A single inspector carried out this inspection. We reviewed the evidence we had obtained during our inspection and used this to answer five key questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

Is the service safe?

People were cared for in an environment that was secure. As the service was new it had been specifically designed and equipped to meet people’s needs and ensure their safety and well-being.

Staffing levels were routinely tailored to the numbers and needs of people using the service at any one time. It was recognised that due to the high levels of need that a stable pool of staff was desirable and the service was able to provide this.

The service’s staff and managers had recently undertaken training in the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLs) to ensure they had the knowledge to protect people who could not make decisions for themselves. We noted that assessments were in place regarding people’s mental capacity to make their own decisions. The managers were aware of recent changes in relation to DoLs guidance and were awaiting further information from the provider, the Norfolk Community Health and Care NHS Trust.

Is the service effective?

People who used the service had complex needs and often significant communication difficulties. We noted that the service had effective links within the Trust for support as well as from external healthcare professionals. When issues arose there was ongoing communication with people’s relatives to ensure they were consulted and involved in their family member's care.

During our visit we observed that people receiving care seemed content. Staff were responsive to people’s behaviours and familiar with people’s differing methods and meanings of communications. This helped ensure that people were supported effectively.

Is the service caring?

Staff were kind and attentive. We observed they were patient when assisting people with their evening meal. We saw that people were not rushed with their meals. If people did not appear to be enjoying what they were offered, an alternative was found.

Is the service responsive?

People’s needs had been assessed before their initial stay at Mill Lodge. However, as staff got to know people they were able to utilise their own experiences of how to communicate and care for them, and incorporate this knowledge in to people’s care planning. We also noted details of how best to offer re-assurance to people if they became anxious so that staff had the information they needed to provide this consistently to people.

We noted from people’s care records that people’s likes and dislikes were clearly recorded and care and support had been provided in accordance with people’s preferences. For example, we were told about one person who had unusual sleeping arrangements. The staff had satisfied themselves, after some trial and error, that this was the person’s choice and this unusual arrangement had been adhered to.

We saw that all families who participated in the service’s survey felt that the service met both their family member’s needs and their needs.

Is the service well-led?

Staff fully understood the ethos of the service and participated in meetings designed to identify areas requiring attention and exchanged ideas about how best to deliver the service for people and their families.

There were quality assurance processes in place to ensure people received a good service. The service worked effectively with people using the service, their relatives and other healthcare professionals to make sure people received their care in a joined up way.