Milton House

Updated 20 November 2020

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 Care Act 2014.

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

The inspection was carried out by two inspectors.

Service and service type

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

A new manager was in post who was not yet registered with the Care Quality Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. 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

During the inspection

We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including the provider and the manager. We 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 reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection –

We continued to seek clarification from the provider to validate evidence found. We looked at training data, staffing data and quality assurance records.

Updated 20 November 2020

Milton House is a residential care home providing personal and nursing care for people aged 65 and over. Some people were living with dementia. The service can support up to 28 people and at the time of our inspection there were 26 people living at the service

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

Infection control measures had been increased since COVID-19. However, CQC signposted the provider towards the guidance for Personal Protective Equipment (PPE) in Care Homes for their staff as we observed that staff were not following the guidance in relation to the type of masks required. The provider has now confirmed that the correct masks have been ordered.

Risk assessments were in place to support people to receive safe care. We discussed with the manager the need to ensure that all parts of the care file were updated with current risk.

People's medicines were managed safely and there were enough staff available to meet people’s needs. People told us they felt safe. The staff team were consistent and had a good understanding of how to care for people who lived at the service.

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.

People, their relatives and staff were positive about how the service was managed. The manager was visible and approachable.

The management team were eager to learn and share good practice and this helped people remain safe. Systems were in place to audit the care provided.

The last rating for this service was good (published 15 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received in relation to safeguarding and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions.

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 coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.