The Mill House Care Home

Since the last inspection there had been changes in registered manager. There was a new registered manager in post who was continuing to make changes to improve outcomes for people. The registered manager was supported by the previous registered manager who was part of the provider's management structure, as well as the owner who is the provider.

At this inspection, we found some improvements to medicines management, care planning and risk assessments. The provider had improved and increased their quality assurance systems and checks which were mostly effective. However, further improvements to some quality assurance systems were needed because some of the issues we found related to medicines, care planning and risk assessments at this visit had not always been identified from completed checks.

Electronic care planning and risk assessments were completed for people however in some cases, where a person had fallen or if people had risks related to certain activity, these were not always completed. However, we were assured people were safe and staff knew people's risks and how to safely manage those identified risks.

Additional checks made sure medicines were administered and stored safely. Better recording of some medicines, such as topical creams and pain patch medicines would help to demonstrate medicines were administered safely. The registered manager took immediate action during our visit to improve medicines administration practices to ensure people continued to receive medicines safely. Positive links with a local GP practice ensured people were reviewed and seen promptly.

Infection control systems ensured the home was clean. Housekeeping staff supported the home in addition to care staff. Maintenance staff completed regular checks on health and safety to ensure the home remained safe for people.

People's overall feedback to us was positive of a service they received that they felt met their needs. People knew how to raise an issue and when they did, they were confident they were listened too. People and relatives could attend meetings to share any feedback about the service. Post pandemic, plans were in place to increase the frequency of these meetings.

People felt the service was responsive to their needs. Staff knew people well and we saw during our visit, staff quickly responded to situations to help maintain an environment that promoted good care.

Staff interacted with people at their pace, unrushed and joked and laughed with each other. Staff in all roles were empowered to involve, engage and to sit and chat to people which helped develop relaxed and genuine relationships. People were involved in pursing their hobbies and interests. Social activities and engagement was a key feature that recognised the importance of promoting people's emotional and physical wellbeing. Day trips, gardening, book clubs, quizzes were just some of the activities people were involved in. Further opportunities were planned with people's involvement to continue to support people's interests.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Visitors were welcomed and there were no restrictions on visiting arrangements. Relatives were able to visit, and they were encouraged to book a visit in advance to help manage any potential risk.

Staff understood their responsibility to report any concerns to protect people from the risk of abuse.

Staff were positive about the management of the home and staff said people received a good quality of care. Staff enjoyed working at the home and staff said it felt like one big family. The provider had their own staff team and did not rely on agency staff so staff who supported people knew them very well. Staff had received training in key areas and staff said they felt supported to pursue additional training and opportunities to increase their knowledge and confidence.