Mill House is a 'care home'. People in care homes receive accommodation and nursing and personal care as a single package under a contractual agreement with the local authority, health authority or the individual, if privately funded. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Mill House provides accommodation and personal care for up to four people who have a learning disability. Mill House is an adapted residential property which can accommodate four people. The service is situated in a residential area of Colchester and is close to amenities and main bus routes. The premises is set out on three floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service. At the time of our inspection four people were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.' Registering the Right Support CQC policy.”

At our last inspection of this service on 12 November 2015 the service was rated Good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring, that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

We found systems and processes were in place to keep people safe. Staff understood their responsibilities for safeguarding people they cared for and assessed risks to their health and safety. Measures were in place to reduce these risks and people were supported to stay safe, whilst not unnecessarily restricting their freedom.

Incidents and accidents were reported and the management team completed a detailed analysis and investigation to reduce the risk of similar incidents happening again. All incidents were reviewed on a regular basis.

Medicines were managed effectively and safely. The premises and environment was generally well maintained and the required safety checks were completed. Infection prevention and control was effectively managed.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills. People's needs were assessed and care was delivered in line with national guidance. Care plans contained detailed information about each person's individual support and their preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

Although most people were unable to fully express themselves verbally, they clearly enjoyed living at the service and appeared to be relaxed and happy. Staff had developed caring relationships with people and treated them with kindness and respect. People felt able to express themselves in a safe and supportive environment.

People continued to receive care that was responsive to their individual needs. Staff had a detailed knowledge of the people they cared for and were able to recognise subtle cues from people that enabled them to respond effectively to th

Mill House provides care and support for up to four adults who have a learning disability. There were 4 people living in the service when we inspected on 12 November 2015.

There was a registered manager in post. 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.

There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

Staff understood how to minimise risks and provide people with safe care. Procedures and processes were in place to guide staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs. People were treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

People received care that was personalised to them and met their needs and wishes. Staff listened to people and acted on what they said. The atmosphere in the service was friendly and welcoming.

Care and support was individual and based on the assessed needs of each person. People’s care records contained information about how they communicated and their ability to make decisions. Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to pursue their hobbies and interests and participated in a variety of personalised meaningful activities.

People or their representatives were supported to make decisions about how they led their lives and wanted to be supported. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. The service was up to date with changes regarding the Deprivation of Liberty Safeguards (DoLS).

People’s nutritional needs were being assessed and they were supported to eat and drink sufficiently. People were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the service. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.

On our inspection on 12 June 2013 we found that the gas and electricity supply had not been tested. We also found that there was no risk assessment in place for the control of Legionella bacteria. On this inspection we found that the gas and electricity supply had been tested and certified and there was a Legionella policy in place.

At this inspection we found that people were asked for their consent to their care and where people were unable to give consent, the appropriate legislation and guidance had been followed. One member of staff told us they had received Deprivation of Liberty training.

People using the service had complex needs that were accurately reflected in their personalised care plans. People seemed happy and relaxed and there were good interactions between staff and people using the service. People were able to be involved with the community and pursue their interests. One person told us "I really enjoy going out walking to the woods".

The service was clean and there were appropriate procedures in place to reduce the risk of infection.

The service was well maintained but there was no current gas or electricity certificate or legionella risk assessment. We could not be sure that people were protected from those risks.

Records were up to date, care plans reflected the needs of people and they were kept securely.

At the time of our visit three out of the four people living at Mill House were out shopping and there was only one person present in the home. The people using the service had complex needs which meant that people were not able to tell us their experiences. The person we saw and met appeared happy, relaxed and well cared for. From our observations and time spent at Mill House we saw that the people living there were receiving the care and support they needed in an individual way and wherever possible staff tried to facilitate choice and independence. Staff looked after people's healthcare needs in a proactive way and medicines were managed safely and appropriately.

The staff team were well trained and supported to carry out their role.

People with whom we spoke told us that they were aware of their care plan. One person told us that a member of their family was also involved, which they were very happy about. One person told us that they were happy with the care and support that they received. One person told us that the care staff were friendly and kind.

People with whom we spoke told us that the care staff support in meal preparation as required. People said that they had been asked if they had any specific dietary requirements, likes, dislikes and cultural needs that the staff should be aware of.

People with whom we spoke told us that they felt safe and able to talk to staff if they were unhappy and/or had any concerns. People with whom we spoke told us that the staff support them to manage their medication. One person told us that they were happy with the staff supporting them with their medication.

People with whom we spoke told us that they liked the staff that worked with them. One person with whom we spoke told us that the staff are "really nice." People told us that staff listen to them and ask them their views.