Archived: Milton Lodge Residential Care Home

Updated 3 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We did not ask for a Provider Information Return (PIR) before this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The registered manager had prepared a PIR and provided this at the beginning of the inspection. The information contained was used as part of this inspection.

We reviewed the notifications we had been sent from the service since we carried out our last inspection. A notification is information about important events which the service is required to send us by law.

This inspection took place on 13, 14 and 15 July 2016 and was unannounced. Two inspectors carried out the inspection over the three days. We met and spoke with the majority of people living at the home. As the majority of people were living with dementia we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at four people’s care and support records and reviewed the medication administration records for everyone living at the home. We also looked at records relating to the management of the service including staffing rotas, staff recruitment and training records, premises maintenance records, a selection of the provider’s audits and policies and other records relating to the management of the home.

Updated 3 September 2016

This was an unannounced comprehensive inspection that took place on 13, 14 and 15 July 2016. At the last inspection completed in December 2015 the provider was not compliant with all the regulations and a Warning Notice was served. This was because accurate, complete contemporaneous records were not maintained in respect of each person living at the home. Two requirement actions were also made; one concerning the failure to meet the requirements of the Mental Capacity Act 2005 and another concerning the support, supervision and appraisal of staff.

Milton Lodge is registered to accommodate and provide personal care for up to 18 people. The home aims to meet the needs of older people, including those living

with dementia. At the time of this inspection there were 12 people living at the home.

Since the last inspection in December 2015, the person who was the registered manager had ceased working at the home and a new manager had been appointed. They were in the process of registering with the Commission but were absent on the days of our inspection. The provider, the duty manager and senior care workers therefore assisted us throughout the inspection. We also spoke with two other members of staff, a visiting relative and a person’s legal representative.

Overall, the relative and staff were very positive about the standards of care and the way people were cared for and supported.

People were safe living at the home as steps had been taken to make sure the environment and the way people were cared for and treated were safe. Some improvement was still needed concerning record keeping.

Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how to take action if they had concerns. Training had been booked for newly appointed staff.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce likelihood of their recurrence.

There were sufficient staff to meet the needs of people accommodated.

Recruitment procedures were being followed to make sure that suitable, qualified staff were employed at the home but there could be some improvement in record keeping.

Medicines were administered by trained staff and generally managed safely. Improvements could be made with better monitoring of medicine administration records to reduce gaps in recording.

The staff team were both knowledgeable and informed about people’s care and support needs. There were good communication systems in place to make sure staff worked to agreed objectives.

Staff felt supported by management but there could still be improvement in making sure formal supervision sessions with a line manager took place in line with the home’s procedure.

Staff were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interests where people lacked capacity to make specific decisions, although this could be better evidenced in the records. People were consulted and gave consent to their care where they were able.

The home was compliant with the Deprivation of Liberty Safeguards with appropriate applications being made to the local authority.

People were provided with a good standard of food and their nutritional needs met.

People’s care needs had been assessed. Comprehensive and detailed care plans had been developed to inform staff of how to care for people. The plans were person centred, covered all areas of people’s needs and were generally up to date.

We saw staffing supporting people in a compassionate and caring way. The relative we spoke with was satisfied with the standards of care provided at the home. Staff were knowledgeable about people’s needs.

A member of staff was employed to provide activities to keep people meaningfully occupied.

There was a complaint system in place and this was well-publicised.

Should people need to transfer to another service, systems were in place to make sure that important information would be passed on so that people could experience continuity of care.

The home had a new manager who had the confidence of a largely newly recruited staff team. There was a positive, open culture in the home.

There were systems in place to audit and monitor the quality of service provided to people.