Inspection on 03/11/06 for Millbrook House

This inspection was carried out on 3rd November 2006.

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

Millbrook House 29/10/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Millbrook House Child Okeford Blandford Dorset DT11 8EY Lead Inspector Amanda Porter Key Unannounced Inspection 3rd November 2006 09:45 X10015.doc Version 1.40 Page 1 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 Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 2 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. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millbrook House Address Child Okeford Blandford Dorset DT11 8EY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01258 860330 Millbrook House (Dorset) Limited Mrs Sharon Chalke Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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. 17th March 2006 Date of last inspection Brief Description of the Service: 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. Weekly fees range from £450 to £560. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 3rd November 2006 and took approximately five hours. The purpose of the inspection was to review the requirement and recommendations made in the last report and to assess all of the key standards. The Registered Manager, Mrs Chalke, and her staff were on hand to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • A pre-inspection questionnaire completed by the registered manager. • 13 comment cards completed by residents; 8 by relatives/visitors; 2 by GPs and 2 by health and social care professionals and care managers. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. Six residents and four members of staff were spoken with and asked their views on the service provided at Millbrook House. Comments received in comment cards and through discussion included: “The best residential home I know.” “A wonderful home with cheerful, caring staff.” “Millbrook House more than adequately fulfils the expectations we had following our first viewing. The atmosphere in the house is always warm and welcoming.” “This is a lovely house and there is a nice atmosphere. The residents are all looked after as well as possible.” What the service does well: Millbrook House continues to provide a very comfortable environment in which to live. Residents are well care for by well-trained and experienced staff. Residents say that staff are very kind and considerate and their privacy and dignity is respected at all times. The home carries out thorough assessments prior to residents moving in and assurances are given that individual needs can be met. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 6 Care plans are clear and easy to follow so that staff know how to care for the residents living at the home. Each one is regularly reviewed with the resident and any chosen representative. Residents’ health needs are well met by the home and community health professionals. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are helped to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious and planned around the likes and dislikes of residents. The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff find easy to follow. The house and gardens are well maintained which provides residents with a comfortable place to live. Residents are encouraged to personalise their rooms with small items of furniture, pictures and a variety of mementos. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. Millbrook House has an ongoing training programme for staff, which means that residents will be cared for by skilled staff. Mrs Chalke manages her home well and she is supported by very competent and committed staff who ensure the home is run in the best interests of the residents living there. Financial procedures within the home also ensure that residents’ interests are protected. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at Millbrook House. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met. EVIDENCE: Four pre-admission assessments were reviewed and showed that prior to people moving to the home their needs had been fully assessed by the registered manager. Residents spoken with during the inspection confirmed they were given information about the home and were encouraged to visit Millbrook House before admission. One resident said: “I came to stay here for one week to find out if I should like it, and found everything very nice.” Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10. Standard 9 will be assessed on a separate occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear care planning system in place to make sure that staff have the information they need to meet residents’ needs. The health needs of the residents are well met with evidence of good support from staff and community health professionals. Residents are treated with respect and their right to privacy upheld. EVIDENCE: The care documentation for two residents was reviewed. Files contained a variety of assessments including: • Moving and handling • Nutrition • The risk of pressure sores. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 11 Information from the assessments was used to formulate plans of care. Plans were easy to read, to the point and informative. They set out individual care needs and how they are to be met. Residents and/or their chosen representatives were invited to be involved in drawing up care plans, which were reviewed regularly. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, the district nurse, chiropodists, opticians and dentists. Comments received from residents and their relatives/visitors confirmed that staff treated them with respect and were supportive and kind. 13 residents responded to the question “Do you receive the care and support you need?” and 9 said “Always” and 4 said “Usually”. Out of the 11 responses to the question “Do the staff listen and act on what you say?” they all said “Yes”. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally residents felt that there was an adequate range of social opportunities available in the home, which reflects their interests and preferences. There is a strong sense of homeliness and inclusion of family and friends in life at Millbrook House. Residents are helped to exercise choice and control in their daily lives within their capabilities and desire to do so. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets their tastes and choices. EVIDENCE: A list of forthcoming activities for residents was displayed in the front hall. A fashion show was organised for the afternoon of inspection. Some residents attended a variety of clubs locally. Members of the clergy were made welcome at Millbrook House and the home held a church service every Thursday and villagers often attended. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 13 Small group activities were organised within the home on a daily basis such as quizzes, crosswords and scrabble. Outside entertainers were also engaged from time to time. One resident said: “Mrs Chalke is dedicated to arranging activities and making our stay here enjoyable.” 13 residents responded to the question “Are there activities arranged by the home that you can take part in?” 3 said “Always”; 8 said “Usually” and 2 said “Sometimes”. It was clear through discussion with residents and from comments received that many of them preferred to arrange their own social activities, which they were free to do and they could spend their days as they wished. The Registered Manager had undertaken a recent survey with regard to the food provided at Millbrook House. Results showed that generally residents were happy with the catering. One concern was raised about the temperature of the food when it was served and it was sometimes cold. Food temperatures are monitored at every meal. In the Commission for Social Care Inspection survey 12 residents responded to the question “Do you like the meals at the home?” 1 said “Always”, 9 said “Usually” and 2 said “Sometimes”. The menu provided choice and the chef was aware of residents’ likes and dislikes. Residents confirmed they could take their meals where they wished and some preferred to eat in their rooms and some preferred the dining room. Residents were able to invite guests to dine with them and the smaller lounge provided space for them to dine privately if they so wished. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to deal with any complaints that might be made by residents. The home’s adult protection policy demonstrates an understanding of abuse and of how to protect residents from it. EVIDENCE: Residents have access to the home’s complaint procedure. In the last 12 months the home has received one complaint, which was investigated appropriately and was found to be partially upheld. The home had a robust policy and procedure to respond to suspicion or evidence of abuse or neglect. Through discussion staff demonstrated knowledge on the protection of vulnerable adults procedures. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within Millbrook House is good providing residents with an attractive, homely and safe place to live. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. EVIDENCE: The home is well maintained both inside and out. The gardens are attractive, safe and easily accessible for residents. The building complies with the requirements of the local fire service and environmental health department. All areas of the home were clean and there were no unpleasant odours. 13 residents responded to the question “ Is the home fresh and clean?” and they all said “Always”. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 16 The laundry was well managed and adequate supplies of clean linen were seen to be available. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment and number of available staff was sufficient to meet the needs of the residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are well trained and experienced, and residents could be confident they would be well looked after and were in safe hands. EVIDENCE: The Registered Manager confirmed that staffing levels were higher than the Residential Forum guidelines. This was due partly to the fact that care staff did undertake some domestic duties, which were directly related to the individual residents they were caring for. 12 residents responded to the question “Are staff available when you need them?” 6 said “Always”; 5 said “Usually” and 1 said “Sometimes”. 8 relatives responded to the question “In your opinion are there always sufficient numbers of staff on duty?” 7 said, “Yes” and 1 said “No”. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 18 During the inspection it was noted that all call bells were answered promptly and staff were seen to be caring out their duties in a calm and cheerful manner. The home has an ongoing training programme, which includes NVQ level 2 and 3 in care. At the time of inspection approximately 25 of care staff held at least one of these awards and some had nursing experience. Four staff recruitment files were reviewed. All the files were well ordered and contained all the information required by law including – : • Completed application forms • Two written references • Enhanced CRB checks • Terms and conditions of employments • Documentary evidence of any relevant qualifications • Proof of identity Training records demonstrated that staff were receiving the appropriate training and recent training included moving and handling; health and safety; fire safety and infection control. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a committed and competent manager, who creates an open and positive atmosphere, which supports good care practices for residents. Although the views of residents and visitors has been sought the information gained has not yet been used to formulate an annual development plan. Residents are assured of sound management procedures, which protect their financial interests. The health and safety of the service users and staff are protected by the policies and procedures followed at Millbrook House. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home is well managed by Mrs Chalke, who is supported by a loyal and consistent staff. Residents and relatives said that she was very approachable and if they had any concerns they would be happy to talk to her knowing that they would be listened to. Mrs Chalke confirmed that she consulted with residents, visitors and staff about the quality of care and facilities at Millbrook House. Recent questionnaires had covered entertainment and social activities and food. Feedback was also obtained through residents meetings and staff meetings, both of which occurred about four times a year. Residents, relatives and staff confirmed that they were happy with the care and environment that the home provided. It was not only a good place to live/visit it was a good place to work. However Mrs Chalke had not yet devised an annual development plan but confirmed it was her intention to continue to provide a good standard of care in a homely environment. The home does not handle residents’ personal finances. Residents are presented with bills for their fees and for any necessary expenses such as chiropody. Records showed that all staff had received recent training in fire safety and manual handling. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and analysed and appropriate action was taken as necessary. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 OP9 OP33 Good Practice Recommendations It is recommended that the staff who administer medication to residents receive formal training in line with the standards for older people. The home should continue to evaluate its performance and produce an annual development plan as part of their quality assurance. Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 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 © 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 Millbrook House DS0000026843.V317798.R01.S.doc Version 5.2 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. 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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