CARE HOMES FOR OLDER PEOPLE
Milton Lodge 35 Mount Road Fleetwood Lancashire FY7 6EX Lead Inspector
Christopher Bond Unannounced Inspection 10th October 2005 09:30 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 Milton Lodge DS0000009694.V259524.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 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 DS0000009694.V259524.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Milton Lodge Address 35 Mount Road Fleetwood Lancashire FY7 6EX 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) 01253 770904 01253 776011 Fylde Care 1990 Limited Mrs Susan Waldermar Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 21 service users in the category OP (older persons 65 and over). 1st June 2005 Date of last inspection Brief Description of the Service: Milton Lodge 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 residents. There are 6 double rooms and 9 single rooms; none of these have en-suite bathroom facilities. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over three hours. Two residents were spoken to during the inspection and two visitors also gave their views. The owner of the home gave the inspector a full tour of the building. Staff records were examined, as were care plans and residents’ information files. Safety certificates regarding the gas, electric, lift and fire system were also examined. What the service does well: What has improved since the last inspection?
The Commission for Social Care Inspection has now registered the manager of the home. New thermostats have been fitted to the washbasins in the residents’ rooms to help ensure that the water temperatures don’t get too hot and injure residents. The manager is supporting care staff in doing their jobs. They meet regularly to discuss important aspects of their role.
Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 6 There has been some redecoration at the home and carpets have been replaced. 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 DS0000009694.V259524.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: This section was not assessed during this inspection. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: This section was not assessed during this inspection. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12, 13 and 14 Social activities and were well -managed, creative and provided daily variation and interest for the people living in the home. Family and friend were encouraged to visit therefore ensuring personal relationships are maintained. EVIDENCE: The residents who were spoken to said that activities were organised regularly and there were often entertainers invited into the home. There were also informal activities such as bingo and quizzes on a weekly basis. Two of the visitors also said that there was often something going on at the home when they were there and they were sometimes asked if they would like to join in. Residents said that they were often given the choice as to whether they wished to go out or not and it was clear that residents went out on a regular basis. Two of residents said that they felt that the care staff were always available to listen to their concerns or enquiries and were always spoken to with respect and dignity. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 and 18 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: Two visitors were spoken to who said that they were confident that their concerns would be listened to should they be unhappy with aspects of the service. The complaints procedure was posted within the home to enable residents to become familiar with the process of making a complaint. The home had a copy of the guidance on suspected abuse ‘No Secrets in Lancashire’. This had been obtained since the last inspection and helped to ensure that the home would follow the proper procedures should abuse be suspected. The manager had demonstrated her knowledge of this procedure, which helped to make sure that resident were not put at risk. There were no concerns regarding care practices at the home. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19, 21,22 and 26 Residents live in a clean, well-maintained home. Residents’ bedrooms are attractive and homely. EVIDENCE: The home was very clean throughout. There were no unpleasant smells. Residents had a choice of two lounges and many were seen smiling and relaxing in the main lounge. There were visitors in both lounges and the décor was appropriate and relaxing. There were toilet facilities on all of the floors and these were quite large. There were aids around for those who needed assistance when visiting the toilet. Thermostats have now been fitted to the washbasins in the residents’ bedrooms to help reduce the risk of scalding. This helps to make the home safer for residents.
Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 13 Guards still need to be fitted to radiators within the home to make sure that residents cannot burn themselves if the heating is turned up too high. New carpets have been fitted in some of the bedrooms and some redecoration has been completed. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 and 30 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. The manager should continue to ensure that sufficient numbers of staff are qualified up to NVQ level 2. Some of the staff had reached this level and a further several more were in the process of achieving this qualification. Care staff files had been improved since the last full inspection. There is still a need for the files to have a photograph of the staff member concerned. This is important to help ensure that proper checks are completed on care staff and identification is clearer. This helps to ensure that residents are safer. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 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 31, 33, 35 and 38 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, 32, 33, 35 and 38 Resident’s benefit from a well run home. EVIDENCE: The Commission for Social Care Inspection have now registered the manager of the home. The manager must now have the necessary training in management and care to assist her in her responsibilities (National Vocational Qualification level 4). It was clear that service users were benefiting from the managers competence in running the home. Care staff were now meeting individually with the manager on a regular basis to discuss their role and for the manager to supervise their responsibilities. Some of the care staff were attending training in health and safety issues that was taking place close to the home. This would help to ensure that the residents were safe and secure whilst living at the home.
Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 16 Systems were in place to help ensure that the residents’ financial issues were handled safely and correctly. Milton Lodge DS0000009694.V259524.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 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X 2 3 Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP28 Regulation 18 (1) (a) Requirement The Registered Manager must ensure that 50 of staff should be trained up to NVQ level 2 or equivalent by 2005. The Registered Manager must complete the Management and Care elements of NVQ 4, or equivalent, by 2005. Care staff files must hold a photograph of the staff member involved. Residents’ records must contain a current photograph of the person involved. Timescale for action 31/12/05 2 OP31 9 31/12/05 3 3 OP29 OP37 Schedule 2 17 (1) (3) 31/12/05 31/12/05 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 OP38 Good Practice Recommendations Radiators should be guarded to ensure that high temperatures do not harm residents’. Milton Lodge DS0000009694.V259524.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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