Background to this inspection
Updated
26 March 2015
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 is 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.
This inspection took place on 2 and 3 February 2015 and was unannounced. The inspection was undertaken by three inspectors.
Prior to this inspection we received some information of concern. We therefore reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We spoke with the local authority and health and social care professionals to gain their feedback as to the care that people received.
During our inspection, we observed how the staff interacted with the people who used the service and how people were supported during meal times and during individual tasks and activities. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with 14 people who used the service, six relatives and two healthcare professionals. We observed a further 12 people who were unable to communicate effectively with us because of their complex needs. We also spoke with the provider, the registered manager, the deputy manager, two registered nurses, 11 care staff, one member of kitchen staff and one member of the domestic staff.
We looked at 13 people’s care records to see if their records were accurate and reflected people’s needs. We reviewed ten staff recruitment files, staff duty rotas, training records and further records relating to the management of the service, including quality audits.
Updated
26 March 2015
Milton Court Care Centre is registered to provide accommodation and support for 148 older people who require nursing or personal care, and who may also be living with dementia. On the day of our visit, there were 106 people living in the home.
The inspection was unannounced and took place on 2 and 3 February 2015.
The service had 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.
People felt safe living in the service. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report potential abuse. Systems in place had been followed and appropriate action taken to keep people safe, minimising any risks to health and safety.
Risk assessments within people’s care records were completed and reviewed. Staff understood how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks.
Staff were not allowed to commence employment until robust checks had taken place in order to establish that they were safe to work with people.
There were adequate numbers of staff on duty to support people safely and ensure people had opportunities to take part in activities of their choice.
Medicines were managed safely and the systems and processes in place ensured that the administration, storage, disposal and handling of medicines were suitable for the people who lived at the service.
Cleaning within the service was not always satisfactory and some areas of the service were not maintained to a clean and hygienic standard.
Staff were supported through a system of induction and on-going training, based on the needs of the people who lived at the service.
The registered manager did not consistently follow the legal requirements outlined in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).
People had a good choice of meals and were able to get snacks and fluids throughout the day.
People had access to health care professionals to make sure they received appropriate care and treatment to meet their individual needs.
Staff talked with people in a friendly manner and assisted them as required, whilst encouraging them to be as independent as possible.
People’s personal views and preferences were responded to and staff supported people to do the things they wanted to do. Staff worked hard to maintain people’s privacy and dignity.
There were regular meetings for staff which gave them an opportunity to share ideas and give information about possible areas for improvements to the registered manager.
People and their relatives knew who to speak to if they wanted to raise a concern. There were appropriate systems in place for responding to complaints.
The service was led by a registered manager who was well supported by the provider.
We had not always received all required statutory notifications from the registered manager in accordance with their legal requirements.
Quality monitoring systems and processes were not always used effectively and had failed to identify the infection control and care plan issues that we observed during this inspection.