Inspection on 01/08/06 for Millfield House

This inspection was carried out on 1st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Millfield House 19/11/07

Millfield House 24/11/05

Millfield House 04/08/05

Millfield House 08/03/05

Millfield House 24/06/04

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

CARE HOME ADULTS 18-65 Millfield House 16 Millfield Folkestone Kent CT20 1EU Lead Inspector Wendy Mills Unannounced Inspection 1 August 2006 09:30 st Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 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 House DS0000023493.V298473.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 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 House DS0000023493.V298473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millfield House Address 16 Millfield Folkestone Kent CT20 1EU 01303 226446 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) MNP Complete Care Group Care Home 8 Category(ies) of Physical disability (8) registration, with number of places Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Millfield House is a care home providing support for up to eight people with physical disabilities. It is a three story semi-detached house with bedroom accommodation on all three floors. It is situated on a residential street close to all amenities. There is disabled access. Parking is limited but a there is an allocated parking space for disabled badge holders. The manager is Ms Debbie Beer. She is currently preparing her application for registration with the CSCI. The fees for this home range between £750 and £1,200 per week. Fees are assessed individually and based upon the dependency level of each resident. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit lasted approximately five hours. A pre-inspection questionnaire and provider’s assessment form completed by the manager were received prior to the inspection. Three of the residents were spoken to in private and a further three were spoken to en passant. Discussion took place between the manager and one of the registered providers. Three members of staff gave their views about the home in private. Documentation, including care plans, was examined. The views of visiting professionals were sought by telephone. A tour of the home was made and both direct and indirect observation was used throughout the visit. Feedback from both residents and staff on the day of inspection was very positive. Care managers and other health and social care professionals also said that they were very happy with the way the home is run and said that good working relationships are maintained. What the service does well: What has improved since the last inspection? A new manager, Debbie Beer, has been appointed. She has earned the respect of staff and better team working is being promoted. The lift has been fitted with a new motor and is now much quieter. More radiator covers have been fitted and those radiators still without covers have been risk assessed. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 6 New staff have been recruited and staff training has increased. Shift patterns have been changed to ensure that there are more staff on duty at times of greater need. Recruitment procedures have been changed. The administration process has been centralised. This means that there is consistency throughout the company, management time is freed up and pre-employment checks are more thorough. 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 House DS0000023493.V298473.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 3, 4 & 5 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. The home makes appropriate pre-admission assessments prior to offering a place in the home. EVIDENCE: The home has a statement of purpose and service user guide. Both documents give good information about the home. All residents have written contracts. Conversation with residents confirmed that they are clear about their rights and responsibilities whilst living in the home. Examination of documentation showed that good pre-admission assessments have been made prior to offering a place at the home. Residents said that they had been able to visit the home to meet the other residents before making a decision about moving into the home Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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, 7, 8, 9 & 10 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. Care at the home is of a high standard and the residents are encouraged to maximise their independence. EVIDENCE: Care plans are up-to-date and in order. They have been recently reviewed. The home is in the process of changing the format of the care plans to make them easier for staff to understand. Some care plans have already been completed in the new format. There is now more detailed and clearer information. Risk assessments are in place. Residents said that they are very well looked after and that the staff are kind and helpful. However, one resident mentioned that a member of the night staff had seemed impatient on one occasion. It is important for the home to ensure that night staff receive as much supervision and training as the day staff. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 10 Many of the residents have communication difficulties and some of these difficulties are profound. Staff were observed to use a variety of forms of communication with the residents. These included using a book with symbols and a light writer. It was noted that the staff on duty on the day of inspection were very good at communicating with the residents using these methods. These staff are commended for the patience and proficiency that they showed when talking to the residents. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 The quality in this outcome area is excellent. This judgement is based on evidence gained both before and during this visit. The home helps the residents make informed choices. It provides an excellent range of opportunities for the residents to take appropriate risks and to maximise their independence. EVIDENCE: The residents said that they participate in a wide range of activities. On the day of inspection some residents were going to the Chinese Circus and others were going out to lunch to celebrate a birthday. Later in the day there was a party to continue the birthday celebrations. Several friends from other homes attended this party. The wishes and aspirations of the residents are documented in the care plans and the home seeks ways of supporting the clients in achieving their goals. The home provides transport for activities and visits home. Activities include visits to the cinema, local fetes, the sea and surrounding countryside and local Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 12 shops. The home encourages the residents to maintain contact with their friends and family by a number of means such as e-mail and telephone. A sample of the previous month’s menus was provided prior to this visit. These showed a good variety of meals that were appropriate to the season. Residents said that they enjoyed their meals in the home and that they contribute to the choice of menu. They also said that they enjoy going out for meals. There is a good understanding of the importance of good nutrition. Inspection of the kitchen showed that is plenty of good quality produce in the home. Special diets are catered for and those residents who need help with eating were given the help they needed in a discreet and caring way. Many of the residents have communication and mobility difficulties and the staff work very hard to minimise these. All equipment is well maintained and many of the staff are very good at using a variety of forms of communication with the residents. The staff are commended for their dedication in learning the skills needed to help the residents with their mobility and communication. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19 & 20 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home respects the privacy and dignity of the residents. The health and emotional needs of the residents are very well met by the home. All aspects of the administration of medicines in the home are well managed. EVIDENCE: The residents said that their privacy is respected. Indirect observation confirmed that help and prompting is given in a sensitive and discreet way. Health and social care professionals say that they are able to work well with the home and that their advice is followed. Records show that all appropriate health care appointments are made and kept. Advice given by health and social care professionals is recorded and carried out. Medication policies and procedures are sound. Medication training for staff is up-to-date. Storage of medicines is safe and the MAR charts are in good order. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home has a sound policy and procedure for dealing with complaints There are systems in place for the protection of residents. EVIDENCE: The home has sound written policies and procedures for dealing with complaints and the protection of vulnerable adults. Staff said that they would have no hesitation in reporting a colleague if they felt any form of abuse was taking place. They also said that they cold not imagine that this would happen as the y see the residents as an extended “part of my family”. Staff were very well aware of the home’s policies and procedures for the protection of vulnerable adults. There have been no formal complaints since the last inspection. Most residents said that they had no complaints and that any concerns they voice are dealt with straight away. They said that the staff help them overcome their worries. However, one resident raised a concern because a member of night staff had seemed impatient. The home must look into this issue and ensure safeguards are in place to prevent a further occurrence. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home is well maintained, clean and comfortably furnished. This provides the residents with a homely and pleasant place in which to live. EVIDENCE: A tour of the home was made in company of one of the manager. Although the house is old and has some tight corners, good use has been made of all space. The communal areas are spacious and provide plenty of room for wheelchair users to move about. Bathrooms are fitted with a variety of disability aids ranging from rails to specialist hoists and baths. The home is well maintained. All areas of the home were safe, clean and free from offensive odours on the day of inspection. The bedrooms are comfortable. They reflect the personalities and interests of the residents. Residents said that they like their rooms and are able to choose the way their rooms are decorated. On the day of inspection they were choosing new carpets for their rooms. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33, 34, 35 & 36 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. Staff recruitment practices, staffing levels, staff training and staff morale are all good. This means that the residents are cared for by a well-informed, caring and cheerful staff team. EVIDENCE: Staff said that they are very happy working in the home and that there has been an improvement in team working and the general atmosphere since the last inspection. They said that the change in the shift pattern has made a significant improvement to the care of the residents, as there are now more staff on at times when they are needed. Staff said that they all get on very well with the residents and that communication in the home is good. There are handovers where “everything is documented, regular staff meeting and one-to-one supervision. Staff said that there is a good level of training, one said “we get updates all the time at staff meetings and briefings”. All mandatory training is on schedule and specialist training is also accessed. There has been recent training in the administration of medication. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 17 Since the last inspection the company has centralised it’s recruitment procedures. This means that there is greater consistency throughout the homes in the group and that there are greater safeguards in place. An administrator carries out the initial checks. She ensures that the application form is completed correctly, makes requests for references and CRB checks and checks the references against information given on the application form. She then ensures that the candidate is available to work the required shifts. Once these initial checks are complete, the complete application pack is forwarded to the manager of the home. The manager then makes a decision about whether to interview the candidate and whether to offer employment. This means that the manager is freed from routine paperwork and can concentrate fully on the suitability of the candidate for the post. The final decision to appoint rests with manager or registered person. The home is commended for this excellent recruitment practice that protects the residents from unsuitable staff. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home is well managed and the views of the residents are taken into consideration when decisions are made about the running of the home. This means that residents can be confident that the home is run in their best interests. EVIDENCE: In depth discussion about the management of the home took place with the manager, Ms Debbie Beer and one of the registered providers, Mrs Jo Pryke. Both have good experience in care and the running of care homes. Debbie previously held the position of registered manager at one of the other homes in the MNP group. Both Debbie and Jo are knowledgeable about good care practice and have an easy rapport with all the residents. Debbie has been successful in gaining both the Registered Managers Award and the NVQ IV in Management and Care. She maintains her continuing Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 19 professional development and has recently attended a Stoke Awareness course. Staff were very positive in expressing their views about Debbie and said that the atmosphere in the home had improved. They said that they valued her leadership and respected her for taking time to work “hand on” alongside. Residents said that, “things in the home are better now that Debbie is in post”. They feel that their views are listened to and that they are given good explanations if their requests cannot be met immediately. They said that they always feel free to express their views about the running of the home and that they talk to the registered providers regularly. Jo Pryke stated that the home is financially viable and that there is sufficient finance for maintenance and other budgetary needs The registered providers send in regular reports about the running of the home in accordance with regulation 26 of the Care Standards Act. Jo is commended for the high standard of these reports. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 4 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 36 Good Practice Recommendations The home should ensure that night staff receive an adequate level of supervision and training. Millfield House DS0000023493.V298473.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 House DS0000023493.V298473.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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