Mill View Care Home

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

The inspection was carried out by 3 inspectors, 2 medicines inspectors 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

Mill View Care Home is a ‘care home’. 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. Mill View Care Home is a care home with nursing care. 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 there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the service, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also asked for 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 (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 24 people and 8 relatives about the home and care provided. We also spoke with 20 members of staff, which included the registered manager, divisional director, nurses, senior carers, care assistants, activity, kitchen and housekeeping staff.

We reviewed a range of records and other documentation. This included 10 people’s care records, risk assessments, safety records, supplementary charts, audit and governance information. We looked at medicines and associated records for 18 people. We also reviewed 4 staff files, to ensure safe recruitment practices had been followed.

After the inspection

We reviewed additional evidence from the provider. This included staff competency checks and governance documentation.

Updated 20 September 2023

About the service

Mill View Care Home is a large purpose built residential care home which is registered to provide both personal and nursing care to up to 180 people. The home consists of 6 separate 30 bedded units which provide a mix of residential, dementia and/or nursing care, although only 5 units are currently in use. At the time of inspection, 117 people were living at the home.

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

We found improvements were required with medicines management, governance processes and record keeping. We also identified staff did not always have time to complete all of the responsibilities asked of them.

We have made recommendations about how staffing levels are determined and the providers quality assurance process.

People felt safe living at Mill View Care Home and overall spoke positively about the care and support they received. Staff were reported to be very busy and as a result were unable to regularly facilitate activities, which was one of their newer responsibilities. Staff had received training in safeguarding and knew how to identify and report concerns. Accidents, incidents and falls were documented and reviewed to identify patterns and trends and consider lessons learned. Risk assessments provided guidance for staff on how to keep people safe and meet their needs. The home was clean, with effective cleaning and infection control processes in place.

Audits and monitoring were used to assess the quality of the care provided. However, these had not consistently identified shortfalls, such as the issues we found with medicines management. The majority of people and relatives we spoke with said they would recommend the home. They spoke positively of the care and the staff who provided this. People, relative and staff’s views were sought through regular meetings. Views were also gathered though surveys and questionnaires. Although any actions from these were added to the home’s improvement plan, feedback was not currently being provided to people or relatives.

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

Rating at last inspection

The last rating for the service was good (published 1 January 2022).

Why we inspected

This inspection was prompted by a review of the information we held about this service, along with concerns reported by the local authority during meetings held with them. Concerns included an increase in safeguarding referrals and other reporting.

We undertook this focused inspection to assess whether the current rating of good was still accurate. This report only covers our findings in relation to the key questions safe and well-led, as these were the only key questions inspected.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings at this inspection.

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

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 and Recommendations

We have identified a breach in relation to medicines management at this inspection. We have also made a recommendation relating to staffing.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.