This inspection took place on 11 and 17 December 2018; the first day of inspection was unannounced.

Millington Springs is a ‘care home with nursing’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Millington Springs accommodates up to 42 people in one building. At the time of our inspection there were 18 people living at the service; seven of those people had nursing needs and 11 people had residential needs.

Millington Springs was registered with the Care Quality Commission on 12 June 2017; this is the first comprehensive inspection of the service since it was registered.

There were two registered managers in post at the time of our inspection; One registered manager was working in another location owned by the provider and was not present during our inspection of this location. The other registered manager who was available at this location during our inspection was also the registered provider. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Statutory notifications for allegations of abuse had not always been submitted as required.

Risks associated with people using bed rails had not always been assessed. Some areas of record keeping for cleaning and kitchen temperature records were not always complete. This required improvement to ensure the quality and safety of services in these areas were assured. In addition, we identified where infection prevention and control practices could improve to help protect people from the risks associated with infections.

People felt the care and treatment they received at Millington Springs was safe. Staff understood and had been trained in how to keep people safe. Recruitment checks helped the provider make decisions on the suitability of staff to work at the service. Sufficient numbers of staff were provided to help ensure people were cared for safely. Other risks to people’s health had been assessed and actions taken to reduce risks. Arrangements were in place for the safe management of medicines Accidents and incidents were reviewed to help identify improvements.

Care needs were assessed and focussed on achieving effective outcomes for people. Staff told us they felt supported by the management team; staff were trained in areas related to the needs of people using the service. People had access to other healthcare professionals such as GP’s and speech and language therapists. The premises were suitable for people.

People were supported to maintain a balanced and nutritious diet, however people would benefit from more choice over how their food was presented and some people may have benefitted from being able to see the food options available. People were supported 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 support this practice. However not all staff were knowledgeable on which people had DoLS approved.

Processes were in place to assess any specific needs associated with the Equality Act 2010 to help prevent discrimination. Information was provided in ways to help them understand choices.

Staff were caring to people and knew them well. People’s independence was promoted. People were supported to maintain their relationships with their relatives and relatives felt welcome when visiting.

People contributed to their care plans and received personalised and responsive care. People had a range of activities provided at the service and were free to pursue their own interests. Processes were in