Inspection on 13/11/07 for Millfield Care Centre

This inspection was carried out on 13th November 2007.

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

Millfield Care Centre 22/02/10

Millfield Care Centre 18/11/09

Millfield Care Centre 24/08/09

Millfield Care Centre 14/11/08

Millfield Care Centre 12/10/06

Millfield Care Centre 20/10/05

Millfield Care Centre 27/04/05

Millfield Care Centre 23/11/04

Millfield Care Centre 23/11/04

Millfield Care Centre 23/11/04

Millfield Care Centre 23/11/04

Millfield Care Centre 28/07/04

Millfield Care Centre 28/07/04

Millfield Care Centre 27/07/04

Millfield Care Centre 27/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Millfield Care Centre Bury New Road Heywood Rochdale Lancashire OL10 4RF Lead Inspector Michelle Haller Key Inspection 13th November 2007 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.V350918.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.V350918.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 mcnally@bupa.com 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 Heidi McNally 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.V350918.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2006 Brief Description of the Service: Milfield 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 previous Commission for Social Care Inspection report is available on request. The home weekly charges range from £339.90p to an upper limit that is dependant on the individuals assessed needs. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection which included an unannounced site visit to the home. The manager was not informed beforehand that we were coming to inspect. The inspection process involved interviews with four people individually and three relatives. Three members of staff were interviewed and in depth discussions with the manager and registered person were also conducted. Eight care files and other records and reports pertaining to the care and support of these people were inspected. Other documents concerning the running of the home were also examined. The Commission for Social Care Inspection (CSCI) ‘Annual Quality Assurance Assessment’ which was completed by the manager also provided information that influenced the outcome of the inspection. Three service users and one relatives CSCI surveys were returned and these were used as part of the evidence when completing the inspection. A tour of the communal areas of the home was also undertaken and during the course of the inspection the interactions between people in the home was observed. What the service does well: Systems in the home are flexible and the general atmosphere is friendly and people are approached with warmth and respect. People at Milfield Care Centre have a high regard for staff and good relationships are promoted between those who live, work and visit the home. People said: ‘Staff are nice.’; ‘it’s lovely, staff are lovely.’; ‘It’s nice here…I’m happy.’ Care plans are very detailed, individualised and relate directly to the person, and people are encouraged to participate and influence the care and support they receive. The home is clean, comfortable and pleasant to be in. People are supported in accessing the local community, maintaining and building relationships, and keeping up to date with what is happening locally and in the wider world. Recruitment and selection processes are robust. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 6 People feel safe and confident, and are protected from exploitation and abuse. 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. Millfield Care Centre DS0000017345.V350918.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.V350918.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Older people) and 2 (adults 18-65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from having their needs fully assessed EVIDENCE: Nine care files were examined in full. Each contained a full needs led assessment that provided information about the persons physical and emotional condition. The assessment uses a scoring system that acts as a prompt for a specialist assessment if the person scores a particular number in an area. For example in relation to the assessment for diet a certain score will prompt staff to complete specialist tissue viability or nutrition assessments. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 9 This system appeared to work well as through case tracking the care for these eight people confirmed that specialist assessments had been undertaken and corresponding care plans put in place as indicated initially. The information recorded on the assessments also confirmed that these involved the person, the social worker, family and others as necessary. Although no direct comments were made, all four respondents returning CSCI surveys felt that they had received sufficient information about the home before moving in. Millfield Care Centre DS0000017345.V350918.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 (Older People) and 6,9,16,18.19 and 20 (Adults 18-65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care people receive is based on their individual needs. In the main people at Milfield Care Centre are treated with dignity and respect. EVIDENCE: Each care plan examined was individualised and centred on the person. A variety of specialist assessments and related interventions concerning identified needs including, falls, moving and handling, tissue viability, Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 11 continence, communication, medication, previous medical history and so forth, had n=been developed. These provided detailed and clear information to staff about the actions they were to take and the expected outcomes. Care plans had been reviewed and attendance lists and signatures usually confirmed that the person was involved. Review records and other correspondence demonstrated that reviews were multidisciplinary, when necessary, and involving a range of specialist health and social care professionals. It was not always possible to confirm through the records that all people received routine health care check-ups, however there was evidence that people had access to dental care, chiropodist, opticians, and routine medical check-ups. Other information in the care files clearly demonstrated that appropriate treatment and monitoring occurred in response to longstanding and newly developed health conditions including diabetes, chest infections and general illnesses. People were seen using equipment such as zimmer frames and pressure relieving cushions and these were clean and appeared well maintained, however a number of wheelchairs required servicing and footplates replacing in order to fully promote peoples safety. On the day of inspection, a visiting health professional was interviewed and commented that staff were co-operative and although the actions were not always document, positive outcomes for people demonstrated that they did follow instructions. This person also identified that the manager had improved liaison with community based health professionals and staff now seemed ‘..more aware of what they have to do to and if they do refer the manager is supportive of recommendations.’ Observation of the interaction between staff and residence living at Milfield Care Centre indicated that people were treated with dignity and respect, and no personal care was carried out in communal areas. The standard of personal care could be improved for people in the EMI unit as in a significant instances people had not been supported to wear shoes or slippers and socks or stockings. People were encouraged to mobilise and do things for themselves and staff were polite to the residents. Comments were mostly positive and included ‘I think it’s brilliant the staff are nice.’; ‘It’s lovely, staff are lovely, just ring the bell and they are there.’ And ‘They (the staff) say –‘we’re happy if you’re happy.’’’; ’ I can have a bath or shower whenever I want.’ And ‘All care is carried out in private.’ Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 12 At the time of the inspection the manager was dealing with one complaint concerning care, the complaints record was examined and the information recorded indicated that in the past such complaints had been dealt with openly and honestly. Daily records were also examined and entries were in the main respectful, however in some cases, the reports lacked detail and did not reflect the care plans or provide a picture of peoples daily experience. The management of medication was assessed on one unit. Staff who administer medication sign to confirm that they have read and understood the medication policy and guidance. There is a registered nurse on duty at all times who takes responsibility for the management of medication on the unit. A medication round was observed and no problems were identified at that time. There was a photograph of each person on the corresponding medication administration record sheet (MARS) and no unexplained gaps were noted. Medication that was destroyed was also recorded on the MARS. The storage and administration of controlled medication was also observed. This system would be improved if both staff checking the item also countersigned the MARS. Otherwise there were no major issues of concern in this area. Millfield Care Centre DS0000017345.V350918.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 and 15 (Older People) and 12,13,15 and 17 (Adults 18-65) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who can express a preference are able to make choices about their lifestyle and opportunities for recreation and activities are made available. EVIDENCE: Two activities co-ordinators are employed by the home and they have responsibility for arranging and facilitating activities, events and outings for people living in the home. The monthly activities calendar suggested that Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 14 people have the opportunity to participate in, playing a variety of games and quizzes enjoy entertainment from outside entertainers such as musicians and dancers, themed movie nights using a projector and large screen, baking and arts and crafts. Outings have included participating in events at a local Church, visits to a local market and trips further a field such as Blackpool Illuminations. BUPA also organise ‘Community Spirit’ weeks and the activities organisers are supported in organising events in which people living their care homes can participate. This year the theme at Milfield Care Centre was ‘foods of the world’ and people were able to participate in wine and cheese tasting events, tea and biscuit tasting, and entrainment with refreshments. These events are open to family and friends and certain groups in the local community. People are also enabled to keep aware of current affairs and issues through participating in national initiatives such as Breast Cancer awareness month and other ‘awareness’ days. People who commented about lifestyle were in the main content about activities saying-‘Activities are not bad- I’ve been to Blackpool illuminations and they are planning a Christmas meal out.’ ; ‘We had a good Halloween party,’. Other comments about activities included- ‘not really enough to do but staff will come and talk to you and play bingo, sing songs and other people come.’ And ‘…. gets bored the activities person tries but she can’t be everywhere.’ The main area for improvement at Milfield Care Centre in relation to activities concerns people living in the EMI unit. Although an activities calendar was in place, cross-referencing the records indicated that most people on the unit did not have regular and frequent opportunities participate in meaningful activities that would promote emotional and physical well being, and prevent boredom. Records demonstrated that in the main the same people accessed activities, however it was noted that ‘being spoken to while receiving support at the dinner table’ was considered an activity, which should not be the case. Staff confirmed that Dementia care training had been provided to senior staff, however people may benefit if all staff who work on the unit received training in dementia care and provided wit the skills to enable them to fulfil their responsibility in developing and planning activities for individuals daily. The manager should ensure that assessments includes ‘life story’ information for each person, this would enable staff to take into account individual experiences and interests when developing group and individual activities. Each of the three people who returned CSCI service user surveys felt that the activities in the home met their needs ‘sometimes’. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 15 Observations confirmed that people could receive visitors throughout the day. People were encouraged to maintain their relationships and spouses were encouraged to spend time in privacy. People said ‘ I have lots of visitors.’ People said the routines in the home were flexible and comments included ‘visitors can come any time they want.’ ‘….gets three visits a day, she always has a drink and we’re given one too.’ ….‘nothings too much for them to do, they are nice people.’ In the main staff were respectful and pleasant and referred to people by their preferred name or title, for example ‘Mr…’ instead of first name. Mealtime on the EMI unit was observed and the process was calm and people were supported with patience. Meal choice was flexible and people were offered an alternative if they didn’t want what was provided. Family members were present to assist in encouraging a good diet and felt free to bring in favourite items from home. The soft diet was presented in a partitioned plate so that foods could be kept separate. The lunchtime meal on the day of inspection was cheese and ham omelette, baked beans and chips, soup and roll and scones and cream. It was observed that people resorted to eating with their fingers or became frustrated when food kept falling from their forks and spoons. This could be resolved if people were assessed to ensure that they were provided with appropriate cutlery and other utensils to assist in maintaining dignity and promote independence at meal times. In the main comments about the meals were positive, people said ‘I’ve put on weight, the food is lovely.’; ‘The food is immaculate.’ And ‘The food is lovely and yes there is enough.’ People who returned CSCI surveys in the main observed that meals ‘usually’ met their needs. One person felt that some food, for example, baked beans, appeared too frequently. The menu indicated that these were offered at least three times a week for different meals, but there was also always an alternative. Other items on the menu included meat pies, hotpots, chicken and fish bakes served with vegetables. Weight charts confirmed that people usually put on weight when they moved into the home, and significant weight losses were investigated and appropriately managed. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 (Older People) and 22 and 23 (adults 18-65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from an environment where they can express their concerns, have access to a complaint procedure and are protected from abuse. EVIDENCE: The complaints record was examined the documents available indicated that complaints were investigated although it was not always possible to confirm that the complainant had been kept well informed of the outcome and consequences of an investigation. The complaints procedure was readily available in different parts of the building including the entrance of the building and on the different units. Complaints are categorised into care, activities, cleanliness, facilities, attitude of staff, external agencies, property, catering, finance and dignity and privacy. Complaints are analysed as a part of the quality monitoring and audit process that is completed by BUPA senior management. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 17 Those who commented were clear that they would speak to the manager if they had any complaints or concerns. The majority of people said that they had made a complaint felt that they had been listened to and treated fairly. There is one complaint known to CSCI being investigated by the home at the time of writing this report. Comments included: ‘I’ve never had a complaint but if I had one I’d just go to them and they’d listen.’ And ‘I would talk to ….the nurse but I haven’t got any complaints.’ The homes protection for vulnerable adult guidelines and policy provided staff with a guide about behaviours and omissions that constituted abuse, however the policy did not appear to link in the local authority adult protection protocol. Staff training records identified that staff have received recent protection of vulnerable adult training. Staff who were interviewed were clear about behaviours that could be considered abuse and were keen to state that if they had any worries they would approach the manager or social service if they were unhappy with the response. The manager had dealt with one POVA investigation since her employment and the action taken safeguarded people living in the home. People living at Milfield appeared confident and said that staff were pleasant and caring. Comments included ‘Staff are beautiful- I’ve no complaints they are always gentle, nothing is too much trouble’ and ‘They love her here staff are all smashing.’ Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 (Older People) and 24 and 30 (Adults 18-65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical environment at Milfield appears safe, generally well-maintained, comfortable and supports independence. EVIDENCE: A tour of all the units was completed and this included all the communal areas of the home, a number of bedrooms and the laundry. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 19 The entrance to the home was clean and welcoming. Each unit entered was clean and free from unpleasant odours. People were observed accessing the different areas of the home independently using specialist equipment that had been provided, such as electric wheelchairs, Zimmer frames and walking sticks. Bathroom and toilet doors were labelled with pictures that would assist with recognition. These were clean and warm and fitted with appropriate aids and adaptations such as handrails and specialist baths. There are a number of small lounge areas that can be used for small group activities or by families and visitors. All equipment, fixtures and furniture appeared clean and free from stains, and were, therefore, pleasant to use. A picture of the occupant had been attached to some bedroom doors, and each bedroom that was entered was clean and warm. Specialist equipment such as rise and fall beds were in place. Rooms had been personalised to suit the individual and people said that they were able to choose their own décor and, whether to have carpet or laminate flooring. The manager stated that the current refurbishment plan for the home included replacing faded carpet and some furniture. The laundry area contained labelled boxes for each person. Good-practice posters were on display concerning storage and handling of soiled laundry. The floors and walls are washable. The washing machine used is from a specialist firm and provided ‘sanitise’ and ‘sluice’ wash programs. Over all, people who returned CSCI surveys indicated that though some areas needed refurbishment the home was usually clean and fresh. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30 (Older People) and standards 32,34 and 35 (Adults 18-65). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at Milfield Care Centre benefit from staff who are employed using a robust recruitment process, who receive training and who are generally provided in sufficient numbers to support the smooth running of the home. EVIDENCE: On the day of inspection there were 85 people living at Milfield Care Centre and the staffing compliment for the morning to late afternoon was 19 care staff; 2 laundry workers; 1 cook and 2 kitchen assistants; one maintenance worker; 4 housekeepers. In addition the home employs 2 administration staff and two activities co-ordinators. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 21 People living in the home did not feel that staffing was a problem although people commented that they did work hard. People stated that staff had time to spend with them and were able to go out on their behalf, one person said‘My key-worker tidies my wardrobes and runs small errands for me- she looks after my welfare.’ Discussion with some staff and observation during the day on the EMI unit suggested that, at times, additional staff maybe beneficial. Discussion with the management team acknowledged their awareness of this and said that they were considering strategies to facilitate more flexible staffing on the unit. Each unit has a senior member of staff responsible for running the unit. Records and calendars indicated that staff training provided since the previous inspection has included- fire safety, in-house POVA training, infection control, manual handling, optical awareness, control of substances hazardous to health (COSHH), safe use of bedrails, basic food hygiene, record keeping and care planning. The manager also identified that 20 care staff have attained National Vocational Qualifications (NVQ) in Care level 2, and this training is provided through a rolling program. BUPA have also introduced a staff development scheme called ‘Personal Best’ which encourages staff to develop good practice. Seven staff files were examined and each contained a copy of the completed application form, two references, additional proof of identity, a photograph, confirmation of criminal record checks and a number also held a copy of a POVA first disclosure. The manager stated that future training plans included, dementia care training for senior staff and ‘Yesterday, today and tomorrow’ dementia awareness courses for staff allocated to the EMI unit. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35, 36 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at Milfield Care Centre benefit from management and administration that is open and respectful, and quality assurance systems have been established. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has achieved CSCI Registered Manager is a registered nurse and completed the Registered Managers Award in August 2007. Other recent training has included health and safety qualification (November 2007), Care of the Dying, Dementia Care and Teaching and Assessing in Clinical Practice. Discussion with the manager and information provided in the AQAA she completed, confirmed that she was able to identify areas of strength and areas requiring improvement in the home. Notes from meetings demonstrated that she was focussed on supporting staff to meet the needs of people, however, individual supervision must also be formalised so that individual issues can be highlighted. People involved in the home identified that the management team were open to suggestions and supportive if there were problems- it was felt that her actions promoted positive relationships and a feeling of security. Comments included: ‘it’s perfect as far as we’re concerned- I like that you have to sign in and out as well and so feel she is safe.’ Furthermore people frequently named the manager as being readily available and easy to approach. Finances for people who cannot take full charge of their own money is managed and audited from BUPA area office. There are a number of strategies in place to assist with Quality Assurance monitoring. These include an annual audit and questionnaire, the registered persons Regulation 26 visits which includes asking people about their satisfaction with living in the home, and analysis of the complaints and comments received throughout the year. The results are published and made openly available. Health and safety at Milfield Care Centre appeared well managed. Documents and correspondence confirmed that equipment and services were maintained, serviced and monitored in keeping with the relevant guidance. According to the training records, health and safety related training including infection control, food hygiene and moving and handling training is provided. The fire log was examined and entries confirmed that all fire checks and alarm tests were completed and fire drills were performed and the outcome and responses assessed. The outcome for people living and working in Milfield could be improved if all members of staff received regular individual supervision and the manager was able to demonstrate that the quality of direct support provided was being Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 24 monitored. It is possible that the BUPA ‘Personal Best ’ initiative could be a part of this process. Information provided in the AQAA in certain section was at times generalised and amounted to statements of intent rather than a description of what actually occurred at Milfield Care Centre. This was discussed during the inspection process. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 25 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 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 X 35 3 36 X 37 3 38 3 Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 16 Requirement The registered manager must ensure that when controlled medication is administered it signed as witnessed by two people. This will reduce the risk of accidental or deliberate omission. Timescale for action 01/02/08 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 OP3 OP12 Good Practice Recommendations The registered person should ensure that peoples personal histories, interests and aspirations are fully documented. The registered person should ensure that a variety of activities is made available in all units so that all people have the opportunity to participate in activities, this will promote emotional well being prevent boredom. The registered person should ensure that people are assessed and provided with utensils and cutlery that they can use. This will ensure that people who can eat independently do so in a dignified manner. The registered person should provide staff with regular DS0000017345.V350918.R01.S.doc Version 5.2 Page 27 3. OP15 4 OP36 Millfield Care Centre individual supervision so that personal performance and other issues can be discussed. This will ensure that staff have their work monitored and assessed as necessary. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. Millfield Care Centre DS0000017345.V350918.R01.S.doc Version 5.2 Page 29 - 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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