CARE HOMES FOR OLDER PEOPLE
Milton House Nursing Home Marton Road Gargrave Skipton BD23 3NN Lead Inspector
Wendy Dixon Unannounced 25th July 2005 13:30 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 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. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Milton House Nursing Home Address Marton Road, Gargrave, Skipton, North Yorkshire, BD23 3NN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01756 748141 01756 748141 Mr Winston Shutt & Mrs Carol Shutt Mrs Hilary Ormrod and Mrs Patrica Sykes Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 25/01/05 Brief Description of the Service: Milton House is registered to provide personal and nursing care for twenty-two service users aged 65 years and above.The main part Milton House is over 200 years old and this provides the lounges and a small number of bedrooms. There is additional purpose built accommodation providing further bedrooms, dining room and a new conservatory lounge. It is suitable for its stated purpose. It is located within a short drive of the village centre. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Monday 25th July 2005.The inspection lasted 4.0 hours (1.30pm to 5.00pm). There were 19 service users resident in the home, 11 requiring nursing care and 8 receiving personal care. The inspection focused on a number of key standards. An inspection of the premises took place, including a number of bedrooms, the homes dining room and lounges. The care records of three service users were examined in detail and these service users were spoken with about the care they receive. There were also discussions with members of staff on duty at the time of inspection. What the service does well:
Milton House provides a very good standard of care. The home had a lovely calm atmosphere and the building makes access easy throughout so service users can use the lounges, gardens and dining room. Detailed plans of care are in place and this helps ensure that all the service users health and social care needs are identified and met. Service users were able to spend their day as they wished. Service users were in their rooms watching TV or reading, some were in one of the homes lounges several were sat in the homes conservatory looking out on to the river. Service users were relaxed and happy to chat about life in the home that they very much enjoyed, talking about the recent trip to Morecombe and looking forward to a trip to Blackpool illuminations. Staff were well informed about service users health and personal care needs and were observed talking and assisting service users in a kind friendly and professional manner. Visitors were welcomed by staff and able to see family/friends either in one of the homes lounges or their room. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 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. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users needs are properly identified and assessed prior to admission EVIDENCE: The preadmission records of 2 service users were inspected. A member of the qualified nursing staff had assessed both service users prior to admission. Service users are able to visit the home prior to admission to meet with staff and see their prospective room before making a decision to come into the home. Information about service users health and personal care needs had been documented and information gathered from relatives and other health professionals giving a good picture of the care that needed to be provided Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 ,9 and 10 The health and personal care needs of service users are well met, EVIDENCE: The care plans of four service users were inspected and found to be of good quality. These contained detailed information about how service users needed to be cared for and showed any health problems were quickly and appropriately dealt with, consulting with other professionals where necessary. These were up dated on a regular basis. Where these service users were spoken to they confirmed that the information recorded was correct and up to date. Care plans were signed by the service users or where more appropriate their relatives showing they were aware of the contents. Medication is safely stored, stock balances checked were correct and administration records up to date showing service users were receiving medication as per the doctors instructions.
Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 10 Staff were observed speaking to service users in a kind and respectful manner bathrooms and toilets are fitted with suitable privacy locks and necessary signage. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Service users can choose to spend their days as they wish, and there is a range of activities service users can participate in if they wish. EVIDENCE: The home had a relaxed atmosphere. Service users were at different points in their afternoon routine, some outside enjoying the gardens or watching the comings and goings at the home. Others still seeing family and friends, reading the paper or having a quiet hour after lunch showing that support for service users is individual to them and not based on fixed routines. There is a range of activities; craft sessions, visiting entertainers and trips out, service users had recently been on a trip to Morecombe and stated they had a great day and were looking forward to the trip to the illuminations next month . The meal served during the inspection was tea; this was nicely presented and enjoyed by the service users who commented on how good the food was at the home. A choice is available at every mealtime and service users can either eat in their rooms though the majority prefer to eat in one of the homes dining rooms as meals are very much a social occasion.
Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16and 18 Service users and their families are aware of how to make a complaint. EVIDENCE: Service users are given a copy of the homes complaints procedure when they are admitted to the home and a copy is displayed on the homes notice board. There have been no complaints about the home since the last inspection. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home offers very high quality accommodation to all its service users and is a clean comfortable and safe place for service users to live. EVIDENCE: Access is good throughout the building. Decoration and maintenance is to a very high standard. The home has secure well-maintained gardens for service users to enjoy. The home was clean and fresh smelling throughout and gloves and aprons were in good supply to help prevent the spread of infection. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Enough properly trained and qualified staff are on duty to meet the needs of the service users EVIDENCE: There were 19 service users in the home on the day of inspection. 11 requiring nursing care and 8 requiring personal care. The minimum number of qualified nurse hours needed to care for these service users is 168hours per week the home provided 180 week commencing 25/07/05 and the minimum number of care assistant hours needed is 335 the home provided 408 week commencing 25/07/05. Enough staff are on duty to meet the needs of the service users. The employment and training files of three members of staff were inspected. These contained the necessary checks and references to help ensure service users are cared for by trustworthy staff who have appropriate experience. Staff had recently attended fire, moving and handling training and infection control training and when spoken to were knowledgeable about up to date care practises ensuring service users receive appropriate treatment. Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 and 38 The home is well managed and provides a safe place for service users to live and staff to work. EVIDENCE: The registered managers are first level nurses and have several years management experience ensuring the home is well managed and service users, relatives and staffs problems/concerns are properly dealt with. The home had a calm relaxed and friendly atmosphere. The registered managers and home owner are available in the home on a daily basis to deal with issues as they arise. Regular meetings are held with service users and to enable everybody who lives and works in the home to have a say as to how it is run
Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x x x x Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 17 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 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 Good Practice Recommendations Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 Milton House Nursing Home J53_J04_S27942_Milton House_V229317_090605_Stage 4.doc Version 1.30 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
