Archived: Milton Court Care Centre

Updated 5 October 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 11 and 14 September 2015 and was unannounced. The inspection was undertaken by three inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert had experience in caring for older people.

Prior to this inspection we 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 spoke with 13 people who used the service, five relatives and one healthcare professional. We observed a further five people who were unable to communicate effectively with us because of their complex needs. We also spoke with the manager, the deputy manager, two unit managers, three registered nurses, seven care staff, one member of kitchen staff and three members of the domestic staff.

We looked at 20 people’s care records to see if their records were accurate and reflected people’s needs. We reviewed six staff recruitment files, four weeks of staff duty rotas, training records and further records relating to the management of the service, including quality audits.

Updated 5 October 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 72 people living in the home.

The inspection was unannounced and took place on 11 and 14 September 2015.

The service did not have a registered manager although the manager, who was new in post, had submitted their application to the Care Quality Commission (CQC) to become 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 secure in the service and confirmed that staff kept them safe and free from harm.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report potential abuse. Appropriate action was taken to keep people safe, minimising any risks to their health and safety.

Personalised risk assessments were in place to reduce the risk of harm to people, as were risk assessments connected to the running of the home. Staff understood how to manage risks to promote people’s safety, and balanced these against their right to take risks.

Accidents and incidents were recorded and the causes of these analysed so that preventative action could be taken to reduce the number of occurrences.

Robust checks took place in order to establish that staff were safe to work with people before they commenced employment.

Staffing levels had been calculated in accordance with current guidance and based on the dependency levels of the people who lived at the home.

There were effective systems and processes in place to manage people’s medicines.

Staff were supported through a system of induction and on-going training, based on the needs of the people who lived at the service.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards were met.

People had choice of good, nutritious food that they enjoyed. We found that people’s weight was monitored, with appropriate referrals made to the dietician when concerns were identified.

Referrals to other health and social care professionals were made when appropriate to maintain people’s health and well-being.

Staff engaged with people in a friendly manner and assisted them as required, whilst encouraging them to be as independent as possible.

Relatives were involved in the review of people’s care needs and were kept informed of any changes to a person’s health or well-being.

There were regular meetings for staff which gave them an opportunity to share ideas, and give information about possible areas for improvements to the 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 manager who was well supported by a robust management structure. The manager and staff told us that they wanted to provide good quality care for people. As a result, quality monitoring systems and processes were used effectively to drive future improvement and identify where action needed to be taken.