Archived: Milton House

Updated 18 December 2014

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 21 October 2014. This was an unannounced inspection which meant the staff and provider did not know we would be visiting. It was carried out by an inspector and an expert by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of care service.

We reviewed the Provider Information Record (PIR) and previous inspection reports before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also reviewed the information we held about the home.

At the last inspection carried out on 21 October 2013 we did not identify any concerns with the care provided to people who lived at the home.

At the time of this inspection there were 41 people living at the home. During the day we spoke with 17 people who lived at the home and seven visitors. We also spoke with eight members of staff, the registered manager and the deputy manager.

We spent time in the lounges and dining areas of the home so that we could observe how staff interacted with the people who lived there.

We looked at a sample of records relating to the running of the home and to the care of individuals. These included four staff personnel files and the care records of four people who lived at the home.

Updated 18 December 2014

Milton House is a care home which is registered to provide care for up to 51 people. The home specialises in the care of older people who require general nursing care. There is a registered manager who is responsible for the home. 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 and associated Regulations about how the service is run.

At the last inspection carried out on 22 October 2013 we did not identify any concerns with the care provided to people who lived at the home.

This inspection took place on 21 October 2014. This was an unannounced inspection which meant the staff and provider did not know we would be visiting.

Throughout our inspection we observed staff interactions were kind and respectful. There was a cheerful atmosphere in the home and people appeared relaxed and comfortable with the staff that supported them. One person told us “we have such a laugh. They know my sense of humour. We do have a giggle.” Another person said “I’d give them top marks. All the staff here are fantastic. They always have a smile and that’s saying something; it’s not an easy job.”

Staff knew what was important to people and they spoke about people in a caring and compassionate manner. For example, one member of staff said “I treat everyone like they were a member of my family. You have to be aware of the things that are important to people.” A visitor told us “all the staff are so kind and thoughtful. My [relative] has always liked her clothes and jewellery to be coordinated. It is something that is important to her and all the staff know that.”

People told us they felt respected by the staff who supported them. Comments included “they always knock on my door before they come in and if I just want to be by myself, they respect that” and “I need help to have a bath. When I first moved here I felt awkward about someone helping me, but the staff are lovely and I soon felt at ease.”

Care plans contained clear information about people’s assessed needs and preferences and how these should be met by staff. This information enabled staff to provide personalised care to people. Care plans had been regularly reviewed to ensure they reflected people’s current needs.

People could see appropriate professionals such as GPs, dentists, district nurses and speech and language therapists. People said staff made sure they saw the relevant professional if they were unwell. One person said “If you say you feel unwell, the nurses are there and they will get the doctor straight away.” Another person told us “I will be seeing the dentist soon as my dentures feel a bit loose.”

People received their medicines when they needed them. There were procedures in place for the safe management and administration of people’s medicines and we saw these were followed by staff. One person we spoke with said “I see the nurse every day. They bring me my tablets three times a day. They never forget me.” Another person told us “Sometimes I need my pain killers. I just need to ask and they bring them straight away.”

People were supported to maintain contact with friends and family. Visitors we spoke with said they were able to visit at any time and were always made welcome. People were supported to be involved in the local community and the home took part in community activities. For example children from a local school regularly visited the home and one person told us staff had taken them to a local fair the previous week.  

Systems were in place which ensured people’s wishes and preferences during their final days and following death, were respected. The home had recently achieved reaccreditation to the ‘National Gold Standard Framework.’ This is a comprehensive quality assurance system which enables care homes to provide quality care to people nearing the end of their life.

People lived in an environment which was safe and well maintained. Regular checks on lifting equipment and the fire detection system were undertaken to make sure they remained safe. Hot water outlets were regularly checked to ensure temperatures remained within safe limits. There was an emergency plan in place to appropriately support people if the home needed to be evacuated.

Staff received training which enabled them to deliver effective care and support. We spoke with staff and viewed training records. We saw staff had good opportunities for on-going training and for obtaining additional qualifications.  A number of staff had attained a National Vocational Qualification (NVQ) in care or a Diploma in Health and Social Care. There was a programme to make sure staff training was kept up to date. Staff had also received training in how to care for people with a dementia.

Staff were up to date with current guidance about how to support people to make decisions  and to keep them safe. 

The people we spoke with told us they would feel comfortable about raising concerns if they had any. Comments included “I could tell any member of staff if I wasn’t happy about something and it would be sorted out.” Another person said “they wouldn’t want you to be unhappy. They would want you to say if you had any worries.” The visitors we spoke with told us they found the registered manager and staff approachable and would not hesitate in bringing any concerns to their attention.

There was an open and transparent ethos within the home. The registered manager told us they were committed to providing high standards of care. This ethos had been adopted by the staff we spoke with and observed. We observed staff morale was very good. Staff made the following comments “I love working here. I wouldn’t want to work anywhere else” and “It is such a happy home. We all work really well as a team.”

There were effective quality assurance systems in place to monitor care and plan on-going improvements. There were audits and checks in place to monitor safety and quality of care.