Miranda House

“We observed variable interactions between staff and people who used the service. Some engagement was limited and distressed behaviour was not always well managed. Staff answered people’s call bells in a timely manner but there was not always a staff presence to support people when needed. Some staff used unsafe techniques when supporting people with their mobility. The registered manager told us they would address this with the staff involved, as all staff had been trained in moving people safely.”

“There were shortfalls with documentation and the storage of some medicines, and information people’s care plans was variable and not always person centred. Strategies to help support people with distressed behaviour and end of life care planning had not been considered.”

“The home was generally clean although some toilets in people’s ensuite facilities were not, and there were odours in some areas.”

“A range of quality auditing systems and processes were undertaken although shortfalls found during this inspection had not been identified. This did not ensure adequate monitoring or management oversight of the service.”

“However, people were assessed before being offered a placement at the home, and regularly thereafter. Risks people faced such as dehydration and malnutrition were well managed. Medicines were generally administered as prescribed, and people had their medicines regularly reviewed.”

“Decision making was promoted and staff requested consent before undertaking any care interventions. People were encouraged to be as independent as possible and enabled to lead healthy lives. People were supported to be part of the community and there were various internal and external social activities.”

“The service worked well with other health care professionals and there was an open, learning culture. Lessons were learnt following an accident or incident. Staff received a range of training and opportunities for development were promoted. Records demonstrated staff were recruited safely.”

“There were systems for people, relatives and staff to provide feedback about the service. Any concerns were taken seriously and addressed in line with the provider’s policy. Staff were kept up to date with people’s changing needs through regular discussions and daily meetings with leaders.”

“There were systems to ensure the environment was safe, well maintained and accessible for people.”

“We identified 2 breaches of regulation regarding safe care and treatment and good governance.”

“In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.”

“We have asked the provider for an action plan in response to the concerns found at this assessment.”