Inspection on 20/02/08 for Milner House

This inspection was carried out on 20th February 2008.

CSCI found this care home to be providing an Good service.

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

Milner House 22/06/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Milner House Ermyn Way Leatherhead Surrey KT22 8TX Lead Inspector Mavis Clahar Unannounced Inspection 20th February 2008 09:25 X10015.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 Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milner House Address Ermyn Way Leatherhead Surrey KT22 8TX 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) 01372 278922 01372 278046 milnerhouse@ashbournesl.co.uk Ashbourne Homes Ltd Miss Toshwatie Latchman Care Home 58 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 58. Date of last inspection 22nd June 2006 Brief Description of the Service: Milner House is a large detached property that has been converted to provide accommodation for fifty-eight service users. Part of the accommodation has been provided in the original building, the remainder in extensions added over the years. The home is currently owned and managed by Ashbourne Homes, and is located on the outskirts of Leatherhead. Access to shops, churches, public transport and other community services are a distance away; however, the home has its own mini bus, which is used to transport service users. The accommodation for service users consists of twenty-six single bedrooms, and thirteen double bedrooms all with en-suite facilities, is situated on three floors, with passenger lifts and stairs to all floors. Communal areas are available throughout the home, compromising of lounge on each floor, dining room on each floor, and a number of quiet areas. The home is surrounded by well-tended gardens and adequate parking facilities. Fees at this home are within the range of £550.17 to £750.00 per week. Hairdressing, chiropody, personal newspapers and toiletries are not included in this price Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This unannounced site visit, which forms part of the key inspection undertaken by the Commission for Social Care Inspection, (CSCI) was completed by Mrs Mavis Clahar on the 20th February 2008 and lasted for seven hours and twenty-five minutes, commencing at 09:25 hours and concluding at 16:00 hours. The first part of the visit was spent with the registered manager of the home, discussing and agreeing how the inspection process would be conducted. This was followed by discussion about the Annual Quality Assurance Assessment (AQAA) she submitted to CSCI in December 2007, the training needs of the care workers and how these needs were being identified and met, and employment and induction of new care staff. A review of the requirements given at the last key inspection was undertaken and these were all completed within the agreed time scale. A review of service users’ files was undertaken and all found to be in good order. Review of care workers records was undertaken and some were found not to contain the required information in line with Care homes regulation 2001 Schedule 2. Requirement was made on these standards. The information contained in this report is gathered from service users’ notes and records kept by the home, from information contained in the AQAA, from relatives’ feedback in the pre inspection questionnaires and from discussions with service users, staff at the home and from visiting relatives on the day of the visit. We (the commission) obtained further information from direct observation. Time was spent visiting and discussing with service users and observing lunchtime activities. Service users were enthusiastic about their home and the service they receive. Service users spoken to said they enjoyed their lunch, which was prepared freshly in the home’s kitchen. Time was spent observing the presentation of the meal, care workers and service users’ interactions and to obtain feedback on the meal, its suitability, taste, texture and amount. The inspector observed that portions were varied to suit the appetite of the service users and that they all ate their meal in a very social gathering, all sitting at tables which were laid for four, with a small vase of flowers and condiments. Service users commented positively on their meal, and the food served at the Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 6 home in general. Many service users spoke highly of the choice of beverages they were offered during the mid-day meal. A tour of the home was undertaken and it was observed that service users’ bedrooms were kept in good condition, both decorative and clean and tidy. Generally, the home presents as clean and tidy The inspector would like to thank all the residents and care staff that made the visit so productive and pleasant on the day. The final part of the visit was spent giving feedback to the manager about the findings of the visit What the service does well: What has improved since the last inspection? The home has involved the use of the local Advocacy services to ensure relatives receive as much information as possible at a difficult time in their lives. The home has agreement with a private chiropodist to visit on a regular basis to ensure all service users who require this aspect of care will not have to wait long for care. The NHS chiropodist only visits twice per year. The home has formed the Friends of Milner House Group, which consists of relatives of service users present and past, staff members and any one from the local community who has an interest in Milner house. The aim of the group is to offer ideas of diversity and interests suitable to the needs of the residents of Milner House. Milner House has been added to the Surrey Historical homes list in September 2007 and is now having many visitors coming to see the beautiful house and surrounding gardens. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 7 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. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3.6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. Standard 6 does not apply to this service. EVIDENCE: Review of service users documents and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The Manager, and in her absence, two Registered Nurses who are trained in the principles of assessment of service users’ needs based on what the care the home says it will provide carries out Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 10 all pre admission assessments of service users prior to them being admitted into the home. Review of a random sample of service user’s files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. 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 feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good and clear care plan in place for service users and this includes appropriate risks assessments. Which forms the basis for care based on the agreed care needs of the service users and demonstrated that trained staff met service users’ health and personal care needs. The home’s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. EVIDENCE: The randomly selected care plans were clear and easy to read, identifying potential and actual risks to service users and detailing how these risks would be managed. The daily work sheet along with discussion with service user’s Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 12 relatives and care workers demonstrated that service users care needs are fully met. The service user or relative signed the care plans to indicate their involvement in deciding what care they received. It was evidenced that care staff undertaking the development and monthly review of the care plans also signed and dated them. Information contained in the home’s Annual Quality Assurance Assessment (AQAA) states “ Named nurses for each service user review and updates care plans monthly, or change care plans as the risk problems or needs changes. All staff are encouraged to read service users’ care plans prior to assisting them. Service users with special needs and allergies are acknowledged by staff”. Personal discussions on the day of the visit with relatives and service users revealed that they were involved in the assessment of their relatives. All service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist healthcare professionals through their GP practice as required and these visits are also recorded in the service user’s folder. Service users are offered a three monthly access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. In discussion with the registered nurse and care worker they were extremely proud of the high standard of care they provided to all service users in the home. Care staff identified as capable to administer medication (Registered Nurses only) are requested to leave a sample of their signature, which is dated in the medication trolley. All service users have a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We were told by care workers that one service user on the day of the site visit was assessed as capable to self medicate. This aspect of medication management was supported in discussion with the Senior Nurse and the manager produced the home’s policy on self-medication. Medication records were checked and found to be correct as documented on the Medication Administration Record (MAR) sheet, Control Drugs records were also satisfactory. Review of the home’s record of receipt and disposal of medication was satisfactory, dated and signed. Only one relative responded to the pre inspection questionnaire and wrote “the home just about meet the most basic needs of my relative but the standards are low”. Five relatives were spoken to on the day of the visit and they all stated they were happy with the care given to the relatives, and that the staff are always polite to them and they were free to visit any part of the home their relative was using. One relative told us “We moved our relative here because we heard of the high standard of care residents get here”. Another relative told us “My relative was not happy in the hospital and wanted to return to her home (Milner House), so we requested the hospital discharge our relative back to Milner House. We are having a break out of the country and wanted to be satisfied our relative was happy before we leave tomorrow. We Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 13 managed to get her discharged from hospital yesterday”. We observed that care workers wore name badges to enable visitors and service users with memory impairment to be sure of whom they are speaking with. We observed Service users being treated in a friendly but respectful manner by care workers. It was noted that care workers communicated amongst themselves and with the manager and with the service users and visitors in English. A number of the care workers are from overseas, with relatively good grasp of the English language. Different accents might be wearisome to some service users and relatives as mentioned by one relative, who stated, “communication is a serious problem. Not enough of the staff speak good enough English to be able to build up a proper relationship with the residents especially those with dementia”. In discussion with a number of service users it was evident they were not bothered by the accents of the care workers. In discussion with service users who were able to understand the questions, they told us that they are treated with respect and dignity, and that they are able to make their own choice. One service user told us “I am very happy here. Everything is so nice. I have my own room; I can have as much privacy as I want”. Another service user said “We have good staff here; they do not ill treat me. I have help to choose my own clothing every day. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. 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 maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The home employs a full time activity-co-ordinator who provides a range of activities based on the individual assessed and agreed needs, including their preferences, cultural beliefs and customs. We were told that wherever possible relatives are encouraged to participate in the planning and carrying out of service users’ activities. Activities includes reflection of the past, current affairs, painting/drawing, crosswords quizzes and trips out. The home also has outside visiting entertainers to the home to provide extra activities for the service users. We were told the home has good contact with religious Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 15 denominations and Holy Communion is provided for all service users who would like to participate. In discussion with service users we were told the home respects those service users who wish not to participate in an activity on any given day. A record of each service user’s daily activity is recorded in their care plans and their files demonstrated activities undertaken and refused. We observed the minutes of the residents meeting and winter newsletters were addressed to each service users’ next of kin and placed on display in reception for visitors to take. Further copies were available for anyone wishing to have a copy. Service users told us visiting is open, and that they can entertain their guests in their bedrooms in private or in the spacious communal areas of the home. We observed that a variety of fresh fruit and percolated coffee was made available for service users and their visitors in reception. Two visitors commented on the smell of hot coffee, saying how welcoming it made the home and it was good to help oneself to a hot drink on these cold days. Four of the service users spoken to said they had choice in their clothing and sometimes they receive help from their key worker. On the day of inspection all service users were dressed appropriately for the weather. We were told the Chef who has been at the home for a long time operates from a four-week menu and there is always a choice of three hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelette etc. One service user told us the Chef is very good and she comes around every day to make sure we are satisfied with our food. There is always a choice of two hot dishes for the evening meal, or we can choose to have sandwiches filled with our own choice. Morning coffee and afternoon tea is served daily and our visitors are also served the same as us. We observed jugs of fruit juices and squash with glasses were placed in the lounges whilst service users were present, and staff was seen offering drinks to service users and their visitors. There were ample amount of fresh fruit, available in the home in the lounges and dining rooms so that service users could help themselves if they wished. The inspector did not sample the lunch, but service users said the food was very good, tasty and the right amount. The inspector observed the presentation of the food was done in a way to stimulate appetite. Some service users had supplements as ordered by their GP or dietician, to maintain body weight or increase appetite. Fruit juices were served with lunch, which was served in the dinning room unless a service user requested to have their meals in their bedrooms. We observed care workers interacting in a friendly but dignified manner with service users during the lunch time, sitting down beside service users and speaking to them whilst helping them with their lunches. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 16 Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 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’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI received no complaints about the home. One complaint was logged at the home, and was l dealt with satisfactorily according to the home’s records; and within the home’s time scale for dealing with complaints. The manager told us that she is in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal complaints. Service users spoken to said they have no need to complain, as they are able to discuss everything with the manager. Two visiting relatives told us that issues raised with the home are dealt with straight away, so that they do not have to make any complaints. We observed that no records were kept of comments made by service users or visitors and recommended that a comments book/log should be kept, to give a balanced record of people’s views of the home. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 18 It was observed that the home’s guest information pack situated in reception contained a complaints procedure and policy, whistle blowing policy, statement of purpose and a recent copy of the last CSCI inspection report for the benefit of all visitors to the home. It was noted that the home received a number of compliments from relatives of service users commending the staff on their kindness and understanding and for the high quality of work they perform. In discussion with care workers, it was apparent they are aware of the homes’ policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use the whistle blowing procedure the manager and the Owners of the home would support them. During discussion with care workers it became apparent they did not have a full knowledge on Equality and Diversity issues relating to the service users they were responsible for. A random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well- maintained and comfortable environment, which encourages independence, and protect their privacy and dignity. EVIDENCE: The home complies with the given requirements regarding fire safety at the home. We noticed that not all bedroom doors had fire door guards fitted and in discussion with the manager we were shown documented evidence of service users occupying these bedrooms who signed to say they did not want the fire guards fitted. The manager told us they have the fire door guards in case the rooms became vacant it could then be fitted for the new resident. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 20 We were told that the nurse call bell system in bedrooms 67 42 and 78 and in the dining room were not working. The maintenance person produced evidence that the parts were on order. He explained that the system worked in a cluster and that is why these rooms supplied by this cluster were out of order. In the mean time the manager told us she has employed extra staff to cover these bedrooms, and hand bells are provided for the use of service users. The manager told us that the management and staff encourage service users to see the home as their own home. It presents as a comfortable, attractive home, which has all the specialist adaptations needed to meet the service users needs and were serviced and records kept verifying this. The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. The home employs a gardener to maintain the grounds and garden in perfect condition for the use of the service users. It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. Generally, the home presents as clean, safe, pleasant, hygienic and tidy and free from offensive odours. Random review of care workers training record demonstrated they have had training in infection control and this was evident in the storage of waste. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was adequate to meet the assessed care needs of the service users. The home has a programme of planned training in place and we were told all members of staff have an individual training record this was verified by the randomly reviewed staff folder audited. The AQAA states, “Over 50 of care workers have obtained the National Vocation Qualification at Level 2 (NVQ L2)”, and in discussion with care workers on the day of the visit they all said they had NVQ L2 qualification and this was evidenced in the random sample of files reviewed. Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training according to the AQAA and this was verified during review of the home’s training records and care workers files reviewed. All newly appointed staff undertakes an induction programme as recorded and Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 22 documented in their personal files. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records Random sampling of care workers file demonstrated the homes recruitment processes are in line with the Care Homes Regulations 2001 Schedule 2 whereby all care workers are Criminal Records Bureau, (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and two written satisfactory references are obtained. Staff files sampled contained the required work history. Care workers are in receipt of terms and conditions of employment as evidenced in their randomly selected files. A review of all Registered Nurses Personal Identification Numbers verified current registration with the Nursing and Midwifery council. We were told that supervision records were up to date and this was verified during random sampling of care workers files. In discussion with care workers some were able to give examples of how the home applied equality and diversity to the different needs and wishes of the service users in their care, and also within the diverse staff group. Staff files contained their up to date training records and it was noted that Equality and Diversity training was not done. In discussion with the manager she provided evidence that this aspect of training was down for discussion with the Company Trainer who was booked to carry out training on 22nd February 2008. A recommendation was made to include Mental Capacity Act training as well. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. 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 the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home. The views of service users and their relatives are actively sought in the running of the home and The service provides training on health and safety issues for all staff and service users are involved in the running of the home. Service users financial interests are safeguarded EVIDENCE: Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 24 The manager is a registered nurse and is in possession of the Registered Managers Award and has recently successfully completed the CSCI manager’s interview to become the registered manager of the home. The manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. In discussion with the manager, it was evident she was knowledgeable about the training needs of the care workers to meet these identified needs. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. Regular residents meetings are arranged and minutes of the meetings are passed to the owners who will action requests as soon as possible. The home does not become involved in service users finance except for service users spending money, which the home oversees. Receipts are kept and logged for all transaction carried out on behalf of service users.. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature fridge and freezer recordings were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Further more they spoke about their understanding of promoting safe working practices based on their health and safety training. Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) (a) (b) Requirement Ensure all staff records comply with items 1-9 of Schedule 2 of the Care Homes Regulations 2001 which must be fully complied with when employing staff at the home All staff to have diversity Training and Mental Capacity Act Training Timescale for action 21/04/08 2 OP30 18 (1) © 20/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone 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 Milner House DS0000066030.V357998.R01.S.doc Version 5.2 Page 28 - 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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