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Inspection on 20/10/05 for Millfield Care Centre

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

This inspection was carried out on 20th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What has improved since the last inspection?

The written information concerning the care of residents on the Nursing Unit is much better, detailed and easy to follow. A person has been employed specifically to work with residents on Wham Bar unit so that they can enjoy going out on a one to one basis, or as a group if they wish. This provision has greatly enhanced the social lives of residentsA computer has been provided to enable residents to "surf" the internet and use digital photography. A greater choice of food is now available to residents on the Wham Bar unit enabling them to have food more in keeping with younger lifestyles. On Pilsworth unit the staff have started work on improving on personal information in regard to the residents

What the care home could do better:

The home has still to make adequate arrangements for those who wish to smoke on the younger adults unit The choice of food for the YDU whilst better than at the last inspection, could still be better . The home does not routinely obtain evidence that they are involving relatives and residents in the written plans, which set out how each person should be cared for. The home does not always make sure that residents have access to the dietician and some routine blood tests for diabetics are not being carried out. Some training that helps staff to keep residents safe has not been given to all members of staff.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Millfield Care Centre Bury New Road Heywood Rochdale Lancashire OL10 4RF Lead Inspector Bernard Tracey Unannounced Inspection 20th October 2005 09.30a 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.V260106.R01.S.doc Version 5.0 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.V260106.R01.S.doc Version 5.0 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) Ashbourne K.W. Limited Mrs Sandra Marilyn McKinney Care Home 92 Category(ies) of Dementia - over 65 years of age (24), Learning registration, with number disability (1), Old age, not falling within any of places other category (52), Physical disability (15) Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named service user (GC) in the category of LD (Learning Disability) may be accommodated within the overall number of registered places. The home is registered for a maximum of 92 service users to include:up to 24 service users in the category of DE(E) (Dementia over 65 years of age) 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 27th April 2005 3. 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 Pilsworth 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) in the Wham Bar Unit. The two upstairs units provide nursing and personal care for 52 Older People. The nursing unit Summit and the residential unit is Hopwood. The home is suitably adapted for disabled access and the majority of rooms have en suite facilities. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this unannounced inspection over a period of 5 hours on one day. The first part of the day was spent in the office talking to the Manager and later looking at safety records. A tour of the facilities was undertaken and the Inspectors also took the opportunity to read through records relating to how the care of residents was planned and carried out. The remainder of the time was spent speaking at length to six residents, three visitors, and three members of staff, as well as making a tour of the premises. Other staff and residents were spoken to over the course of the day. What the service does well: What has improved since the last inspection? The written information concerning the care of residents on the Nursing Unit is much better, detailed and easy to follow. A person has been employed specifically to work with residents on Wham Bar unit so that they can enjoy going out on a one to one basis, or as a group if they wish. This provision has greatly enhanced the social lives of residents. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 6 A computer has been provided to enable residents to “surf” the internet and use digital photography. A greater choice of food is now available to residents on the Wham Bar unit enabling them to have food more in keeping with younger lifestyles. On Pilsworth unit the staff have started work on improving on personal information in regard to the residents 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 Version 1.10 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.V260106.R01.S.doc Version 5.0 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): The key standards were examined at the last inspection Satisfactory systems are in place for introducing new residents, so that the individual can make an informed choice about moving into the home. Assessment of individual need is made before each resident moves into the home to ensure that the home can provide the care needed by the individual. EVIDENCE: The key standards were examined at the last inspection on the 27th April 2005. All of the key standards were met. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 9 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): 6 19 (18 – 65 year old ) and 7 8 9 10 (Older People) Care plans in place provide staff with an in-depth knowledge of how to care and support each resident in a manner of their choosing. The health needs of residents are met, with evidence of good multi disciplinary working taking place on a regular basis. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 10 EVIDENCE: Wham Bar Unit (Younger Adults) A selection of care plans were examined. Care plans are comprehensive and cover all daily living skills and how each need is to be maintained with the resident. Information relating to specific conditions is also contained on each file, allowing staff to digest and understand more about the physical needs of the resident. Resident’s choices, preferences, independence and privacy and dignity are all recorded in the care plans. Each care plan was seen to be reviewed at a minimum 6 monthly, but in the main owing to the changing needs of residents, this was being done on a more frequent basis. 3 care files looked at supported this. All residents have separate assessments in place relating to nutrition, moving and handling and skin integrity, which are reviewed on a monthly basis by staff, with the nurse in charge of the unit overseeing and monitoring such reviews. Relationships with local GP’s was said to be good, and there was evidence of GP involvement with individual residents. Staff provide the necessary support for residents to attend appointments with GP’s or at the hospital and if a resident wishes them to will accompany them to the appointment. Residents spoken to said they felt their health care needs were “well met” and if they had any issues regarding their health they said would speak with the nursing staff. Summit Unit (Nursing) Hopwood Unit (Residential) Pilsworth Unit (Dementia Care) Individual care plans were in place for each resident. The care plans of 5 residents were examined. They gave clear instructions and guidance on how the care needs of the residents were to be met when problems had been identified. The care plans included information about the residents’ routines in relation to their daily living. The care plans were reviewed monthly and any changes were noted and acted upon. The nurse in charge informed the inspector that a review of the documentation in respect of the care plans on Summit Unit had been undertaken. It was evident from examining care plans progress has been made with the documentation clearly stating the care needs of each resident. One care plan indicated that the resident was a diabetic and was to have his blood glucose monitored three times a day. Examination of the documentation revealed that the instructions in the care plan were not being carried out. Further examination of the documentation revealed that the resident’s weight Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 11 had been increasing and although there was an intention noted to refer to the dietician, the staff could not confirm that this had taken place. The resident himself said he was very happy in the home and that the staff “always treat me well” and “being cared for in bed they always answer my buzzer promptly”. The resident or their relative had signed none of the care plans examined. A discussion with one relative identified that whilst she was kept continually informed about her relatives’ condition she had not been involved in the drawing up of the care plan. Residents and relative must be involved to ensure that important and relevant information is obtained, thereby ensuring an accurate and agreed care plan is in place. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. The residents were weighed at least on a monthly basis and the weight recorded on a chart kept in their care plan. A discussion with the residents identified that they had access to other health care professionals, such as dentists, opticians, chiropodists and district nurses. Evidence of these visits was kept in the residents’ individual files. An example of this was found in the care plan of one resident on Pilsworth Unit. An assessment had identified that the resident had an increased risk of falling or placing himself on the floor. The home had requested a joint assessment from the moving and handling advisor and the physiotherapist from the Moving and Handling Advisors, who had visited the resident and advised the home through their written assessment. The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an accurate record of medicines received into the home and returned back to the pharmacist. Designated and appropriately trained staff administered medicines. All members of staff receive instruction and training in preserving the privacy and dignity of service users on induction, and a signed form indicates acceptance that the training has been given and received during the induction process. Medical examination and personal treatment is provided in the privacy of the service users own room. Relatives and friends are encouraged to visit as often as possible and the home operates an open visiting policy, which is referred to in the Statement of Purpose and confirmed in discussion with service users relatives at the inspection. A discussion with the residents identified that they feel their privacy is respected and that they are treated with kindness. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 12 There is a policy in place that ensures that service users who are terminally ill are given care and comfort, and at death they are handled with due dignity and propriety. The service users’ wishes regarding terminal care and arrangements after death are discussed, usually with the representative, and carried out in accordance with their stated wishes. The Registered Manager ensures that the appropriate attention and pain relief is administered and that service users are able to spend their final days in their own rooms unless there are strong medical reasons to prevent this. The Registered Manager ensures that staff and service users who wish to offer comfort are enabled to do so. Relatives and friends of a service user who is dying are supported and able to stay with the service user as long as they wish. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16, 17 Residents take part in a range of activities both within and outside of the home, they have good links with the community which enriches their lives and provides them with social and educational opportunities. Meals are varied, and in the main the choice indicated generally provides for a “younger” palate thus ensuring that residents may enjoy similar meals eaten by their peers. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 14 EVIDENCE: Wham Bar Unit (Younger Adults) Residents spoken with said they felt they could live as they wished at Millfield. Of 3 spoken with all said they could make their own decisions about rising, retiring, use of room, who to socialise with, when to go out, what to eat, and 2 particularly commented on the “freedom” they felt to have in their lives. The home has recently acquired a computer which has been set up in the lounge on the YDU and Bury College have been booked to attend the home and provide lessons on digital photography and lessons on how to use the computer and internet for any residents interested. Since the last inspection, an activities co-ordinator has been employed specifically for residents on the YDU for 20 hours per week. Activities are now more varied and provide for one to one support with leisure as well as group activities. Where ever possible, residents are encouraged and supported as necessary to join in a range of different social circles to partake in normal, everyday living such as going to the pub, having meals out, shopping, going to the park, swimming, watching football at Rochdale Football Club etc. On the day of the inspection, it was arranged for a small group of residents to go to a local pub and join in the weekly pub quiz. A qualified massage therapist visits the home regularly, and provides a massage service to a number of residents. Visitors may visit the home as often as they wish, and are welcome to stay for as long as they wish. Residents in conversation said they do receive visitors and that the staff make them feel welcomed. The provision of food to residents was looked at on the last inspection, and as there were a number of issues relating to choice and variety, this standard was revisited on this inspection. Since the last inspection, the chef has spoken individually to each resident and made a list of the foods residents would like to see more of on the menu, and also foods which they would like to see included. As a result of this, the menu does (on most days) incorporate a different choice of meal for the residents on the YDU to choose. However, on some days, the choice detailed is no different to the choice indicated for the other parts of the home. For the choice to be a real choice, a different meal should be included on the menu for each day for the YDU residents. Residents spoken with said they welcomed the “additional choices” and did recognise that the chef was willing to try and accommodate their wishes. Residents said they “enjoyed” the food, and they received “enough to eat”. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 15 Summit Unit (Nursing) Hopwood Unit (Residential) Pilsworth Unit (Dementia Care) A discussion with residents indicated that they were satisfied with the range of activities provided by the home. The home employs an activities person who organises events and activities within the home as well as trips out to various places of interest. The programme of activities was displayed so that residents were aware of what was “going on”. Apart from details about games and activities it gave information about other events that were of interest. There was also information about when the hairdresser and chiropodist would be visiting. A relative told the inspector that he had “nothing but praise” for the staff. Several of the residents spoken to were looking forward to the forthcoming trips out. The activities organiser said that the transport used for the trips out was varied. It ranged from Black Cabs (these are able to transport wheelchairs),” Dial a Ride” buses and buses or coaches that can transport wheelchairs. The residents spoken to said that they were satisfied with the personal choices and freedom that they were able to enjoy. They said that they could choose how and where they spent most of their day. Several residents chatted to the Inspector, whilst they were relaxing in their own rooms. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff had a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse to residents. EVIDENCE: A discussion with residents and 2 relatives indicated that there was a general awareness of how to make a complaint. A copy of the Local Authority’s Inter Agency Abuse Procedure was in place and a discussion with care staff and management identified that there were aware of the procedure to follow in the event of any allegation of abuse. ot all members of staff had undertaken training in the protection of vulnerable adults. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 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 (Older People ) 28 (Younger Adults) The standard of accommodation is generally good, providing residents with a homely, clean and attractive environment in which to live. EVIDENCE: The manager was able to provide a schedule of planned refurbishment that the home is about to commence which includes re-decoration of the lounges and corridors. Since the last inspection the carpet on the upper floor has been replaced. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 18 The refurbishment will also include the replacement of all floor coverings in the personal accommodation on Pilsworth Unit and 6 bedrooms on the Summit and Hopwood units. The manager stated that new chairs and bedroom furniture would be provided within the intended upgrading, throughout the home. The home has recently appointed a new handyman who will provide a planned maintenance plan once he has settled into his role. During discussions with the inspector it was emphasised the importance of maintaining records of planned maintenance as well as work carried out. The use of communal lounge accommodation on the Pilsworth unit requires reviewing, as all residents were being directed to the small lounge by the dining room whilst the large airy lounge at the far end of the unit was unused. Staff said that residents choose not to use this facility and prefer the smaller lounge. On the Wham Bar unit, the provision of suitable accommodation for residents who choose to smoke remains an outstanding requirement from two previous inspections, and that the home has failed to address adequately. Residents said that the arrangements made by the home were not suitable, particularly in relation to the limited space. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 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): The key standards were examined at the last inspection. The deployment and numbers of staff are sufficient to meet the needs of the residents. The procedures for the recruitment of staff ensure residents are safeguarded from the appointment of individuals who are unsuitable to care for residents. EVIDENCE: The key standards were examined at the last inspection on the 27th April 2005. All of the key standards were met. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 20 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 35 38 (Older People) 37 39 42 (Younger Adults) The health, safety and welfare of residents and staff was both promoted and protected. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 21 EVIDENCE: The management structure communicates a clear sense of direction and leadership from which residents and staff benefit. From discussions with residents and relatives they are able to meet with the manager on a daily basis if they wish. Staff spoken to appreciate the style of management. The ease of interaction between staff and management demonstrated the open approach promoted by them. There are strategies in place to enable staff, residents and relatives to contribute to the way in which the service is delivered through regular meetings. Staff meetings are held regularly and recorded and residents’ questionnaires have been introduced. There appears to be a sound system for the management of residents’ funds operated by the administrator. The home does not act as appointee for any residents. At the time of inspection policies and procedures were in place that evidenced the homes awareness of health and safety legislation. Detailed risk assessments are carried out for all safe working practices and system/equipment are maintained and serviced on a regular basis. There are thermostatic control valves on all sinks and baths/showers and the water temperatures were checked regularly. Staff have undertaken food hygiene training and first aid is undertaken by the nurse on duty. Infection control procedures were in place and further staff training was planned for this coming year. There is a business plan and financial plan for the home. The residents are not involved in the business and financial planning of the home but are involved to some degree in the monitoring of quality via their meetings and questionnaires. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 22 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 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 37 3 38 3 Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 23 YES 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 OP7 Regulation 15 (1) Requirement To ensure an accurate and agreed care plan there must be evidence of resident/ relative involvement in drawing up and review of care plans. The home must ensure that residents are referred to the dietician when the need arises. The home must provide a suitable designated smoking area for residents who choose to smoke. Outstanding requirement in the timescale of 1st July 2005 All staff must receive training in the Inter Agency Abuse procedures for the protection of vulnerable adults. Timescale for action 01/02/06 2. 3. OP8 YA28 12 23 01/01/06 30/03/06 4. OP18 12 30/03/06 Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA17 Good Practice Recommendations The chef should detail a different meal for each day for residents on the YDU enabling them to have something different to older people if they so wish. Millfield Care Centre DS0000017345.V260106.R01.S.doc Version 5.0 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. 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