The Old Mill

Not everyone who used the service received the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

The registered manager had notified us of some but not all the safeguarding allegations they were legally required to. Quality audits were carried out to monitor the quality of the service provided, however the monitoring of staffs' time keeping whilst actioned were not always formally recorded.

Staff had a good knowledge of the people they supported and had access to information in peoples' care plans and risk assessments. This information that helped guide staff to care and support people safely and effectively. However, these records could be more detailed to help reflect staffs' knowledge and reduce the risk of impact to people if the staff member with knowledge left.

We have made a recommendation to the provider about improving the level of detail within people's care records and risk assessments.

Not everyone needed medicines administration support from staff. Where this support was required, staff were trained to administer people's prescribed medicines safely. Their competency to administer medicines in line with their training was checked by more senior staff. People fed back that staff were kind and respectful towards them. People told us there were enough knowledgeable and trained staff to meet their care and support needs. Staff understood how to keep people safe from poor care and harm. Staff confirmed that they would feel confident to whistle-blow any concerns they had to their registered manager or the CQC. Where people wanted to discuss their end of life wishes this information would be recorded to guide staff.

Staff told us they were trained in infection prevention and control and people confirmed that staff followed good practice guidance in relation to this. Systems were in place to learn lessons when an incident, accident or near miss occurred or there was a risk of this.

People, and their relatives had positive opinions on the communication of the office staff and management team. They told us the various ways staff requested feedback on the service. This included verbally during staff spot checks and via a survey. Staff were encouraged to discuss and review their performance through supervision and team meetings.

Staff encouraged people, where this level of support was required, to drink and eat plenty. People told us they were encouraged by staff to make their own choices and these choices were respected. Staff helped promote and maintain people's privacy and dignity. People gave examples of how staff did this. Staff also encouraged people to be as independent as possible. With the support from staff, people were able to remain in their own homes. Staff also encouraged people and their relatives, where appropriate, to be involved in discussions around their support and care needs.

The registered manager worked with external health and social care professionals. This helped people receive joined up care and support. There was a process in place to investigate and resolve complaints where possible. Actions were taken because of learning to try to reduce the risk of recurrence.

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.