Inspection on 01/06/05 for Milton Lodge

This inspection was carried out on 1st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Milton Lodge 24/05/07

Milton Lodge 17/07/06

Milton Lodge 10/10/05

Milton Lodge 15/10/04

Milton Lodge 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Milton Lodge 35 Mount Road Fleetwood Lancashire FY7 6EX Lead Inspector Chris Bond Announced 1 June 2005 st 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 Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Milton Lodge Address 35 Mount Road Fleetwood Lancashire FY7 6EX 01253 770904 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) Fylde Care 1990 Limited Care Home 21 Category(ies) of Old Age (21) registration, with number of places Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 15th October 2004 Brief Description of the Service: The home is situated in a quiet residential area of Fleetwood opposite the Mount Gardens and close to the sea front. There is a range of community leisure activities available within a half -mile radius of Milton lodge. Fleetwood town centre is within walking distance of the home and there are local shops close by. Local bus and tram services operate from close by and there is a regular bus service into Blackpool from Fleetwood town centre. The home provides personal care for service users aged 65 years and above. Milton Lodge is registered for both male and female service users, however traditionally it is used by only by females. The Home offers accommodation for 21 service users. There are 6 double rooms and 9 single rooms; none of these have en-suite bathroom facilities. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 9.30am and took place over 6 hours. The Inspector spoke to four staff members, the management and two visitors. The Inspector spoke at length to four residents and more during the tour of the home. Comment cards were received from most of the residents and a GP. Resident’s care records and staff files were examined and a tour of the home was undertaken. The Inspector also used the information provided by the homeowner in the pre-inspection questionnaire, to gain evidence of the care and service provided. What the service does well: The residents of Milton Lodge were well looked after. The care staff worked well as a team and showed a good understanding of the needs of the people living at the home. Care documentation was well written and comprehensive. Meals are based on good home cooking; they are varied with an alternative available if required. Residents were pleased with the choice and variety available. The manager assessed each new resident before being admitted to the home and this information was used to comply a care plan. The plans were reviewed regularly to make sure that each resident’s changing needs were addressed. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Visitors spoken to during the inspection said that the management and staff were very supportive and made sure that they were kept up to date with any changes. The home was very well presented and very clean. Some of the rooms at the front of the home had good views over Mount Park. One resident said, “my room is lovely, I’m very pleased”. This contributed to a relaxed, homely environment. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 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 Lodge F57 F09 S9694 Milton Lodge V207245 010605 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 Lodge F57 F09 S9694 Milton Lodge V207245 010605 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) 2, 3 and 5 All new residents have a full assessment completed prior to moving into the home, ensuring that the home can meet their needs. EVIDENCE: Six residents’ personal files were looked at which included all of the people who had most recently been admitted to the home. It was clear that the manager of the home was carrying out detailed needs assessments prior to new residents being admitted. This would clearly help when planning what care the resident would need within the home. The manager confirmed that good assessment was a priority to ensure that the home would be able to care for the residents successfully. Two of the most recent residents were spoken to. They confirmed that they had the chance to look round the home and see their rooms before they made a decision to move to the home. All of the residents had been issued with contracts. These were kept in their personal files. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 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 home ensures that residents’ health and personal care is closely monitored and reviewed so that the staff team meets individual needs. Residents are treated in a respectful manner. EVIDENCE: Examination of care plans and daily notes confirmed that the home asked for advice from other professionals such as the district nurses, GP and incontinence advisor when this is needed. Notes were kept of the outcome of any visits or healthcare professional input, providing evidence that individual health care needs were met. All of the plans were reviewed on a regular basis. There were lots of comments from residents about the care that they received. One lady said, “this is a lovely home, and the girls are so nice”. All of the ladies that were spoken to were very complementary about the way that their needs were met and all of them felt that they were treated with respect. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 10 None of the residents were responsible for their own medication. Systems were in place that ensured that medication was handled correctly and professionally. The records of all the people who received medication were seen and there were no concerns. Each resident had a photograph attached to their record sheet to help prevent mistakes. Only senior care staff gave out the medication. There was evidence that the pharmacist visited the home to advise on medication issues. A comment card was received from one of the local G.P.’s who said that he was satisfied that health care and medication was being dealt with correctly and professionally by the home. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 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) 12,13 and 15. Meals are nutritional and a varied diet is provided to residents ensuring they receive meals that promote their health. Visitors are welcome at any time ensuring personal relationships are maintained. Social activities were adequate but could be improved to provide a more fulfilling lifestyle for residents. EVIDENCE: The feeling generally amongst the residents and visitors to the home was that activities and entertainment were adequate. One relative commented that the home “could do more” in the way of entertainment for the residents. A singer was booked on a monthly basis, and care staff said that they did what they could to accommodate recreational interests and needs. It was felt by the inspector that this was an area that could be improved upon and more research needs to be done into activities that are appropriate for all of the ladies in the home. There were quite a few visitors to the home during this inspection. One lady said that she was always made to feel welcome by the care staff and management. Another visitor said, “my mum is looked after really well and the food looks lovely”. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 12 The dining room was spacious and attractively decorated. All of the ladies that were spoken to said that the food was very good. One resident said, “I always look forward to mealtimes, it’s just like home cooking”. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 13 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) 16 and 18 The complaints procedure was satisfactory but not all were aware of how to complain. Service users are put at risk by inadequate abuse procedures and training. EVIDENCE: The complaints procedure was available in the Service User Guide and Statement of Purpose but the procedure was not available to residents and visitors in the main part of the home. Two residents wrote, via comment cards, that they were unaware of the procedure. This was rectified during the inspection and the procedure was posted up outside the dining room. A copy of ‘No Secrets in Lancashire’ was available during the last inspection but this could not be found during the current inspection. This is the procedure that the home must follow if abuse is suspected and contains important information on forms of abuse. The home had it’s own policy regarding suspected abuse. All of the ladies that were spoken to during the inspection said that they felt safe and secure in the home. The manager needs to familiarise herself with the expected procedure, and training needs to improve for care staff in this important area. Some staff that were interviewed were unaware of the correct procedure. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 14 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, 23, 25 and 26 Residents live in a clean, well-maintained home. Residents’ bedrooms are attractive and homely. Water temperatures are too high, which puts residents at risk of scalding. Radiators are not all guarded, which affects the safety of the residents. EVIDENCE: The communal rooms were comfortable and furniture was appropriate to meet the needs of the residents. The residents’ bedrooms were all individual, reflecting their preferences and contained personal possessions. The whole home was tastefully decorated and looked comfortable and homely. All of the ladies that were spoken to said that the home met there needs both with regard to their own rooms and communally. Rooms at the front of the house had good views of the Mount Park that was opposite the home. One resident said, “my room is lovely, I’m very pleased”. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 15 The home was very clean throughout. There were no unpleasant smells. The domestic was spoken to and she confirmed that the home is cleaned on a daily basis and thorough practices are used in dealing with issues around incontinence. The laundry area had been painted since the last inspection and care staff can wash their hands in a separate hand-wash basin after touching soiled laundry. The water temperature in some of the rooms was quite high and steps must be taken to ensure that the temperature is thermostatically controlled to prevent scalding. Similarly, not all of the radiators in the home were guarded. This situation must be addressed to ensure service users are not put at risk. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 16 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 The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. Staffing levels are appropriate to meet the needs of the people accommodated. Staff are well trained to ensure they have the competencies to meet residents needs. EVIDENCE: The staff rotas for the home confirmed that sufficient staff were employed to ensure that the needs of the residents are dealt with correctly. There were no concerns from visitors and relatives regarding staffing levels and all of the residents said that staffing was sufficient. The recruitment procedures were good, and Criminal Records Bureau checks were seen for all of the people employed at the home. Staff files were in need of attention and information was sometimes difficult to find due to poor organisation. Staff files did not contain a photograph of the staff member. There was little evidence to suggest that staff were appropriately supervised. The manager should continue to ensure that sufficient numbers of staff are qualified up to NVQ level 2. Two of the staff had reached this level and a further seven were in the process of achieving this qualification. The manager showed the inspector a list of TOPSS led training that care staff were accessing at the local community centre. This encompassed the whole of Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 17 the core -training programme and also dealt with confidentiality and challenging behaviour. It was pleasing to see that most of the care staff had either completed this course or were in the process of doing so. All care staff should access training in Abuse Awareness as soon as possible. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 18 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) 31, 32, 36 and 38 The home is well managed and run in the best interests of the residents. There is good leadership and direction to ensure that residents receive consistent care. Care staff do not receive the individual guidance and support needed to ensure a constant high standard of care. EVIDENCE: The manager of the home was in the process of applying for registration with the Commission for Social Care Inspection. The home would benefit from having a registered manager in charge. Care staff and residents were complementary of the manager’s approach to managing the home. Staffing files showed that supervision of staff was not taking place and care staff confirmed this. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 19 As discussed previously in this report the hot water temperature in some of the rooms was quite high and steps must be taken to ensure that the temperature is thermostatically controlled to prevent scalding. Similarly, not all of the radiators in the home were guarded. This situation must be addressed to ensure service users are not put at risk. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 20 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 3 3 x 3 x 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 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x 3 x 1 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 1 3 x x x 1 x 1 Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 21 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 31 Regulation 8 Requirement The home must have a manager that is registered with the Commission for Social Care Inspection Staff files must contain all of the information set down within schedule 2 of the Care Home Regulations. The Registered Person must ensure that training is available to help ensure that service users are not put at harm or risk. The Registered Person must ensure pipe work and radiators are guarded or have guaranteed low temperature surfaces The Registered Person must ensure that water temperatures are regulated by thermostatically controlled mixer valves. All staff must receive regular, documented, formal supervision Timescale for action 31/07/05 2. 29 19 31/07/05 3. 18 and 30 13(6) 31/07/05 4. 25 and 38 13 31/07/05 5. 25 and 38 36 13 31/08/05 6. 18 31/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 22 No. 1. 2. Refer to Standard 28 16 Good Practice Recommendations 50 of the care staff team should achieve NVQ qualifications A copy of the complaints procedure should be available for all of the service users and their relatives to see. Milton Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Lodge F57 F09 S9694 Milton Lodge V207245 010605 Stage 4.doc Version 1.30 Page 24 - 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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