place to make sure that the manager and staff learned from events such as falls, accidents and incidents. This reduced the risk of harm to people and helped prevent such incidents in the future.

Is the service effective?

From our observations people were happy with the care that had been delivered and their needs had been met. One person told us, "The care here is excellent.' From speaking with staff and our own observations we found that there was a good understanding of people's care and support needs. Staff we spoke with were clear about how best to support people while maintaining their independence and dignity. Care support plans we read clearly identified areas of concern and staff followed individualised care support plans.

Is the service caring?

People were supported by sympathetic, professional and patient staff who gave encouragement when supporting people. We noted staff interacted with people in a caring manner, asking about their wellbeing and assisting people to organise their days. One person we spoke with told us "we are always asked how we are and if there is anything we want."

Is the service responsive?

We saw in people's case notes we read that relatives were updated regularly by care support staff [where appropriate] on people's wellbeing and when a review of their care plan was planned. The home held residents' meetings and published information on a regular basis on a newsletter which was posted through each person's door. The home had a transparent complaints policy. People we spoke with told us the manager was approachable and they would feel comfortable raising any concerns with her.

Is the service well-led?

The manager held regular staff meetings and used them to communicate issues related to the day to day running of the home. Staff we spoke with were clear about their roles and responsibilities and confirmed that they had the opportunity to attend regular staff meetings. They said they felt supported by the manager. There were systems in place to ensure training was kept up to date for all staff and that the home was continually reviewing its management processes.

We found that the provider had ensured that people had effective up to date support plans which met their needs. People were asked for their consent before they received assistance. Medication administration was effective and safe. Staff received appropriate training and support. Quality assurance arrangements were in place to ensure the service operated to the required standard and any necessary improvements were made.

The service provider's Supported Housing Services Division had recently taken over management responsibility for Millicent Preston House. As a result, systems had been improved and new procedures put in place. For instance, there was a new assessment and care planning process although there had not been time to properly implement this yet. Staffing needs of the service had also been reviewed to bring more accountability and responsibility to roles and the way the service was delivered to people. As part of improving systems, a review of medication procedures had been carried out and audits had been conducted.