Archived: Milton Lodge Residential Care Home

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.

During this inspection we followed up on some outstanding areas from our last inspection of the home that was conducted on 4 January 2013. They concerned the respect and dignity afforded to people who lived in the home, care and welfare, the home's environment and cleanliness and record keeping.

People told us care staff were polite and treated them with respect and dignity. We observed care staff were patient, friendly and upheld the privacy of the people who lived in the home.

We found that care plans accurately reflected people's needs and had been drawn up with their involvement.

We observed the home had made improvements concerning the environment and many rooms and communal areas had been redecorated, had new carpets and new bedding provided.

The provider had measures in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Records we looked at were accurate, up to date and were easily accessible to us during our visit.

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. However, sometimes people's privacy and dignity was not respected.

People's needs were assessed but care and treatment was not consistently planned and delivered in line with their individual care plan.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People told us they were comfortable in their surroundings but the environment was not always adequately maintained.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Records were kept securely but people were not protected from the risks of unsafe or inappropriate care and treatment because records were not consistently accurate and up to date.