Milton Grange

Milton Grange is a care home that provides personal care for up to 16 older people. At the time of the inspection, there were 15 people living at the service.

People’s experience of using this service:

People who were able to communicate with us told us they felt safe and everyone was relaxed with the staff and each other. They were cared for by a consistent staff team who had received training to carry out their roles. People received assistance to take their medicines as prescribed.

People were supported to access health care services. People’s dietary needs and preferences were assessed and where needed, people received support to eat and drink.

People received care that was compassionate, respectful and responsive to individual needs. Care plans were comprehensive and reviewed each month.

People and their relatives knew how to complain, although no complaints had been received in the last 12 months.

No people were receiving end of life care at the time of our inspection visit. The staff were proud of the care they provided at the end of people’s lives.

The manager and staff shared a clear vision about the quality of care and service they aimed to provide. They worked in partnership with other organisations to make continuous improvements and develop best practice.

More information is in detailed findings below.

Rating at last inspection:

Good (report published in September 2016).

Why we inspected:

This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up:

We will monitor information received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

Milton Grange provides residential care for up to 16 older people. There were 15 people living in the home at the time of our visit, some of whom were living with dementia.

The manager and owner had run the home for 27 years. They took a hands on approach and had built up positive relationships with people and staff. People had confidence in staff and told us that staff were caring and friendly. There was a relaxed atmosphere in the home and staff worked well as a team. People were supported by staff who took the time with people that they needed. We saw staff being kind and patient with people and offering reassurance when they needed it.

The manager had created an open transparent environment with information clearly on display and easily accessible. The manager was highly visible around the home and was able to present information to us with ease.

People told us they felt safe living in the home. Staff were aware of what constitutes abuse and the actions they would take if they suspected if someone was being abused. Staff were able to explain how to escalate any concerns about poor practice.

People were supported by enough staff who had been recruited safely. Relevant checks were undertaken before people started work. For example references were obtained and checks were made with the Disclosure and Baring Service to ensure that staff were safe to work with vulnerable adults. The manager told us the staff team were consistent and there was no use of agency. This meant people were supported by staff who knew them well.

Staff were proud of the home achieving accreditation with Gold Standards Framework at beacon status. This is a nationally recognised framework for ensuring people receive a high quality standard of end of life care. The manager told us they felt passionately about the award and they had celebrated by hosting a party for people, family and staff. There were several examples of how the home had achieved this ward such as the use of a coding system, advanced care planning. They also celebrated the memory of people who had passed away and there were photographs on display.

People had opportunity to be involved in activities that interested them. There was a lively atmosphere within the home and people told us they could do as much or as little as they liked.

Peoples risk were assessed and plans developed to ensure that they received care which minimised the risks of them coming to harm. For example people at risks of falls had a falls risk assessment which included input from a healthcare professional if necessary and recommendations how to support the person safely. Accidents and incidents were monitored by the manager so that trends or patterns could be identified and actions taken to prevent a re-occurrence.

Medicines were managed safely. Medicine Administration Records (MAR) were signed to indicate that people had received the correct medicine. Medicines were kept securely and staff who were responsible for administering medicine had undergone training and were aware of actions to take if an error occurred.

There were quality monitoring systems in place which included regular checks of care plans. Any improvements needed were highlighted and there was a process for ensuring actions were recorded and checks made to ensure they were completed. Other checks included infection control, mattresses and environmental health and safety checks.

People had access to healthcare when they needed it; peoples care records demonstrated contact with a variety of healthcare professionals. One person told us that staff recognised if they were unwell and arranged for them to see their GP. They told us “I am well looked after.”

People had personalised care plans which were took account of their likes, dislike and preferences. They were kept up to date and reviewed when needed and staff were knowledgeable about peoples care needs.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We found that care plans accurately reflected people's needs and had been drawn up with their involvement. People expressed satisfaction with the care they received and told us the staff were "nice people".

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Records showed that there were effective recruitment and selection processes in place.

The provider had suitable quality assurance procedures in place to manage the health and welfare of people living in the home. People were able to comment on the service provided.

People living at Milton Grange were very positive about their experience of living at the home and no one had any complaints or concerns about how the home was run and managed. They told us that they had good relationships with the staff, who were described as 'lovely'.

We spoke with staff who understood what safeguarding was and what they would do if they suspected someone was being abused. Staff told us they felt fully supported by their manager

We saw that personalised care plans were in place for people, with assessed needs being identified and managed.

We found that the home had systems for reviewing and monitoring the quality of service provided to people.