Inspection on 05/09/05 for Milbanke HFE

This inspection was carried out on 5th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Milbanke HFE 21/04/09

Milbanke HFE 14/01/09

Milbanke HFE 15/12/08

Milbanke HFE 20/10/08

Milbanke HFE 24/09/08

Milbanke HFE 23/06/08

Milbanke HFE 28/08/07

Milbanke HFE 20/09/06

Milbanke HFE 26/04/05

Milbanke HFE 20/12/04

Milbanke HFE 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Milbanke Home For The Elderly Station Road Kirkham Lancashire PR4 2HA Lead Inspector Denise Upton Unannounced 5 September 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Milbanke Home For The Elderly Address Station Road Kirkham Lancashire PR4 2HA 01772 684836 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lancashire County Care Services Mrs Jennifer Kerr Care home only 28 Category(ies) of PD Physical Disability (6) registration, with number OP Old Age (22) of places Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Staffing must be provided in accordance with the Residential Forum Staffing Guidance by April 2004. The service should at all times employ a suitably qualified and experienced manager who is registered with the NCSC. The external windows and paintwork of the home must be repaired and repainted by 31 March 2005. The cubical toilets to the ground floor of the building must be redesigned to provide a totally enclosed environment for each toilet by 31 March 2005. Service users in the physical disability category may only be accommodated in the designated, 6 bedded rehabilitation unit, which must not accommodate any service user under the age of 55 years. Date of last inspection 26th April 2005 Brief Description of the Service: Milbanke Care Home is presently registered to provide residential accommodation for up to 22 older people who do not require nursing care. However, due to current building and redevelopment work to provide extended residential accommodation, a new day care facility and office accommodation, the number of service users accommodated has been restricted. In addition to the main residential accommodation, a designated six bed self contained intermediate care unit is normally in operation at the home however due to the current building programme, this facility is temporarily housed elsewhere. This facility when operational, is registered to accommodate service users over the age of 55 years and housed in a separate area of the building to provide time limited accommodation and support to service users with a view to enabling them to return to their home environment. Milbanke Care Home is located in a convenient location close to the main shopping centre of the town and local amenities. The accommodation is purpose built, arranged over two floors and offers individual bedroom accommodation to all service users. Although individual bedroom accommodation does not provide an en-suite facility, bathing and toilet facilities have been upgraded and refitted, are sufficient in number, conveniently situated and provided with appropriate aids to promote independence. A stair lift has been provided for ease of access throughout the home until the existing passenger lift is operational again following completion of the building programme in that particular area of the home. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of eight hours and started at 9.00am. The inspector spoke with the senior officer on duty, a member of the care staff team and the cook on duty. In addition, four people who live at the home were spoken with individually and brief general discussion also took place with several other residents in the lounge area that is currently in use. A limited number of records and policies and procedures were also examined and a tour of the current resident accommodation also took place. During the course of this inspection, five resident comment cards provided by the Commission For Social Care Inspection were completed. This provided further information on how residents felt that Milbanke Care Home was meeting their needs and requirements. What the service does well: Milbanke Care Home has a group of staff that work well together and who display a good understanding of the needs of residents and are keen to provide a high quality service to people who live at the home. Residents spoken with felt they were well looked after and that the staff group helped them to feel safe and secure. One service user spoken with said the staff ‘are all very good and will help you all they can’. It is clear that there is a good relationship between residents and staff that help service users feel comfortable. Recruitment procedures are robust and consistently applied to ensure that the staff employed is suitable for their role and to ensure service users are well protected. The atmosphere in the home is very relaxed and visitors are made welcome at any time of the resident’s choice. The organisation is very committed to provide staff with the training they need to ensure they have the skills and abilities to perform their duties to the best of their ability. Meals are varied with an alternative choice available. Residents were pleased with the choice and variety offered and spoke highly of the quality of the meals served. Staff were seen responding to the residents needs appropriately and all tasks were carried out in a sensitive and caring way. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The manager and staff at Milbanke Care Home work hard to ensure that the needs of residents are well met and that residents feel comfortable living at the home. However there are a number of things that could be improved. The individual care plan that tells staff what the individual resident can do for themselves and what help may be needed should be reviewed at least on a monthly basis and amended as required. Whilst there is no suggestion that residents needs and requirements have not been fully met, the routine monthly review of care plans would ensure that the information is kept up to date. The registered manager is very experienced and competent in running a care home for older people but should undertake a specific qualification especially for managers of care homes to make sure the home is run in the best way possible. It is understood that this course of training will be arranged in the near future. Although all staff are required to have mandatory training in health and safety matters a number of the more recently appointed staff have yet to undertake this training. It is understood that this training will also be arranged in the near future. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the six standards were assessed at this inspection. EVIDENCE: None of the six standards were assessed at this inspection. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 There is a clear and consistent care planning and review process maintained in the home. The systems adopted, in the main, adequately provide staff with the information they need to satisfactorily meet service users needs. However all care plans should be reviewed on a monthly basis to ensure the information remains accurate. The home has a structured process in respect of medication and improvements have been noted that offers greater protection for service users accommodated. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 11 EVIDENCE: Individual plans of care are available in the main residential unit of the home that incorporate the outcome of relevant risk assessments to ensure that all aspects of health, personal and social care needs are identified and addressed. However it was noted that care plans of late have not been reviewed on a monthly basis and amended as required. Whilst there is no suggestion that this has compromised the individual care provided or impacted on the daily lives of service users accommodated, all care plans and individual risk assessments should be reviewed on a monthly basis and outcomes documented. At the last inspection it was identified that formal holistic care plans were not maintained in the intermediate care unit. Through discussion with the person in charge, it is understood that multi disciplinary care plans have now been developed and introduced in respect of service users accommodated in the intermediate care unit. However, as the unit is temporarily housed in an alternative residential facility the newly devised care plans could not actually be evidenced at the time of this inspection. At the last inspection the pharmacist inspector visited the home and assessed the medication standard. Various requirements and recommendations were identified and the management team has made significant progress in addressing the items raised. However a small number of issues remain outstanding. It was noted that there are still occasional dose omissions in the drug administration record without explanation and although controlled drugs are not currently required, a controlled drug register of standard format should be obtained and staff trained on how to use it. From discussion with the senior person on duty, it is understood that the duty officer now checks medicines weekly to ensure that all medicines are used within the expiry date. It is recommended that in order to evidence this practice, the weekly check of medication be recorded and signed by the person undertaking the task and any comments noted. Requirements and recommendations identified in respect of the intermediate care unit could not be evidenced at this inspection due to the temporary relocation on the unit to alternative accommodation. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users taste and choice. EVIDENCE: Meals and mealtimes at Milbanke Care Home are given high priority with a varied and balanced menu provided that is designed round the known likes and dislikes of service users living at the home. Service users spoke positively about the variety and quality of the meals served with one service user describing the food as ‘very good and plenty of it’ and stated that ‘you can have what you want, I had a salad at lunch because I did not want the steak Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 13 pie’. Another service user individually spoken with was very pleased with the meals served and confirmed that a choice was always offered. The same service user also said that ‘I always enjoy my meals and have no complaints’. These views were further reinforced on the Commission For Social Care Inspection comment cards that a number of service users completed at the time of inspection. The menu is reviewed on a regular basis to reflect seasonal changes and service users are encouraged to voice their opinion as to the type of foods they would like to eat at various meals. The inspector was able to observe lunch being served that was well presented and appetising. Specialist diets in respect of medical needs are provided and diets in respect of religious or cultural requirements could also be accommodated. It was identified that one service user is currently having her meals blended, however all the separate components of the main meal were blended together. In order to maintain appetite and nutrition, it is strongly recommended that each separate component of the meal be blended separately to enable the service user to experience the various textures, flavour and taste of each of the foods served. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints procedure with some evidence that service users feel their views are listened to and acted upon. Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The corporate complaint policy and procedures in operation at Milbanke Care Home has previously been evidenced and is fully compliant with requirements and recommendations and identified in the Statement of Purpose and Service User Guide. Although no complaints have been raised for some period of time, a record is maintained of any complaint made including details of the investigation and any action taken. A number of service users spoken with were aware that the home had a complaint procedure and stated that they felt confident that any concern would be ‘looked into properly and sorted out’. A staff member spoken with was also very aware of the complaint procedure and understood her role if a service users raised a complaint with her. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 15 There are also a variety of policies and procedures available for the protection of service users. These include an Adult Protection Policy based on the `No Secrets` document and a whistle blowing policy to protect service users from abuse or discrimination. Service users are informed with regard to personal insurance and also that staff are not permitted to accept gifts or witness any legal documents. It is understood that adult abuse forms part of the ‘Skills For Care’ induction training provided to newly appointed staff and is also further reinforced during National Vocational Qualification (NVQ) training that is undertaken by the majority of staff. Staff training material in respect of adult abuse was evidenced at the time of inspection and adult abuse training for all staff is a mandatory training topic that is provided ‘in-house’. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The communal and private accommodation currently occupied by service users has very recently been upgraded including structural improvements to the existing building. This has provided service users with a spacious, attractive and homely place to live. EVIDENCE: There are currently eleven service users in residence who have now all moved to alternative upgraded accommodation in a designated area of the building. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 17 The bedrooms are spacious and communal accommodation is bright and welcoming. All current accommodation now in use is double-glazed and bathrooms, showers and toilet facilities have been relocated and upgraded to good effect. New furniture and bedding has been provided throughout and service users spoken with were all very pleased with the new accommodation. The change of accommodation and upheaval of moving does not seem to have impacted on service users to any great extent with one service user spoken with stating that ‘all the staff are very good and will help you all they can’ and another service user saying that ‘the staff are all very good and helpful that made things easier’. Milbanke Care Home has a variety of policies and procedures in place for the control of infection and safe handling of waste products including clinical waste and dealing with spillages. Laundry facilities are currently temporarily relocated off the main corridor of the home and continue to be situated away from kitchen and dining areas and does not intrude on service users accommodated. All laundry is washed at an appropriate temperature and it is understood that facilities continue to comply with the Water Supply (Water Fittings) Regulations. As part of the upgrading programme new sluices have been provided to both floors of the building. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 & 30 There is a good match of well-qualified staff offering consistency of care within the home. The arrangements for staff training are very good with staff demonstrating a clear understanding of their roles. There is a structured and robust recruitment process applied in order to protect service users. EVIDENCE: Milbanke Care Home staffing levels and skills mix are determined in accordance with the assessed needs of service users accommodated. Additional staff are on duty at peak times of activity and two night staff have ‘waking watch’ responsibility during the night time period with a member of the management team ‘sleeping-in’. There is sufficient ancillary staff employed to ensure standards in respect of domestic and catering are maintained. There is a clear commitment to the training and development of all staff at Milbanke Care Home. All newly appointed care staff undertake a basic induction to the home and then work through the detailed ‘Skills For Care’ Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 19 induction-training programme. NVQ training is encouraged and currently 10 of the 15 care staff employed at the home have successfully achieved a National Training Qualification (NVQ) award in care. In addition, all staff undertakes a variety of other training initiatives some of which is mandatory training, in order to provide a high quality service. The organisation operates a structured, corporate recruitment process in order to protect service users. Since the last inspection, only one new member of staff had been appointed. Unfortunately because of the recent move to temporary office accommodation in a different area of the building, the staff personal files could not be located at the time of inspection. However, through discussion with the senior officer on duty and the member of staff in question, the inspector felt confident that the corporate policy in respect of recruitment practices had been followed and the necessary declarations, references and clearances had been obtained and deemed to be satisfactory prior to the newly appointed person actually taking up post in the home. Staff spoken with were interested in the training available with one carer stating that she felt ‘service user were very well looked after and cared for’. Comments from service users spoken with and comments made on the Commission For Social Care Inspection comment cards confirmed that service users felt well cared for at Milbanke Care Home. One service user spoken with commented that ‘the staff will do anything for you including personal shopping they are all always very kind and helpful. If there is a problem, the management team will always listen and try to sort things out’. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 & 38 The registered manager is competent and experienced and provides clear leadership throughout the home. However the registered manager should obtain a nationally recognised care manager’s qualification to ensure she has the required skills and abilities to manage the care home. The home regularly reviews aspects of its performance through a good programme of self-review Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 21 and consultations which include seeking the views of service users and staff however this process could be further extended to encompass all stakeholders. Systems are in place to ensure as far as possible the health and safety of service users, staff and visitors. EVIDENCE: The registered manager at Milbanke Care Home is competent and experienced to ensure the home meets its stated purpose, aims and objectives. In addition, the registered manager has also undertaken recent additional training to increase her skills and knowledge. Although the registered manager has already achieved qualifications in care, a more advanced NVQ qualification in care and management is required. It is understood that this course of study is planned to commence in the near future. As at previous inspections, staff and service users spoken with were very positive with regard to the help and support of the registered manager with one service user saying that ‘she will help you all she can’. General comments from service users and staff was that the home remains a good place to work and live with a family like atmosphere that service users respond well to and feel comfortable with. It was clearly evident from observation that there is a very good rapport between residents, staff and visitors that helps to create sense of belonging. As identified in the last inspection report, Milbanke Care Home regularly reviews aspects of its performance through a good programme of self-review and consultation, which includes seeking the views of service users, staff and informally the views of relatives. In addition the ‘Investor In People’ award has been achieved. Service users confirmed that they are regularly consulted and that their views and opinions are taken into account. As recommended in the last inspection report, anonymous questionnaires could be developed for other stakeholders to express their views in order to support the informal system already in place. However one service user spoken with chose not to complete the Commission For Social Care Inspection service user comment card saying that the questions on any quality assurance questionnaire in relation to the home were always the same and should be changed and made more varied. Milbanke Care Home ensures safe working practices are maintained through implementation of the home’s policies and procedures and staff training in respect of health and training issues. A new corporate policy in respect of health and safety issues has recently been issued that was evidenced at the time of inspection. As previously evidenced, external environmental risk Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 22 assessments have been undertaken that is of particular importance at this present time because of the on going building programme and updated risk assessments have very recently been completed in respect of fire safety and service users accessing the outside environment. It is understood that to date, no formal risk assessments have been undertaken with regard to the updated internal accommodation currently in use however these risk assessments will be completed in the near future. Currently two members of the management team have completed the ‘First Aid At Work’ course and a further member of the management team is to undertake this course of study. Once this had been accomplished a qualified first aider will be on duty at all times. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 x x x x x x 3 Score Standard No 7 8 9 10 11 Score 3 x 2 x x Standard No 27 28 29 30 3 3 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 x 33 3 34 x 35 x 36 x 37 x 38 3 Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement The management team must ensure that medication records are signed immediately after medication is administered with particular reference to dose ommissioms without explanation. (Time scale of 30/05/05 not met) Timescale for action 30/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 9 Good Practice Recommendations All individual care plans and risk assesements should be formally reviewed on a monthly basis and amended as required. It is recommended that the officer who undertakes the weekly check of medicines, signs a document to this effect with any comments recorded. A controlled drug register of standard format should be obtained and staff trained on how to use it. Where a meal is required to be blended, the components of the meal should be blended seperately to ensure the service user can enjoy the various individual tastes and textures The registered manager should have achieved an NVQ F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 25 3. 15 4. 31 Milbanke Home For The Elderly 5. 38 Level 4 or equivalent in care and management by 2005. Internal environmental risk assessments of current service user accommodation should be undertaken as soon as practical and it is recommended that a qualified first aider be on duty at all times. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Milbanke Home For The Elderly F57 F09 S32617 Milbanke HFE V247408 050905 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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