Mill House

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The service was not always responsive and has moved to requires improvement in this key question. The care people received did not always meet their individual needs and preferences. Staff knew people’s likes and dislikes and what was important to them. They had the opportunity to attend meetings, however it was unclear how information was gained from people and how this information was used. People did not always have plans in place for their future care.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed feedback from people on whether the care they received met their individual needs and preferences. People felt the staff knew them and their needs well. However, some people told us their care was not always delivered in line with their preferences. One person said, “They wake me up at 8 o’ clock if I’m still asleep. I would like to lie in sometimes, but they wake me up. They tell me it’s bedtime and take me to bed. I don’t get a choice.” Another person’s preference was a bath however there was not one that was suitable for them to use. A third person told us, “All the staff know everything there is to know about me. I like to go to bed early, about 6pm usually. They know that.”

Staff told us they found out about people’s preferences by talking to them and those that were important to them. Staff knew people well, their histories and likes and dislikes. The manager could not evidence they understood how to provide person centred care as when we asked them about this they referred to the provision of personal care rather than person centred care.

We observed some nice interaction between staff and people. People were given choices and staff used the information they knew about people to ensure they had person centred care. Staff were observed playing a game with 1 person which was known to help them settle.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were unable to tell us how they were involved with the planning and review of their care, however relatives felt involved with this. A relative told us, “They keep me updated with care plan reviews, so I know what’s going on.”

Staff were able to explain how they involved people with the delivery of their day to day care. They told us they explained care tasks to people and encouraged them to do things for themselves. The manager told us a monthly conversation had been introduced with residents where ‘everything’ was discussed with them. They also told us resident meetings had been introduced, they said, “Sometimes residents just look at you, so they are a failure.” This meant the manager had failed to understand how to engage and involve people in these meetings.

Resident meetings had been introduced. It was unclear how this information was used to make changes as there were no action plans formed in response to these meetings. People’s care plans included information about their preferences although there was no evidence to show how and if people had been actively involved in this process. There was a complaints policy in place. We could not be assured this was followed as the manager told us the provider responded to complaints and complaints records were not available within the home for us to view.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People and their relatives were unable to confirm if they had been involved in the planning of future care. We received no negative feedback relating to this.

Staff told us that some people had end of life plans in place, and they had talked to people about what their wishes were. The manager confirmed not everyone would have a care plan in place for decisions about their future. They said all people had ReSPECT forms and they were aware when people had funeral plans. ReSPECT forms contain a personalised recommendation for clinical care in emergency situations where people are not able to make decisions or express their wishes.

ReSPECT forms were on file for people, and these showed that where appropriate people had been included in this process. However, there were no end-of-life care plans in place for any of the people we viewed. It was unclear when people were end of life care as the information the manager told us did not always match records on people’s file. The funeral plans the manager told us were in place were not always documented on people’s files or available to view. This meant people may not receive the support needed at the end of their lives.