About the service:

Himley Mill is a care home that accommodates 86 people in three separate households. Beech, Kingswood and Woodlands. At the time of our inspection 76 people were living in the home. Within each household there are various communal areas including lounges and dining areas. There are also garden areas that people can access.

People’s experience of using this service:

The care people received was safe. Individual risks to people were considered. Safeguarding procedures were in place. Medicines were managed in a safe way. There were enough staff available for people. Infection control procedures were implemented. Lessons were learnt when things went wrong in the home.

The care people received was effective. People were supported to have maximum 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. Staff received training that helped support people. People received support from health professionals when needed. People enjoyed the food and were offered a choice. The environment was adapted to meet people’s needs.

People and relatives were happy with the staff that supported them and staff supported them in a kind and caring way. People were offered choices, remained independent and their privacy and dignity was maintained.

People received care that was responsive to their needs. The care they received was individual and specific to their needs. People had the opportunity to participate in activates they enjoyed. There was a complaints procedure in place. Plans were in place when people were receiving end of life care.

The service was well led. Systems were in place to manager quality within the home, information was used to drive improvements. The provider sought the opinions of people who lived at the home and used this information to make changes. Staff felt supported to and listened to.

More information is in the full report.

Rating at last inspection:

Requires Improvement (Last report published 24 May 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This comprehensive inspection visit took place on the 10 April and following further information of concern we also inspected this service on 1 May 2018 this was unannounced.

Himley Mill is a nursing home. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Himley Mill is registered to accommodate up to 86 people in three separate households, Beech, Kingswood and Woodlands. Within each household there are communal areas including a dining room and garden area for people to access. This is the first inspection since the provider changed in 2017.

There was a registered manager in place on the first day of inspection, however they have since left their post and a new manager is now in place. 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.

All risks to people had not been fully considered to ensure they were safe. We asked the provider to take immediate action and after the inspection and they offered us the necessary reassurances within the 72 hour timeframe. We found people were not transferred in a safe way and guidance for staff to follow was not always in place.

For some people when needed capacity assessments were not in place and decisions were not always made in people’s best interests. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

There were some audits completed by the provider however these had not always identified when improvements were needed in relation to people’s risk and areas of concern we identified during out inspection. People did not receive always receive care that was timely or responsive to their needs. The provider had not fully considered how to support people who were unable to verbally communicate their needs and wishes.

People were protected from the risk of abuse. There were sufficient, suitably recruited staff available to offer support to people. Staff were trained and supported to meet people’s needs. There were systems in place to ensure medicines were managed in a safe way. Staff followed infection control procedures to ensure the environment was clean and safe for people.

People enjoyed their meals and had the opportunity to participate in activities they enjoyed. When needed, people receive support from health professionals who the home worked jointly with. People were happy with the care they received and were encouraged to be independent. People’s privacy and dignity was promoted and they were encouraged to make choices over how to spend their day.

The provider had a complaints procedure in place. Staff felt supported be the management team and were happy to raise concerns. People were encouraged to give their feedback on where the service could be improved. There was a registered manager in post and they understood their responsibility around registration with us.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This is the first time the service has been rated Requires Improvement.