Inspection on 15/08/05 for Milkwood House

This inspection was carried out on 15th August 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

Milkwood House 04/10/06

Milkwood House 24/01/06

Milkwood House 15/11/04

Milkwood House 03/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Milkwood House Hill Brow Liss Hampshire GU33 7PB Lead Inspector Annie Taggart Announced Monday 15 August 2005, 12:30pm 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. 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. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Milkwood House Address Hill Brow, Liss, Hampshire, GU33 7PB 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) 01730 895485 Milkwood Residential Care Limited Mrs Linda Walker Care Home 43 Category(ies) of PC Care Home only 43 registration, with number of places Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Total of 43 persons one of whom is under 65 years of age. Date of last inspection 14/10/04 Brief Description of the Service: Milkwood provides accommodation and care for fourty three older people including those with dementia. The Home is located on the West Sussex/Hampshire border a few miles from Petersfield with its shops and other amenities. The building consists of a large converted 3-storey house with an extension to the rear. In addition a more recent purpose built extension to the side of the building provides additional rooms to the ground and lower ground floor. The accommodation consists of thirty one single and six double rooms, some of which have en-suite facilities. There is a large landscaped garden to the rear of the property and parking facilities are available at the front. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place at 12.30pm and lasted for 5.5 hours, which covered the early and late shifts. During the visit the inspector spoke to all of the people in living in the home and held longer conversations with eleven residents and two visitors. A tour of the building was undertaken during which all bedrooms and communal areas were seen. Six care plans and six staff files were seen and the inspector met with five staff members. The inspector spent time with residents over the lunch period and observed interactions with staff members. Records, including fire, health and safety and maintenance were seen and the inspector also observed the storage and recording of medication. Prior to the visit the inspector read the last two inspection reports and any other correspondence and documentation regarding the service. A pre-inspection questionnaire had been completed by the home prior to the visit and this was used to provide additional information. No resident or family/visitors feedback forms have been received to inform the visit. The registered manager Mrs. Walker and the general manager Mrs. Flett were present at the time of the visit and assisted with the inspection process. What the service does well: The home provides an attractive, homely and well-maintained environment for the people who live there. A large attractive garden is available and residents say they enjoy sitting out in good weather. There is a committed and well-trained staff team, many of who have been at the home for many years. Residents in the home say that they are very happy there and that they are treated with kindness and respect. There are a variety of organised social activities and a mini-bus is available to facilitate outings. Residents say that the food provided is of a very high standard. The home is managed in an open and inclusive manner by a competent and caring manager. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 6 Records in the home are in good order and working practices are designed to protect the people who live in the home. What has improved since the last inspection? What they could do better: 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. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5, 6 Prospective residents and their families receive sufficient information to enable them to make an informed choice about whether they would like to live in the home, needs are assessed and visits to the home encouraged. EVIDENCE: There is a Statement of Purpose and Service User Guide available, which contain comprehensive information regarding the services and facilities available in the home. The manager carries out detailed pre-admission assessments either in the prospective resident’s present accommodation or in hospital to ensure that the home can meet individual needs. Each new resident receives a contract setting out the terms and conditions of occupancy and the document is agreed and signed by the resident or their representative. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 9 Residents in the home confirmed that they were able to visit the home prior to moving in and were aware that their care needs had been assessed and recorded. Milkwood House does not provide intermediate care Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. 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 feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11 There is a comprehensive care plan in place for each person living in the home, which contains information for staff on how the person wishes to be supported. Residents are treated with dignity and their privacy is respected. EVIDENCE: There are comprehensive care plans in place for each person living in the home which contain detailed information to inform staff on how to support each resident. The plans include personal details, preferences, personal care needs and social activity. There is also a separate plan in place for care needed during the night. There is evidence of input from a variety of health professionals including doctors, district nurses, community psychiatric nurses and physiotherapists. The plans had been signed by the residents and had been reviewed on a monthly basis. To assist with infection control, when visitors enter and leave the home they are requested to use an anti-bacterial hand gel which all members of staff also carry with them for use in between caring for individual residents. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 11 The people living in the home said they were treated with kindness and dignity and that their privacy was respected. One person said that they did not always like joining in with other people and sometimes just needed to spend time in their room. Staff members were observed interacting with residents in a friendly and respectful manner. The shift handover was observed where staff members coming on duty were verbally updated on the health and emotional wellbeing of each resident. The home has policies and procedures in place for the storage and administration of medication and all staff members who administer medication attend relevant training. There is an agreement in place with a local pharmacy and all records were in good order. During the tour of the building topical creams prescribed for one resident were found in the rooms of several other people. The manager of the home immediately had the creams removed but a requirement has been made in order to ensure this practice does not continue. Wherever possible residents stay in the home until the end of their lives and last wishes are recorded in the care plan. The home endeavours to make accommodation available for relatives to stay with their family member, should they wish to do so. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. 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 maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Individual lifestyle choices are respected and families and friend made welcome when they visit the home. There is a varied choice of freshly cooked meals available and people have a choice of where to eat. EVIDENCE: The people living in the home said that there lifestyle choices were respected and staff members demonstrated an awareness of each person’s individual needs. The atmosphere in the home was calm and friendly and support was offered in a discreet manner. There are a variety of activities available and the home including exercise sessions and musical entertainment, there is also a mini-bus available to enable regular outings. One person said that they had especially enjoyed a trip to Southsea for fish and chips. There was a karaoke session during the afternoon and residents were singing and up dancing with staff members and with each other. One person said they really loved the garden and that staff would take them out there for a walk. An annual garden party is also held at the home. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 13 Two visitors were spoken to and both said they were made very welcome. A resident said their family could visit at any time and were always offered a tray of tea. Lunch, which was the main meal of the day, consisted of braised steak, creamed potatoes, fresh vegetables and bread and butter pudding. The food was freshly cooked, looked attractive and there were alternatives available. People’s likes and dislikes are recorded in the kitchen, as are allergies and special requirements. The home can accommodate diabetic, vegetarian and pureed meals and menus are displayed. The people living in the home were very complimentary about the chef and the food provided and confirmed that a snack was available at any time. People were observed having the meal in the dining room, lounge or in their own rooms according to their wishes. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 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’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Residents and their families can be confident that complaints will be recorded and investigated. The policies, working practices and staff training in the home are designed to protect residents from abuse. EVIDENCE: There is a complaints procedure available, a copy of which is included in the Statement of Purpose and Service User Guide. A copy of the document is also posted in the home. There has been one formal complaint within the last year and this was investigated to a satisfactory conclusion by the management of the home. Smaller “grumbles” from residents are also recorded and there is a book available in the dining room for comments on the meals to be made. A section of the book records outcomes from the comments or complaints. Residents said they would feel confident about making a complaint to the manager. There are policies and procedures in place regarding the protection of vulnerable adults from abuse and staff members at the home attend adult protection training. Staff members spoken to in the home were aware of their responsibilities should they suspect an abuse had taken place. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 Milkwood House provides an attractive, comfortable and well-maintained environment for the people who live there. Communal areas are furnished and decorated to a high standard and bedrooms have been personalised by the people living in the home. EVIDENCE: There are two lounges, dining areas and a quiet room available at the home and all are decorated and furnished to a high standard. The house is light and airy and very clean and hygienic. A large attractive landscaped garden is available to the rear of the building and can easily be accessed from the house. The front of the house has a large shingled car parking area with patio areas near the house. Tables and chairs are positioned around the garden and the front of the house and residents said they really enjoyed sitting out in good weather. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 16 Sufficient toilet and bathing facilities are available, including assisted baths and there is a lift and stair lift between floors. District nurses provide specialist pressure relieving equipment when required and the home has raised toilet seats, handrails and grab-rails fitted to aid mobility. Bedrooms are also decorated to a high standard and have been personalised with ornaments, paintings and furniture brought to the home by the people living there. Bedrooms have door locks and keys and some residents were seen locking their rooms when they left them. All of the residents spoken to said they were really happy with their rooms and with the facilities available in the home. One person said, “It’s a very pleasant place to live, very comfortable and homely”. When bedrooms are vacated they are re-decorated and three rooms have recently been completed. New carpets have been purchased for some bedrooms, the sitting room and corridors and some furniture has been renewed. Risk assessments are in place for each resident regarding mobility and other personal risks associated with the environment. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 There are sufficient staff members available to meet the assessed needs of the current residents in the home. Staff members are employed following a robust recruitment procedure and are offered training and support. EVIDENCE: There were five care staff and four ancillary staff on the early shift and the people working matched the rota for the day. The manager of the home was working in addition to these numbers. Five staff files were seen including the most recent people employed by the home and all required documentation was in place including current Criminal Bureau Checks and references. Many of the staff have worked at the home for a number of years and have built up a good relationship with the people they support. There is a commendable commitment to staff training in the home and records show that over 70 of the staff team has achieved NVQ 2 or above. Staff members receive a comprehensive induction and then attend mandatory training in line with current guidelines. Staff training records showed attendance at a wide variety of courses including stroke management, diabetes, dementia, supervisory skills and managing positive care. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 18 One staff member said, “It’s brilliant here, it’s my first job in care, the residents and staff are great and there are lots of opportunities for training, I am already doing my NVQ 2”. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. 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 the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37, 38 Milkwood House is run by a competent and committed manager who attends further training in order to improve her skills. The home is managed with the best interests of both residents and staff in mind and records are in good order. EVIDENCE: The manager of the home Linda Walker holds the Registered Managers Award, Advanced Management of Care and is an NVQ assessor. Ms. Walker is currently updating her qualification to become an internal verifier and is attending training in person-centred approaches in dementia, in order to improve the service offered to people living in the home. Both the residents and staff in the home spoke very highly of Ms. Walker and said that she was always approachable and supportive. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 20 One long serving staff member said “I stay here because I like the way the place is run, it’s for the residents and I can always go to the manager for advice and support”. The home does not hold any monies in respect of residents and any expenditure incurred is invoiced to their representatives. There is a financial plan in place for the running of the home and this includes finances available for repair and renewal. Staff members confirmed that they receive regular supervision sessions, which include discussion on work practices. Annual appraisals are also carried out and records are kept on file. Records for the home were seen including fire, health and safety, water temperature records and electrical and environmental health checks. All records were current and in good order. A maintenance person is employed at the home and the general environment was safe and records well kept. The home runs a quality assurance system, which includes regular surveys which are sent to residents, families and other professionals involved with the home. The responses are collated and some comments are included in the Service User Guide. The manager of the home attends six-monthly management meetings with other managers and senior partners in the group to ensure consistency of approach and share new ideas. Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 3 3 3 Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP 9 Regulation 13 Requirement Topical creams should not be used other than for the person for whom they are prescribed. Timescale for action immediate. 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. Refer to Standard Good Practice Recommendations Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Milkwood House H60-H11 S14630 Milkwood House V235896 150805 Stage 4.doc Version 1.40 Page 24 - 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. 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