Inspection on 24/11/05 for Millfield House

This inspection was carried out on 24th November 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millfield House 19/11/07

Millfield House 01/08/06

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 Julian Graham Announced Inspection 24th November 2005 09:30 Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 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.V251762.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 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.V251762.R01.S.doc Version 5.0 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 Miss Cleo Drury Care Home 8 Category(ies) of Physical disability (8) registration, with number of places Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Restricted to people aged between 19 to 65 years Manager to have NVQ 4 by 2005 Date of last inspection 4th August 2005 Brief Description of the Service: Millfield House is an 8 bedded Home providing support for people with physical disabilities. The Home is a semi-detached house with bedroom accommodation on the ground, first and second floor. It has disabled access and is situated in a residential street in the centre of Folkestone, a short walk from the amenities within the town. Parking is limited but a few allocated spaces have been made available. Miss Cleo Drury is the registered manager. She is supported by the assistant group manager and her deputy. Staff are well trained, motivated and supervised. Service users are provided with external and in-house activities. The refurbishment and decorating programme is ongoing. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 09.30 and lasted approximately five hours. A pre-inspection questionnaire and provider’s assessment form completed by the manager were received prior to the inspection. Six feedback comment cards from residents were also received and five from relatives, indicating satisfaction with the service. Seven residents were spoken with, including sharing the lunchtime meal with them. Staff were also observed both directly and indirectly as they were working with residents. Two staff were interviewed privately in the office. Two visiting relatives were spoken with. Time was spent with the manager, including looking at some paperwork and a brief tour of the premises was undertaken. Feedback from the residents on the day of inspection was very positive, and included comments such as: “I have more control over my life”, “I have enough interesting things to do”, “I go out a lot”, “It’s fun”. Two feedback cards from residents referred to “sometimes” being provided with suitable activities. Comments from the residents included: “I couldn’t praise them highly enough”; “the staff are brilliant with x”. What the service does well: Morale is high amongst the staff team, with two staff referring to a “good team spirit.” Staff are being well led by the manager and there is consistency of care from a settled and well trained team which is benefiting the residents. A relative and a resident said there is a lot of laughter in the home. Residents are each continuing to benefit from a regular and structured physiotherapy routine, which is in turn helping them to be more independent in their movement and less reliant on staff. The home is good at raising funds through arranging social events involving the residents and their families; and through these endeavours has recently been able to purchase some parallel bars to help the residents with their physiotherapy programmes. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 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.V251762.R01.S.doc Version 5.0 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): EVIDENCE: Not inspected on this visit. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 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, The care planning system is satisfactory, providing staff with the information they need to meet residents’ needs. Any restrictions in choice and freedom need better documentation to show how decisions are made and who made them. Residents are supported to participate in the life of the home in accordance with their abilities and wishes. EVIDENCE: Since the last inspection, care plans now include individual personal goals the residents have chosen which specifically relate to improving their mobility, for example, neck control and general dexterity. A sample of care plans were viewed and as before, these highlight residents’ needs with detailed guidance regarding support needs in relation to rising and retiring. Two residents have recently requested to have rails fitted to their beds to prevent them falling out. Whilst risk assessments are in place, there needs to be a clearer record of the decision making process in these instances, as it is a potentially restrictive practice. Residents are encouraged to participate in some household chores dependent on their abilities and wishes, and the manager said that this includes helping to prepare some dishes like pizzas and making cakes. This is done on the dining room table as there is no disabled access to the kitchen. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 10 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 Personal development is a high priority in the home, and active and fulfilling lives are promoted. Routines are flexible and meals are varied and nutritious. EVIDENCE: Staff said that residents are continuing to significantly progress in caring for themselves. One resident, for example, is now not needing staff support to use the toilet. One resident was assisted by a team leader to communicate with the inspector and say how she is experiencing life in the home. Staff were seen communicating with residents with good effect and with patience and respect. All the residents have busy programmes throughout the day in line with their own needs and wishes. One resident works in a voluntary job for three mornings a week. Whilst the day programmes of many of the residents revolve around their physiotherapy needs, opportunities to access the community are regularly given. These include individual shopping trips, cinema, visits to places of interest, meals in restaurants and so on. The manager said that staff try and ensure that each resident is able to have a full day out each week. Residents confirmed that routines in the home are flexible. One resident likes to be up and about at 06.30, for example, whilst another prefers to get up much more leisurely. The two visiting relatives spoke very positively about all Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 11 aspects of the home and the care it provides. They said they are always made welcome whenever they choose to come, and are kept informed by staff of their relative’s well being. Residents said they like the food and have a say in drawing up the menus. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 12 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 Staff have a very good understanding of residents’ support needs and residents’ healthcare is promoted. EVIDENCE: A resident who needs a lot of support in his personal care said that staff assist him with patience and sensitivity. A staff member who was interviewed gave a very good example of how residents’ privacy and dignity would be promoted when helping them with a bath. One resident said she can have a bath with staff support when she likes. Access to physiotherapy input, both in-house and from external sources, is well planned and regular. MAR charts were viewed, and as recommended from the last inspection, handwritten entries are now checked and countersigned by a second staff member, and codes are entered when medication is not given. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: Not fully inspected on this visit. The two staff who were interviewed, however, were clear of the action to take in the event of any allegation or suspicion of abuse. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 14 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): 24,26,30 The standard of the environment is generally good within the home providing residents with an attractive, comfortable and homely place to live. EVIDENCE: A brief tour of the premises was undertaken on this visit, and is being well maintained. The kitchen has been completely upgraded since the last inspection. Other than the kitchen, the specially adapted home is accessible to the residents. The lounge is due to be re-decorated shortly, and in a colour agreed by the residents. Three bedrooms were viewed and these were attractively personalised. There was a record on each resident’s file to the effect that they had been consulted regarding furniture and fittings they require. Since the last inspection, residents have been provided with a lockable facility in their rooms and have been offered a door key. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 15 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): 31,33,34,35,36 Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Staff are well trained and feel valued and supported. EVIDENCE: Staff who were interviewed demonstrated very good understanding and awareness of their role and responsibility and said they enjoy working in the home. Excellent access to training courses is provided, although training on infection control is now overdue. Staff said they are well supported by the manager, and records of individual supervision sessions were seen. Staffing levels during the week are good, with care staff being supported by a cook, domestic and physiotherapy aid. Three care staff are on duty at weekends. The file of a staff member recently employed was examined and showed good recruitment practice. References were taken up and there was evidence of a satisfactory CRB and POVA check. This person is in the process of receiving induction training. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 16 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 Residents are benefiting from a well run home. EVIDENCE: The manager is continuing to provide good leadership with an approach that is helping create an open, positive and inclusive atmosphere. Both staff and residents said that she is approachable and accessible, and both were seen to be very relaxed and comfortable in each other’s company. Strategies for obtaining the views of residents include formal and informal meetings with residents, a newly instituted suggestion box, which residents are using to good effect, and periodic feedback questionnaires, a sample of which was seen during the visit. The manager was able to demonstrate that the results of this feedback is analysed and that action is taken in response. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Millfield House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x x DS0000023493.V251762.R01.S.doc Version 5.0 Page 18 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 YA42 Regulation 18 Requirement Staff to receive training in infection control. Timescale for action 24/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations Decisions resulting in restrictions in freedom or independence to be fully documented. Millfield House DS0000023493.V251762.R01.S.doc Version 5.0 Page 19 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.V251762.R01.S.doc Version 5.0 Page 20 - 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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