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Inspection on 12/10/06 for Millfield Care Centre

Also see our care home review for Millfield Care Centre for more information

This inspection was carried out on 12th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents said that the staff always encouraged them to do as much for themselves as possible and said that staff were "kind", "caring", "good", "of my age group" and "that you could have a laugh with them". The home keeps residents` relatives well informed. One response stated "Nursing staff are always `on the ball` when he is unwell. They inform me of hospital appointments and doctor call outs. Because of this it is now 4 years since he has had to be admitted to hospital." The staff spoken to during the inspection enjoyed working at the home and were keen to do as much training as they could. Residents who use wheelchairs were able to go into the well-kept gardens on their own, without asking staff for help. The home was adapted for residents who were disabled and was kept in a good state of repair. Residents thought the food was good and said they were always given a choice. Menus showed meat, fish and fresh fruit and vegetables were regularly offered and special diets were being followed. Staff helped residents at meal times in a caring way

What has improved since the last inspection?

The home has met the requirements and recommendations made following the last inspection. In particular the younger residents have a room where they can go if they wish to smoke. The home routinely obtains evidence that they are involving relatives and residents in the written plans, which set out how each person should be cared for.

What the care home could do better:

Some carpets in bedrooms need replacing and the home need to provide a plan for further improvements to the environment.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Millfield Care Centre Bury New Road Heywood Rochdale Lancashire OL10 4RF Lead Inspector Bernard Tracey Unannounced Inspection 12th October 2006 09:30 X10029.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 Millfield Care Centre DS0000017345.V298306.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 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. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millfield Care Centre Address Bury New Road Heywood Rochdale Lancashire OL10 4RF 01706 621222 01706 627688 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) BUPA Care Homes (AKW) Ltd Mrs Sandra Marilyn McKinney Care Home 92 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (52), of places Physical disability (15) Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 92 service users to include:Within the maximum 24 service users in the category of DE (E) (Dementia over 65 years of age) to include 5 service user aged 60 - 65 in the category of DE(Dementia) Up to 15 service users in the category of PD (Physical Disability under 65 years) Up to 52 service users in the category of OP (Older People over 65 years) The service should employ a suitably qualified and experienced Manager who is registered by the Commission for Social Care Inspection 20th October 2005 2. Date of last inspection Brief Description of the Service: Millfield Care Centre is a two- storey purpose built home situated close to the town centre of Heywood. Access to public transport and the motorway network is good and there is ample parking to the front and rear of the home. The home is registered to provide nursing and personal care in four distinct units up to a total of 92 residents. On the ground floor one unit provides nursing care for residents in the dementia category, and in separate accommodation nursing care is provided for up to 15 Physically Disabled residents (18 - 65 years). The upstairs unit provides nursing and personal care for 52 Older People. The home is suitably adapted for disabled access and the majority of rooms have en suite facilities. The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody; £ 8.50 Hairdressing; From £5.25 to £18.50 Newspapers; As charged Outings/Activities; Cost dependent on outing Fees charged by the home provided in September 2006 are in the range of: £329.01p to £658.77p. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that the site visit was going to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. Twelve residents, 2 relatives and 3 General practitioners responded; where appropriate their comments have been included in the text. The home was also asked to fill in a questionnaire. The Inspector spent 6 hours at the home. During this time he looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the buildings was undertaken and time was spent looking at records regarding safety in the home. He also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. The Inspector spent time speaking to 12 residents as well as speaking to 2 relatives, 12 staff, and the acting manager. The key National Minimum Standards was looked at on this visit to the home. What the service does well: Residents said that the staff always encouraged them to do as much for themselves as possible and said that staff were “kind”, “caring”, “good”, “of my age group” and “that you could have a laugh with them”. The home keeps residents’ relatives well informed. One response stated “Nursing staff are always ‘on the ball’ when he is unwell. They inform me of hospital appointments and doctor call outs. Because of this it is now 4 years since he has had to be admitted to hospital.” The staff spoken to during the inspection enjoyed working at the home and were keen to do as much training as they could. Residents who use wheelchairs were able to go into the well-kept gardens on their own, without asking staff for help. The home was adapted for residents who were disabled and was kept in a good state of repair. Residents thought the food was good and said they were always given a choice. Menus showed meat, fish and fresh fruit and vegetables were regularly offered and special diets were being followed. Staff helped residents at meal times in a caring way. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 6 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. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 7 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 Outcomes 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) Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 8 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 the following standard(s): 2 (Adults 18-65) 3 (Older People) Standard 6 does not apply The quality outcome in this area was considered good. A thorough assessment of each resident is made prior to admission to ensure that residents’ needs would be met at the home. This judgement has been made using available evidence including a visit to this service. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 9 EVIDENCE: New residents are admitted following an assessment undertaken by members of staff, usually by the registered manager. When the home is contacted the initial reasons for the referral are established and a pre admission assessment is then arranged. Because of the nature of the client group admitted to the older people’s service, it is more appropriate that the resident’s representative visits the home to assess the facilities and have the opportunity to meet with the staff to discuss the way their needs of their relatives’ will be met. Younger adults are invited to view the facilities and meet both residents and staff before making a decision to move into the home on a trial basis. Adequate time and opportunity to make a decision regarding the placement is afforded the individual and this opportunity enables them to discuss how the home can meet the person’s individual requirements. Clear and detailed information concerning trial visits and the length of the ‘settling in’ period is included in the Statement of Purpose. Emergency admissions are avoided as far as possible. A discussion with the two most recently admitted residents indicated that they were completely satisfied with the information they had been given by the home and felt that the arrangements made to visit the home, one on a week long trial, were extremely helpful. The home develops a care plan based on the assessments made prior to admission to the home. There is evidence within the care plans, and in discussion with the residents, that any potential restrictions on choice, freedom, services or facilities, likely to become part of the residents’ daily life, had been discussed and agreed with the individual during assessment. Any changes in status are agreed with the resident and their representatives and recorded within the care plan. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 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 the following standard(s): 7 8 9 10 (OP) and 7 9 18 19 20 (Adults 18-65) The quality outcome in this area was considered good. This judgement has been made using available evidence including a visit to this service. There is a clear and detailed care planning system in place that includes residents’ involvement and provides the staff with the information needed to meet the needs of the residents. The arrangements in place ensure that the residents’ physical and emotional health care needs are being adequately met. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 11 EVIDENCE: Residents on the older peoples’ unit receive a formal assessment from a qualified member of staff using a detailed assessment format. The care management assessments and the hospital care plans are obtained prior to admission to the home, and a copy is held in the residents’ notes. Individual care plans are in place for each resident. The care plan is generated from the single care management assessment and the assessment provided by the home. The plan sets out how the current and anticipated needs are to be met. The care plan would also include any changes in the resident’s condition. Signatures in the care plans, indicating that the individual agreed with the plan and any alterations made to it after consultation with the individual, should be obtained to confirm this involvement. Risk assessments are in place for service users and records are maintained in the service user care plan. The manager operates an open door style of management, encouraging relatives to approach her with any problems or worries either in the home or by telephone. A relative spoken with stated he was satisfied that he could approach the manager with confidence at any time and “always found Sandra to be helpful, kind and very professional”. As with residents on the older peoples’ unit, younger adults referred to the home receive a formal assessment from a qualified member of staff using a detailed assessment format. The care management assessments and the hospital care plans are obtained prior to admission to the home, and a copy was seen in the residents’ notes that were examined during the inspection. Any potential restrictions on choice, freedom, services or facilities that become part of the residents’ daily life, had been discussed and agreed with the resident during assessment, and recorded in the care plan., Two residents spoken with confirmed that they had been given “good and full information about how the home is run before coming in the place.” The care plan is generated from the single care management assessment and the assessment provided by the home. The plan sets out how the current and anticipated needs are to be met. There is evidence that the resident together with family, friends or advocate are involved in the drawing up of the plan. Care plans examined had been reviewed on at least a monthly basis, which is above the necessary requirement of this standard. The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 12 accurate record of medicines received into the home and returned. Designated and appropriately trained staff administered medicines. Observations made during the inspection indicated that staff had developed a good rapport with residents and there were several examples of spontaneous and humorous interactions with residents and staff. Arrangements for appropriate access to specialist medical care, including Psychiatrists and Community Psychiatric Nurses are in place, where necessary. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 13 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 assistance 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 the following standard(s): 12 13 14 15 (Older People) 12 13 15 17 (Younger Adults) Quality in this area was considered good. This judgement has been made using the evidence available including a visit to the service. Social activities provide daily variation and interest for people living in the home. EVIDENCE: The resident’s involvement in social activities varies greatly according to their abilities and nursing needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 14 the television. The choices residents made each day varied, dependent upon their mental frailty but residents generally chose what time to get up, go to bed, what clothes to wear, where to spend their day, what food to eat, whether to participate in activities. Overall, residents considered they were encouraged to do what they could for themselves and make appropriate choices through the day. The home has employed two staff with responsibility for the provision of activities. Positive feedback from residents, relatives and care staff were received regarding the increased provision of activities. The home gathers a social history, usually from the relatives, which is used to identify interests and hobbies previously undertaken by the resident. This social history is used to help to provide the staff with details and to encourage the individual to participate in appropriate activities. Residents told the Inspector that they are able to have visitors at any reasonable time and they can see their visitors in private. Two relatives told the Inspector that the staff at the home always made them very welcome. Records of food provided to residents confirmed that all receive a varied and nutritious diet. The residents were asked what they would like to eat and alternative meals are available. The food was served from a hot trolley that was brought through into the dining room. The tables were nicely set with tablecloths, napkins and cruets as well as freshly cut flowers. Hot and cold drinks were served. The residents spoke positively of the food provided. Appropriate assistance and encouragement was given to those residents who required help with feeding. The home provides a suitably portioned plate for residents who require a pureed diet so that all elements of the meal are separated. The inspector-spent time talking with the chef, who clearly demonstrated that she was aware of the appetites and preferences of each person and spoke of the need to present the meals in an appetizing way. There was a choice of main courses and the chef confirmed that further choices were available from the kitchen. Residents said that they “really liked the food”. Snacks, such as pizza, toast or cheese and biscuits are available for staff to access during the period when the main kitchen is closed Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 16 18 (Older People) and 22 23 (Younger Adults) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were confident that complaints would be listened to, taken seriously and acted upon. Appropriate systems were in place to protect residents from abuse. EVIDENCE: Discussion with resident’s relatives indicated that there was a general awareness and information provided that enabled people to make a complaint if they desired. A detailed and accessible complaints procedure was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Inspection of policies and procedures operated at the home and discussion with staff throughout the home indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. Staff are enabled to Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 16 attend protection of vulnerable people training that is organised and provided by Rochdale Social services. The manager of the home has undertaken training, which enables her to provide instruction in relation to the Protection of Vulnerable Adults. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 19 26 (Older People) 24 30 (Adults 18-65) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of accommodation is generally good, providing residents with a homely and attractive environment. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 18 EVIDENCE: The front and rear of the building are overlooked by mature gardens, lawn and various patio areas. The grounds were well maintained and the patios areas were accessible to residents in wheelchairs. One resident said he very much enjoyed the choice of being able to take himself into the garden, independent of staff. Furnishings and fittings were of a good quality and residents interviewed were extremely satisfied with their bedrooms, some of which opened onto the landscaped gardens and patio areas. Since the last inspection the home have provided a new lounge on the Wham Bar Unit for those residents who liked to smoke. Residents on Pilsworth Unit were now using both available lounges, which provided greater flexibility and better use of the available space. The carpets in bedrooms 45 and 65 need replacing and the general manager was asked to review all of the bedrooms on the Residential unit in respect of further replacement carpets required. Residents said staff kept the building clean and odour free, inspection of the premises supported this view. Discussion with two domestic staff verified that sufficient staff and equipment were provided to ensure the home was maintained in a clean and hygienic condition. An infection control policy was in place and training was provided in this area. Staff spoken with described safe infection control practice. Satisfactory practice was in place with regard to disposal of clinical waste. The laundry was sited away from the food preparation area and was seen to be clean and orderly. Sufficient and suitable equipment was provided and laundry was attended to efficiently. Three residents said that they were satisfied with the laundry system at the home and that there was a quick turn around on the clothes sent for cleaning. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 19 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, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 (Older People) and 32, 34 & 35 (Adults) Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Staff are well trained to ensure they have the competencies to meet residents needs. The deployment of staff throughout the day is sufficient to meet the needs of residents. EVIDENCE: Staffing levels within the home were seen to meet the needs of residents. Care staff that undertook their duties in a friendly and caring manner promptly supported residents’ needs. Resident’s confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as “ok”, “nice people”, “alright”, “find time to listen” and “good”. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 20 Sufficient ancillary staff were employed e.g. domestics, laundry and kitchen assistants, cook and handyman. Staff were in the main knowledgeable about the needs of residents and demonstrated that they understood their own role. Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken. These include references, criminal record bureau disclosures and for nursing staff registration with the Nursing and Midwifery Council. New staff undertake a full induction programme that is followed by further in house training. Several staff are presently undertaking National Vocational Qualifications in care at Level Two. The home has an ongoing training programme that staff can apply for. Since the last inspection several staff have received training in abuse awareness and more are booked to attend in the future. Staff spoken with showed that their knowledge had increased since the training and that they were more aware and confident in reporting concerns. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 21 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 policies 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 31, 33, 35 and 38 (Older People) and Standards 37, 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 the following standard(s): 31 33 34 35 36 (Older People) 37 39 42 ( Younger Adults Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of residents Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager is a qualified nurse who has many years experience in caring for residents. At the time of the inspection the manager was on sick leave and a peripatetic home manager who in turn is supported by the general manager, was supporting the home. Throughout the inspection the Inspector was able to observe the professional, capable and approachable manner in which the manager undertook her role when dealing with residents, staff and visitors. The home has good systems in place to gather staff, residents and relatives’ views as part of the monitoring of quality. Staff spoken to had a clear understanding of their role and what was expected of them. The Inspector saw documentation that confirmed that staff received regular supervision. The home did not act as appointee for any residents. However, they did manage the personal allowances of a number of residents. A discussion with the administrator in relation to how the home managed the finance indicated that a safe and audited system operates. Banked monies were held in a pooled residents account. Whilst in-house records showed the total amount held for each resident, bank statements did not provide this detail. Information provided by the manager and examination of the records, confirmed that all safety equipment is regularly serviced. The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. The home’s handyman, who is supported in his role by the corporate estate manager, takes responsibility for maintenance and safety checks. Evidence was seen that indicated that fire extinguishers, alarms, lifts and hoists are all serviced and maintained as required. The Portable Appliance Test had been undertaken. A current certificate of inspection was available for the electrical and gas supplies to the home. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 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 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 3 35 3 36 3 37 X 38 3 Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 24 NO 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 OP19 Regulation 23 Requirement A programme of renewal of furniture carpets and curtains is to be produced and implemented. The carpets in bedrooms 65 and 45 need replacing. Timescale for action 30/11/06 2. OP19 23 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. Millfield Care Centre DS0000017345.V298306.R01.S.doc Version 5.2 Page 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. 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