Mill House is a ‘care home’. People in care homes receive accommodation and nursing or 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. Mill House accommodates up to 45 people in one building. At the time of our inspection there were 27 people living at the care home.

At the time of our inspection Mill House did not have a registered manager in post. An application for registration had been submitted by the current 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.

At our previous inspection in October 2015 the service was rated “Good”. At this inspection we found the service remained “Good”.

At our previous inspection we found people were not protected against the appointment of unsuitable staff because robust recruitment practices were not always followed. Attention had not been given to some aspects of recording how people should be given their medicines. At this inspection we found improvements had been made to staff recruitment procedures and the management of people's medicines.

We heard positive comments from people using the service at Mill House such as, “We feel very comfortable here”. “I looked at several homes so that I could choose the right place and I am very pleased with this place”.

People were protected from harm and abuse through the knowledge of staff and management. Risks in respect of people's daily lives or their specific health needs were assessed and appropriately managed with plans in place to reduce or eliminate those risks. Sufficient staff were deployed and robust staff recruitment procedures were used. We home was clean and had been well maintained.

Staff were supported to maintain their skills and knowledge to support people. People were assisted 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. People were consulted about meal preferences and enjoyed a varied diet. People’s health care needs were met through on-going guidance and liaison with healthcare professionals.

People received support from caring staff who respected their privacy, dignity and the importance of their independence. People received personalised care and had opportunities to take part in activities both in the care home and in the wider community. People were supported to maintain contact with their relatives. Care was provided for people at the end of their life. There were arrangements in place for people and their representatives to raise concerns about the service. Effective quality monitoring systems were in operation. The current manager was approachable to people using the service, their representatives and staff.

Further information is in the detailed findings below.

We did not speak with any people at this inspection as we were following up on an action we made at the last inspection. We found at our inspection on the 8 October 2013 a thorough recruitment procedure was not in place to protect people from the risks of unsuitable staff. At this inspection the registered manager told us about the changes they had made to make sure the required information was in place before new staff started working at the service. We examined some personnel records and found an effective recruitment and selection process was now in place.

When we inspected there were 37 people living in the home. We spoke with 11 people who used the service and seven staff. We also made our own observations during the visit.

People who used the service told us they were satisfied with the service they received. Most people said the staff supported them and met their needs. One person who used the service said "I'm perfectly happy here."

Most people told us that staff treated them with dignity and respect. One person said “staff respect me as a person.” We saw staff speaking and responding to people in a kind and respectful manner.

The care records showed us that people's health needs had been assessed before they came to live in the home. These records included information from health and social care professionals which helped ensure people got the care and treatment they needed.

Some recruitment records showed that new staff had been completely checked to make sure they were suitable to work with vulnerable people. The home trained their staff and had the procedures which protected people from any form of abuse. People told us they did not have any complaints but would speak to the manger or staff if they had any concerns. One person said “I went to the manager and things got immediately resolved.”

The service and the building were monitored and risk assessed to ensure they were suitable for the people who used them.

The evidence we collected showed us the service kept people safe and met their care needs.

This inspection took place on 21 and 22 October 2015 and was unannounced.

Mill House is a care home for up to 45 people. At the time of our inspection there were 34 people living at the home.

Mill House had 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.

People were not fully protected against the risk of being cared for by unsuitable staff because robust recruitment procedures were not always applied.

Medicines were stored and managed safely although we found the policy had not always been followed for counter-checking hand written directions for giving people their medicines.

People were protected from the risk of abuse by staff who understood safeguarding procedures.

There were sufficient numbers of staff who received appropriate training and had the right knowledge and skills to carry out their role.

Management and staff at Mill House protected people’s rights through an understanding of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS).

People received support to meet their health care needs and were consulted about the meals they were provided with.

People were treated with kindness, their privacy and dignity was respected and they were supported to maintain their independence.

People received personalised care and there were arrangements in place for people and their representatives to raise concerns about the service.

The vision and values of the service were communicated to staff. Quality assurance systems were in place to monitor the quality of care and safety of the home. As part of this, the views of people using the service were taken into account and responded to.