Milton House Nursing and Residential Home

Updated 18 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors, one member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Milton House Residential and Nursing home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Milton House Residential and Nursing home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to the registered manager, deputy manager, two relatives and two people who lived at the service. We reviewed a range of records including three peoples care records and multiple medication records. We looked at three staff files in relation to recruitment and supervisions and a variety of records relating to the management of the service.

After the inspection

We spoke to nine relatives, a further six people who lived at the service and three staff members. We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and quality assurance records.

Updated 18 November 2022

About the service

Milton House Nursing and Residential home is a residential care home providing personal and nursing care to up to 22 people in one adapted building. The service provides support to older people and younger adults who may be living with physical disabilities or dementia. At the time of our inspection there were 18 people using the service.

People’s experience of using this service and what we found

People were supported to have their medicines safely by competent and trained staff. We found some improvement was needed in the recording of some medicines however the provider worked to improve this at the time of the inspection. We made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, not all records relating to people’s capacity and DoLS applications were clear. We have made a recommendation about this.

Care plans had been developed which helped guide staff on how to provide, person centred care which reflected people’s preferences.

Staff were caring in their approach, acting in the best interests of the people. People enjoyed a variety of activities, which included taking part in community events and local church groups. The provider was keen to expand the activities schedule and was working with people to continually review their interests and greater increase their opportunity.

People and their relatives were asked to give their feedback about the service on a regular basis. The registered manager used these comments to review the care provided, developing action plans when needed, which helped to continually improve the service.

People and relatives were happy with the care provided by the service. One relative said, “The care is fantastic, and they do the best they can do.” One person told us, “[Milton house] has nothing to improve, it’s very good.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 August 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to review the breaches found at the last inspection. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Recommendations

We made a recommendation around the providers management and auditing system of some medicines and we also made a recommendation about their recording of people's capacity. The provider took action to amend and improve practice when this was highlighted on inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.