Inspection on 19/11/07 for Millfield House

This inspection was carried out on 19th 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 House 01/08/06

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 Mark Hemmings Key Unannounced Inspection 19th November 2007 09:30 Millfield House DS0000023493.V355195.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.V355195.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.V355195.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 acting manager Type of registration No. of places registered (if applicable) deb_beer@yahoo.co.uk MNP Complete Care Group Ms D Beer Care Home 8 Category(ies) of Physical disability (8) registration, with number of places Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Restricted to people aged between 19 to 65 years Date of last inspection 1st August 2006 Brief Description of the Service: Millfield House (the Service), is registered to provide accommodation and personal care for up to eight adults who have a physical disability. The premises are a large detached house that is located in a quiet residential street. There is step-free access around all parts of the accommodation used by the people in residence. All of the people have their own bedroom each of which has a private wash hand basin. There is a shared use lounge/dining room and various other rooms that you would expect to find in anyone’s home. The Registered Provider gives useful information to prospective people who might want to live in the Service. There is a Service Users’ Guide. This is a brochure that outlines the principal features of the facilities and services available in the Service. There is a document called the Statement of Purpose. This gives a more detailed account than does the Guide. Also, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference. The current weekly fee for residence in Millfield House runs from £749.20 to £1200.97. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence in relation to the Service received by the Commission since the last inspection. Another source of evidence involves any written information received from the people who use the Service, from their relatives and from social workers (care managers). Also, the Inspector completed an unannounced visit to the Service. This took about five hours to complete. During this time, the Inspector spoke with three of the people in residence. The Inspector also spoke with the Group Manager, with the Acting Manager, with the Deputy Manager and with two of the care workers. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. There are no Required Developments at the end of this Report. What the service does well: The people who use the Service consider that Millfield House provides them with a relaxed and comfortable setting within which to make their home. They think that they receive all the assistance they need. They consider that they are served with good quality meals. People are assisted to seek and to follow medical advice. Suitable arrangements are in place to handle and to dispense medication. Sensible steps have been taken to promote health and safety in the Service. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Millfield House DS0000023493.V355195.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.V355195.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are arrangements to ensure that prospective people who might want to move in will have their needs assessed and their wishes acknowledged. EVIDENCE: There have not been any new admissions to the Service for some time. None are planned in the foreseeable future. However, there are arrangements in place to respond to someone moving in. The Group Manager and the Acting Manager in consultation with the person concerned, will complete an assessment of the prospective person’s needs for assistance. This will be done before a decision is made about whether or not the Service is a suitable place for the person’s residence. As part of this process, the person concerned will be asked to describe their preferences and wishes about their everyday lives. This will be done so that these choices can be respected. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 9 Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The health and personal care that people receive, is based upon their individual needs. People are actively involved in making decisions about things that affect them. Sensible provision is made to promote an independent lifestyle. EVIDENCE: The people who use the Service say that the care workers offer them all the assistance they need and that this is provided in a reliable and consistent manner. There is a written plan of support for each person. These are important documents. This is because they form one of the means by which people who use the Service can be informed about and can agree to the Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 11 assistance they will receive. Also, the plans are a source of reference information for the care workers. People are assisted to make decisions about their own lives. This means that they can be as independent as they want to be. When extra help is required, this is delivered in an appropriate manner. For example, people are assisted to manage aspects of the personal spending monies. Sensible arrangements are in place to help the people in residence to lead normal lives, without entertaining unreasonable risks to their wellbeing. This is not done in an intrusive manner and the result is not overly cautious. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service can choose to become involved in a range of social and vocational activities. They are helped to keep in touch with members of their families. Good quality meals are served. EVIDENCE: The people who use the Service are free to choose what to do each day. The pace of daily life is relaxed. There are no unnecessary rules or routines to disrupt the experience of a normal domestic setting. The people who use the Service have individual weekly calendars of activities that they can undertake. People say that their time is adequately occupied. The Acting Manager is going to continue to review the range of opportunities Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 13 provided for the people in residence. She recognises that this will require careful consideration of the things that are most likely to engage the interests of the people concerned. The people who use the Service are assisted to keep in touch with family and friends. People can receive visitors at any reasonable hour. They can meet with their visitors in the privacy of their bedroom if they wish to do so. The Acting Manager in consultation with the people in residence, consults with their relatives. This is done so that they know how things are going. The people who use the Service say that they receive good quality meals and they always have enough to eat. The menu indicates that a normally varied diet is provided. People are actively engaged in deciding what dishes to have. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. People are supported in accordance with their wishes. They are assisted to promote their physical health. Suitable arrangements are in place to manage medication. EVIDENCE: The people who use the Service say that the care workers are kind and considerate. There is a family atmosphere in the Service. The people who use the Service are assisted to maintain their physical health. Care workers keep a tactful eye open, so that medical attention is sought promptly should the need arise. Since the last inspection visit, family practitioners and various other medical resources have been involved in a timely manner to support the care provided in the Service. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 15 Suitable arrangements are in place to enable medication to be stored securely and to be administered in accordance with the doctors’ instructions. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There is an effective system for dealing with complaints. The wellbeing of the people who use the Service is safeguarded. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. Since the last inspection, neither the Registered Provider nor the Commission has received any formal complaints relating to the Service. There is a written procedure that explains how people can raise a concern about the Service. The people who use the Service say that they can approach members of staff if there is something on their mind. The care workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances in which the well being of people who use the Service might become jeopardised. They people in residence say or indicate by their relaxed manner that they feel safe living in Millfield House. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 17 Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service are provided with a homely setting that promotes their independence. EVIDENCE: The Service provides a suitably domestic setting in which the people in residence can make their home. They say that they are comfortable living there. The kitchen is clean and well organised. The local Department of Environmental Health has said that suitable food hygiene practices are in use. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 19 The property is fitted with a modern automated fire detection system. It is understood to meet the requirements of the Kent Fire and Rescue Service. The Registered Provider has completed an organised assessment of the adequacy of the fire safety provisions in the Service. This assessment has not indicated the need for any additional measures to be introduced. Suitable facilities are in place to enable people’s laundry to be done. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are enough members of staff on duty. Security checks are completed in relation to new employees. Support workers know what they are doing. EVIDENCE: There are at least three care workers on duty during the day and the evening. For some periods of time, there can be up to five care workers on duty. At night time, there are two people on duty. The people who use the Service say that care workers are always around and willing to help whenever they need them. Care workers think that the Service is adequately staffed. The Registered Provider completes a number of security checks for new members of staff. This is done to ensure that they are suitable people to have unsupervised access to the people who use the Service. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 21 New care workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work without direct supervision. This is important because the quality of care delivered in the Service, depends largely upon the adequacy of the competencies care workers have to hand. The Acting Manager is going to review aspects of the way in which the introductory training is organised and recorded. This is being done to ensure that all of the required subjects are indeed being suitably covered. She will be doing this exercise using a national model of good management practice. In addition to the introductory training, existing care workers undertake a number of training courses. These are designed to further develop their skills. Each of the care workers meets with the Acting Manager on a regular basis. This is done so that their work can be reviewed and so that any problems can be resolved. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Service is well managed. The quality assurance system should be strengthened. Various measures are in place to safeguard health and safety. EVIDENCE: The Acting Manager is qualified and she has applied to the Commission to be registered in her post. She operates a number of systems that are designed to ensure the efficient running of the Service. One of these involves ensuring that care workers are kept up to date with how things are going for each of the Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 23 people in residence. This means that they are better able to give assistance in an appropriate and consistent manner. The people who use the Service are invited to comment informally about how things are going on a day to day basis. There is also a more organised consultation process. This involves the people in residence and their relatives telling the Registered Provider what they think in general about the Service. This system now needs to be developed so that the stakeholders concerned are informed about what is going to be done to respond to any suggested improvements. The Acting Manager is going to complete this development by 1 April 2008. After this has been done, it should be possible to increase the score for Standard 39 at the time of the next Key Inspection. The Registered Manager says that all items of equipment in use in the Service remain in good working order. The continued operation of the fire detection and fire management system is checked regularly. There are regular fire drills. There now needs to be an additional arrangement to double-check that all of the care workers know how to operate the Service’s fire safety procedure. The Acting Manager is going to see to this by 1 January 2008. The Registered Provider checks the building and the accommodation to ensure that potential environmental hazards to health and safety are addressed. Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 24 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 X 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 2 X X 3 X Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Millfield House DS0000023493.V355195.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 House DS0000023493.V355195.R01.S.doc Version 5.2 Page 27 - 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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