We carried out a review of the data available to us about The Mullion on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Mullion, you can give feedback on this service.
The Mullion is a residential care home providing care and accommodation for up to three people who are living with a learning disability. At the time of our inspection there were three people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of safe, effective and well led the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
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.
The provider's vision and values focused on person-centeredness, being passionate about making a difference to people's lives and ensuring positive outcomes for people. We observed staff understood and cared for people in a manner that was in keeping with these principles.
Staff anticipated and managed risk in a person-centred way, there was a culture of positive risk taking. Staff demonstrated their knowledge of people and how to support them to manage their individual risks. There were appropriate policies and systems in place to protect people from abuse. Staff and the registered manager understood their responsibilities to safeguard people. Accidents and incidents were documented and investigated with action taken to prevent a reoccurrence.
People's needs were assessed, regularly reviewed and included their physical, mental health and social needs. People were supported to maintain contact with their family members and the provider facilitated visits for people living in the home in accordance with government guidance.
People received their medicines safely in line with their preferences and by staff who knew them well. However, we found some records relating to medicines had not always been completed in line with best practice. The provider took action to address this during the inspection.
Staff told us there were enough staff to meet people’s needs and we observed safe staffing levels throughout the inspection; staff appeared unhurried and responsive to people. Staffing levels were based on the needs of the people living at the service and were changed in response to people’s changing needs. Safe recruitment processes were in place and people were supported to be involved in recruitment.
People were supported with personalised menu planning and care plans confirmed people’s dietary needs had been assessed with support and guidance recorded for the individual. People were supported to see health care professionals according to their needs. The management and staff team worked in partnership with a variety of healthcare professionals and had developed good working relationships which supported positive outcomes for people.
People's rooms were personalised, and people were offered opportunities to be involved in deciding the décor. There was some required maintenance, and some outstanding actions, that once completed would enhance the environment.
Staff were positive about the training they had received. They told us they felt confident and competent in supporting people with their individualised needs. Staff new to the service, including agency staff, were supported with a robust induction programme.
The provider's vision and values focused on person-centeredness, being passionate about making a difference to people's lives and ensuring positive outcomes for people. The registered manager was passionate about person-centred support and deployed staff effectively to ensure they had time to spend with people to meet their needs and to promote their independence.
The provider had systems and processes in place for monitoring the quality of care and to drive improvements. Staff felt included, confident and supported in making suggestions. The registered manager spoke about the importance of valuing staff and strived to be inclusive and supportive.
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 this service was good (published 12 December 2017).
Why we inspected
We received concerns in relation to safeguarding and management oversight. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained good based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Mullion on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This inspection took place on 12 October 2017 and was announced 24 hours in advance to ensure someone would be at the home.
At the last inspection on 30 June 2015 the service was rated Good. At this inspection we found the service remained Good.
There was a friendly atmosphere in the home and staff supported people in a kind and caring way that took account of their individual needs and preferences. People and their families were supported to express their views and be involved in making decisions about their care and support.
There were systems and processes in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.
Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.
Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.
The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People could be confident that any concerns or complaints they raised would be dealt with.
We received positive feedback about how the service was managed. A new manager had been in post since May 2017 and had applied for registration. There was an open and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.
This inspection visit took place on 30 June and 1 July 2015. The inspection was announced 24 hours in advance because the service was a small care home for younger adults who are often out during the day.
The Mullion provides accommodation, personal care and support for up to three people who have learning disabilities. There were three people using the service at the time of this inspection.
The service has a registered manager. 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.
We observed the care and support provided to people to help us understand their experiences of the service. We also spoke with their relatives who told us they felt the service provided safe care and support. There were systems and processes in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.
Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.
Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were in place or had been applied for.
People received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.
Some areas of the home were in need of repair and redecoration and there were plans in place to ensure the home environment continued to meet people’s needs.
The atmosphere throughout the home was friendly, calm and caring. The staff spoke about people in a respectful manner and demonstrated understanding of their individual needs.
The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.
Relatives spoke positively about how the service was managed. There was an open and inclusive culture within the service, which encouraged people’s involvement and their feedback was used to drive improvements. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.
We saw that care plans were not kept under regular review and some were dated 2011 and 2012. This had been picked up the quality auditing system with a target date set for the end of July 2013
We saw that most of the improvements to the environment that we asked for at the last inspection had been addressed.
There were processes in place to ensure that medicines were stored and administered safely. Only trained and competent staff attended to this.
Staff told us they enjoyed their jobs and they thought the home was well run. They knew the people they supported well and showed a good understanding of their needs and wishes.
We met two casual staff, one permanent member of staff and the acting manager. All staff were kind, friendly and respectful to the people they were supporting. The casual staff were employed from a "bank" of staff recruited and trained by the organisation. They knew people well and said they had received appropriate training as well as on going support.