The inspection took place on 12 March 2018 and was unannounced.

Millfield Care Home is situated close to Heywood town centre. There is ample parking to the front of the building for visitors.

Millfield Care Home 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.

The home operates with three units; On the ground floor there is the Wham Bar Unit that provides nursing care for younger adults. On the first floor there is Summit Unit that provides mainly general nursing care and Hopwood Unit that provides personal care. There is a fourth unit on the ground floor that is not currently in use. On the day of the inspection there were 60 people living at the home, 13 in Wham Bar, 20 in Summit Unit and 27 in Hopwood Unit.

At the time of the inspection there was a manager who was in the process of registering with the Care Quality Commission. 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 told us they felt safe at Millfield Care Home. There was an appropriate safeguarding policy in place and staff had undertaken relevant training. We looked at staffing levels across the home. On the day of the inspection staffing levels were sufficient to meet people’s needs.

Staff files included all relevant documentation and each individual had a disclosure and barring service (DBS) check to help ensure their suitability to work with vulnerable people.

Individual and general risk assessments were in place and relevant health and safety records were in evidence. We looked at medicines systems across the nursing units and saw these were safe and records were complete and up to date. Infection control procedures were adhered to throughout the home.

Information in care files was comprehensive and monitoring sheets for issues such as food and fluid intake and positional changes were completed as required.

The staff induction programme was thorough and mandatory updates and further training were on-going. Staff supervisions were undertaken regularly and we saw completed records.

The kitchen was well stocked with fresh and frozen supplies and was clean and tidy. Nutritional requirements and special diets were recorded and adhered to and people were given choices with regard to meal options.

The service was working within the legal requirements of The Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People told us staff were kind and caring and we observed friendly and relaxed interactions throughout the day. People’s privacy and dignity was respected and records were kept securely to help maintain confidentiality.

Residents’ and relatives’ meetings, where people could raise concerns and put forward suggestions, were held regularly.

The service encouraged people to be as independent as possible. We saw evidence that people who used the service, and their relatives if they wished to, were involved in care planning and reviews. Appropriate information was given to people who were thinking of using the service and their relatives.

People told us staff were responsive to their needs. Care plans we looked at were person-centred and very detailed and were reviewed and updated on a regular basis.

There was a range of activities, outings and events on offer at the home. Activity records were held to evidence what people had enjoyed and participated in.

People were given choices and beliefs, religion and diverse interests were respected. People’s wishes for their care when nearing the end of their lives was clearly documented and