This inspection was unannounced and took place on the 17 May 2017. This was the first inspection of Millfield Nursing and Residential Care Home since our registration of the provider under the Health and Social Care Act in April 2016. Millfield Nursing and Residential Care Home provides accommodation, nursing and personal care for up to 45 older adults, which may include some people living with dementia. At the time of our visit, there were 35 people living at the service, including 19 people receiving nursing care and some people living with dementia.

There was a registered manager at this service. 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 and relatives felt people were provided with safe care. People’s care and medicines along with the environment and equipment used for their care were safely managed.

Staff understood risks to people’s safety from their health conditions and environment and the care actions required help reduce those risks, which they usually followed. Care and safety incidents were closely monitored. Management actions and remedial measures helped to ensure people’s safety or prevent any reoccurrence of any safety incidents when required.

The provider’s arrangements for staff recruitment and deployment helped to ensure people’s safety at the service. Emergency contingency planning helped to ensure people’s safety in the event of forseen emergency.

People, relatives and staff were confident and knew how to speak out if they had any concerns about people’s safety at the service. Staff were confident, knew how to recognise abuse and report and any concerns about people’s safety if they needed to.

People and relatives were happy with the care provided by staff who were qualified, trained and supported to provide care that met people’s assessed needs. Staff understood and followed the Mental Capacity Act 2005 (MCA) to obtain people’s consent or appropriate authorisation for their care.

People enjoyed their meals at the service and they were supported to maintain and improve their health and nutrition. Staff consulted with relevant external health professionals and followed their instructions for people’s care when required.

People received care from staff who were kind, caring and compassionate. Staff treated people with respect and promoted their dignity, rights, independence and involvement in their care.

People were provided with the information they needed about their care and the provider’s service they could expect to receive. Staff understood and followed what was important to people for their care and supported them to maintain their contacts with family and friends.

People’s care was often individualised but not always timely or inclusive. Environmental and equipment adjustments were not always made to fully enable people’s individual independence or orientation. A range of relevant adaptations and equipment were provided to help people move or eat and drink independently.

Staff understood and followed what was important to people for their care, daily living routines and lifestyle preferences. Staff knew how to communicate with people and supported them to engage and participate in home life and the wider community.

People and relatives knew how to make a complaint about the service if they needed to. People’s views about the service were regularly sought, well received and used to make care and service improvements when required.

The service was generally well managed and led. Staff understood their role and responsibilities for people’s care. Management arrangements for communication and record keeping helped to ensure this. Regular management checks and consultation with people, relati