Inspection on 29/10/08 for Millbrook House

This inspection was carried out on 29th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millbrook House 03/11/06

Millbrook House 17/03/06

Millbrook House 28/09/05

Millbrook House 23/03/05

Millbrook House 18/01/05

Millbrook House 15/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Millbrook House Child Okeford Blandford Dorset DT11 8EY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Clarke     Date: 2 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Millbrook House Child Okeford Blandford Dorset DT11 8EY 01258860330 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Millbrook House (Dorset) Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Four rooms only may be used for double occupancy at any one time. Rooms which may be used as doubles are Rooms: 1, 5, 15, 20 and 21 to 28 inclusive. No more than three service users may be provided with day care at any one time. Two service users, known to the CSCI, under the age of 65 may be accommodated. Date of last inspection Brief description of the care home Millbrook House is registered to provide accommodation and personal care for up to 33 people who have frailty of old age. The home is located in the North Dorset village of Child Okeford, between the towns of Blandford and Shaftesbury. The home has been extended on two occasions building onto the original Georgian House. The last extension also incorporates refreshment-making facilities, a sluice/laundry room, hairdressing room and bathroom with a parker bath. The accommodation is arranged over three floors with passenger lifts serving all floors. There are 25 single rooms and 6 double rooms. There are two lounge areas and two dining rooms. The home has large well-maintained gardens, with easy access for residents. 0 Over 65 33 Care Homes for Older People Page 4 of 26 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit to the home as part of an inspection. We received a Annual Quality Assurance Assessment which set out the improvements and arrangements for providing of care and other information about the service. We also received responses to our have Your Say questionnaire 9 from individuals who live in the home and 7 from staff. This information was used to help us in making a judgement about the quality of care provided in the home. As part of this inspection we looked at a number of documents and records including care plans, staff recruitment and training and those relating to health and safety practice in the home. We also looked at the arrangements for the administering and management of medication. Fee 510-640 pounds a week inclusive of all care and facilities other then items such as Care Homes for Older People Page 6 of 26 chiropody and hairdressing. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home undertakes good pre-admission assessments so that they can make an informed decision about their ability to meet identified care needs. Evidence: We looked at a number of pre-admission assessments they provided good information about the health and social care needs of the individuals. One of the areas identified by the home is to get more information about the interests and hobbies of the individual as part of their assessment and this would certainly improve the assessment. We spoke to one individual about their coming into the home they said they had been given information about the home and I spoke to one of the staff about what help I needed. All individuals who responded to the Have Your Say questionnaire said they had received enough information about the home before they moved in. Where individuals are known to social services a copy of their assessment is obtained by the home. Care Homes for Older People Page 10 of 26 Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning and arrangements for meeting the health care needs are good providing staff with the necessary information so that the health and social care needs of individuals can be met. The practices of staff and policies of the home help to make sure individuals are treated with respect and their dignity upheld. Evidence: A number of care plans (4) were looked at and were informative and included information about the daily needs of individuals, moving and handling assessments, risk assessments. Reviews had been held regularly. Care plans had been signed by the individual. There was little information relating to the individuals personal circumstances, history and important relationships. We looked at medication administering records and they had been completed as required with no gaps in recording and signatures of any changes to medication. There is a system in place to stock and audit drugs when they are received. Controlled drugs are stored in secure separate cupboard and records completed as required with two Care Homes for Older People Page 12 of 26 Evidence: signatures of staff. One individual received insulin and staff have been trained to administer insulin. One individual was self-administering their medication and a risk assessment had been completed. Refrigerator is used to store medication where this is needed, temperature is monitored daily. Information is kept regarding all medication given to individuals. Staff have received training in the area of medication. Individuals who live in the home have full access to health services such as chiropody, optician and community nurse service. An occupational therapist also visits the home regularly and the home can make direct referrals for advice and support. Individuals said in their survey response that they receive the medical support they need. One individual said they call the doctor if they notice I am not well In talking with individuals who live in the home they all spoke of staff being very good and talk to me in a way I like. When asked about respect for privacy they said its up to me what I do always. Staff were observed talking and interacting with individuals in a sensitive and appropriate manner. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for meeting the social and recreational needs of individuals who live in the home are good and there are opportunities for individuals to maintain their links with family and friends. The homes practices and daily routines are flexible so that individuals are able to exercise choice and have control over their lives. The meals provided in the home are varied and meet nutritional needs of the individuals who live in the home. Evidence: We spoke with a number of individuals who live in the home about the activities provided. They told us that there is daily program and a notice on noticeboard confirmed this. Activities arranged include exercise, dominoes, quizzes and Scrabble. On the day of our visit a church service was being held and the inspector was told that on occasion people from the village attend this service. Other individuals we spoke to about activities said they felt there was enough to do and I could go if I wanted. The manager said that alot of individuals arranged their own time and choose not to take part in the activities arranged by the home. Care Homes for Older People Page 14 of 26 Evidence: We asked about family and friends visiting the home and was told that this is always encouraged and how welcoming the home is . On the day of our visit a relative was visiting and she was provided with lunch. The home organises a yearly garden party inviting family and friends and is planning a Xmas party. We spoke to a number of people about how they spend their day and whether they were able to organise and choose their own routines. One individual said they pleased myself where I go and another said that staff were very flexible. When asked about getting up and going to bed one individual said its up to me they would always come back later if I asked (this was someone who needed help in getting up). We looked at the menu for the previous 2 weeks and they offered a wide variety of meals. Individuals we spoke with about the meals provided in the home all said they were good with one individual saying no question they are exceptionally good and another perfect. There is no daily choice for lunchtime though one person said that they were usually offered an alternative if there were something they didnt like on the menu. There is a choice offered for tea and breakfast. Another said the meal was not very hot. The inspector had lunch which was well presented and certainly very enjoyable however it was not as hot as it should have been. This was discussed with the manager at the time of our visit and she recognised this was a difficultie which they had tried to improve and would look at other ways the meal could be served and be hotter perhaps through the use of portable hotplates/trolley. Respondents to the Have Your Say questionnaire said always 7 usually 1 sometimes 1 to Do you like the meals in the home? Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has clear complaints procedures in place and individuals living in the home are able to register their concerns or complaints. The home has procedures in place so that they can respond professionally to any allegations of abuse though protection of individuals would be improved by all staff undertaking Safeguarding Adults Training. Evidence: We spoke with individuals about what they would do if they had any concerns or complaints about the service they receive. Individuals said they would always speak to someone either a member of staff or the manager. All of the individuals said they believed they would be listened to and something would be done. They were aware of the complaints procedure and all respondents to the Have Your Say questionnaire said they knew how to make a complaint. One respondent said they would write to the owner or speak to the manager first. A staff member said in their questionnaire response that they felt what the home does well was the service is always ready to hear any comments from residents and families about anything of concern and act on it appropriately. There have been no complaints made since the last inspection. The home has procedures in place in order to respond as required to any allegations of abuse. We spoke to a group of staff about their knowledge of what constitutes abuse and they were able to give good example such as refusing to give choice, verbal i.e. shouting. We also spoke about what they would do if an individual made an allegation Care Homes for Older People Page 16 of 26 Evidence: to them they were very clear about reporting to the manager. We looked at staff training records for 4 members of staff and found that two had not undertaken Safeguarding Adults training. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment which is well maintained and decorated to a good standard with procedures and practices in place to prevent infection and maintain hygiene to a high standard. Evidence: In looking around the home it was evident that a good standard of decoration is maintained, rooms are decorated as necessary. During the past year 8 rooms had been re-decorated and re-carpeted.New equipment has been purchased for the kitchen and garden furniture. A new lift has been installed in the home and carpeting in communal areas renewed. Individuals said they always found the home clean very well kept and well cleaned. A number of individuals spoke of the well kept gardens. All respondents to the questionnaire said the home is always fresh and clean. The home has procedures in place to maintain infection control and staff are provided with the necessary protective clothing. Staff have received Infection Control training. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. However the protection of individuals in the home could be improved by making sure all staff undertake Safeguarding Adults training and by making sure there are adquate members of staff on duty at all times who have First Aid training. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. Evidence: On the day of our visit there were 5 care staff on duty am with 4 pm and two waking night staff. Records showed that this is the norm for the home. In talking with individuals they all said how there felt there is always enough staff around staff always there if you want them they give me the help I need. All respondents to the questionaire said there was always staff available when you need them. One individual commented they always here for me to help and assist in all my needs. We looked at recruitment records for 4 members of staff all had Criminal Record Bereau checks, detailed and complete application forms and two references. Training records showed they had completed moving and handling, health and safety. Two had completed Safeguarding training. One who was a member of night staff had not Care Homes for Older People Page 19 of 26 Evidence: completed first aid training. Staff wwe spoke with had also undertaken dementia training and care of the dying and Bereaved. Staff have undertaken NVQ Level 2 and 3 professional qualification. One individual we spoke with said that staff are very well trained and good at what they do. Staff who responded to the questionaire all said they received training relevant to their role and helped in understanding and meeting individual needs of individuals who live in the home. One staff member said the most recent training I had was Dementia it was very good and helps me a lot to understand the residents behaviour especially those with dementia. Another staff member said my training and knowledge has given me a very good understanding of the care systems and its a pleasure to continue working to a high standard to which I have been trained. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent and experience manager and the home provides an environment where individuals can express their views about the service they receive. The health and safety practices of the home help to make sure the welfare of those who live and work in the home is protected as far as possible. Evidence: We spoke with individuals who live in the home and staff about the manager of the home they described her as someone we can easily talk to approachable. One staff member commented the manager is very approachable, listens and takes action of what ever concerns we have. Is supportive. Another said staff can always speak to the seniors and manager if anything they need support with regarding any needs of residents or staff is required. The manager has extensive experience working in a care setting. The home has quality assurance questionnaires for individuals who live in the home. Care Homes for Older People Page 21 of 26 Evidence: Results of these were seen by us and showed that there is a high degree of satisfaction about the quality of service provided in the home. Residents spoke of attending residents meeting and said they found them helpful lets us know what is going on and we can say if theres something we would like and tells us about any changes. Records relating to the fire system were looked at and showed that weekly fire tests take place and annual servicing last being 08/09/08. The Dorset Fire and Rescue service undertook an inspection in March 08 and found satisfactory standard of fire safety.Staff undergo regular fire training and drills. Other equipment such as hoists and lift had been serviced in the past year. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 13 The registered manager shall make suitable arrangements for the training of staff in First Aid. This relates to the need to make sure there are adquate staff trained in First Aid specifically during the night. There is guidence on the CSCI professionals website about having adquate staff who are first aid trained. 01/03/2009 2 30 13 The register manager to 01/03/2009 make suitable arrangements for the training of staff in Safeguarding Adults. This is so that the home makes every effort to protect individuals in their care from abuse and that staff have the necessary knowledge and understnding of abuse. Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans to be more person focused with information about the individual other then personal health and care needs i.e. personal history. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!