Millview short stay respite service is a care home that offers a short breaks service to people who have a physical disability, a learning disability or both. The home is managed by Stockport Disability Services who are part of Stockport Metropolitan Borough Council. 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.

Millview is a purpose build unit registered to accommodate 4 people for respite care and support. At the time of inspection, the service was providing respite care to 42 people. Milllview is part of a wider provision of supported accommodation for people with learning disabilities which included supported housing.

The first day of inspection took place on the 30 July and was unannounced. We returned to the service on 1, 6, 17 August 2018.

The service was previously inspected in March 2016 and at that time was rated good overall. The service was rated as being good in the four domains of effective, caring, responsive and well-led and rated as Requires Improvement in the Safe domain. This was because we found the provider to be in breach of Regulation 12, safe care and treatment. The provider was not taking reasonably practicable steps to reduce risks in relation to good infection control processes.

Following the last inspection, we asked the provider to complete an action plan to show how they would ensure they met the regulations. The action plan detailed the arrangements made to ensure the service was compliant with Regulation 12.

At this inspection we found the service continued to be in breach of this Regulation. This was because effective infection control policies and procedures were not in place to ensure the cleanliness of equipment, and health and safety and environmental checks were not being completed consistently. We also found new breaches of this regulation relating to how the service managed risk.

We identified breaches of three further regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to Regulation 11, Need for consent, Regulation 17,Good Governance and Regulation 18, Staffing.

We identified two breaches of the Care Quality Commission (Registration) Regulations 2009. These were a failure to submit notifications of incidents, accident and safeguarding concern and failure to have a registered manager in post.

It is a condition of registration that the service has a registered manager in place. At the time of inspection, the service did not have a registered manager. 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. The CQC had not received an application from the registered manager to deregister when they had left their post in April 2017. We advised the current manager to begin the process of registering with CQC as a matter of urgency and we took action to deregister the previous manager from the location.

The service kept records of accidents and incidents and these were investigated and monitored within the service. We could see that action was taken to reduce the risk of accidents reoccurring.

We looked at how people were supported to take their medicines safely. We found that people were supported appropriately with this but that checks were not being completed to ensure medicine that required storage at low temperatures could be stored safely.

We saw records that demonstrated staff received training, supervision and spot checks. However, the records indicated that some training needed updating

The service had systems for governance in place but these were n

This was an unannounced inspection carried out on the 17 March 2016. The service was last inspected on 29 January 2014 and we found the provider met the all regulations we looked at.

Millview is a care home that offers a short breaks service to people who have a physical disability, a learning disability or both. The home is managed by Stockport Disability Services who are part of Stockport Metropolitan Borough Council. The home is a purpose built bungalow which has four single bedrooms, two bathrooms, a combined lounge dining room and a large kitchen. It is situated in the Marple area of Stockport.

There was a registered manager in place. 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.

On the day of our inspection there were three people using the service. We spoke with one person during our visit and they told us they were very happy with the care they received. There were effective systems in place to ensure people’s safety and manage risks to people using the service. Staff could describe the procedures in place to safeguard people from abuse and unnecessary harm. Recruitment practices were robust and thorough, although not all of the documents relating to each staff members recruitment was held at the service. These were held at the providers head office.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines. Staff were trained in medicines management.

People were cared for by sufficient numbers of suitably trained staff. We saw staff received the training and support required to meet people’s needs well. Staff spoke highly of their training and said this prepared them well for their role.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and preferences. People had detailed, individualised support plans in place which described all aspects of their support needs.

Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions to enhance their capacity and where people did not have the capacity, decisions had to be in their best interests.

Health, care and support needs were assessed and met by regular contact with health professionals. People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. Suitable arrangements were in place and people were supported and provided with a choice of suitable healthy food and drink ensuring their nutritional needs were met.

People participated in a range of activities both in the home and in the community and received the support they needed. People were able to choose how they spent their time and what they did.

Staff had good relationships with the people using the service. Staff were aware of how to support people to raise concerns and complaints. The complaints procedure was also available in a pictorial format. We saw the provider had received one complaint in the last 12 months.

There were effective systems in place to monitor and improve the quality of the service provided.

We found one breach of the regulations during our inspection. You can see what action we have asked the provider to take at the back of the report.

During our inspection we spoke with two people who used the service and two family members. We also spoke with two family members by telephone. All of them said that they were happy with the care and support provided. One person told us “I have been coming for about three or four years and it has been great ever since “. Another told us that they liked the food and that the staff team respected their privacy and dignity. One of the family members we spoke with told us that they felt comfortable leaving their relative at Millview and felt that they were safe.

We also spoke with the registered manager and two of the support workers. The support workers said that they liked working at Millview with one of them having worked there for many years.

We looked at the care files and daily diaries for two of the four people who were having a short break at the time of our inspection. We found that they contained information to assist the care workers in carrying out their duties to meet the person’s needs.

We did not look at personnel files to check on recruitment documentation as no one had been newly employed to work specifically at Millview for 15 years. However we were told that there were procedures in place should the need arise to recruit new staff that would ensure only suitable people were employed.

We spoke with an officer of the Stockport Social Services Quality Assurance team who told us that they had received no concerns regarding this service.

Millview offered short stay respite care for up to four people. We spoke to a person staying at the home and their family member during our inspection.

The visitor told us that the staff were "very good" and that the staff and the care they give "is excellent" and that they "couldn't fault it". They told us the staff always kept in contact and consulted with them when decisions were being made about the care of the person staying at the home.. The visitor also told us that their family member loved coming to Millview and that they "look upon it as a holiday".

We were told by family visiting the service that the staff were "very professional" and they always respected people's dignity and independence. We were also told that staff got to know the families well and always encouraged them to make regular contact so that they can be informed of changes that would make the persons stay more comfortable.

We spoke to one person who was visiting the service and they told us that they had been using the services at Millview for a long time and they told us they were "very happy" and the staff "are excellent".

We spoke to one person staying at the home at breakfast time and they told us they "liked it here". The person who was visiting the service told us that they used the service for respite and the staff tried to ensure that the person having respite had the same room each time they stayed so that they were familiar with the surroundings.

Millview offered short stay respite care for up to 4 people. The people who used the service were called ‘guests’ therefore we have used this name throughout our report.

We spoke with guests and family members either during our visit to Millview on the 6 September 2011 or by telephone a few days later.

People told us that they were given information about the service to be provided before they visited the home. We were told that the guests had visits to the home which were known as ‘tea visits’ to introduce them to the support workers and other guests. People could have as many tea visits as they wanted before they had an overnight stay.

Comments we received were; “induction excellent;” “had several visits before staying overnight;” “written information was provided;” very, very professional in their approach.” No one we spoke with had any complaints. They all said that they felt comfortable in talking with the managers and support workers.

During our visit to the home we looked at the accommodation and spoke with the manager and support workers who were on duty that day. We also spoke with the senior supervisor by telephone a few days later.

As with the guests and family members none of the staff we spoke with had any concerns or complaints about the service.

We talked to Stockport Advocacy who told us that the service had a good reputation amongst parents and that overall they had no concerns.

We also talked to the District Nurse who attended the home when their services were required; they also had no concerns.