Inspection on 12/07/05 for Milton Lodge

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 21/08/07

Milton Lodge 09/10/06

Milton Lodge 22/12/05

Milton Lodge 16/02/05

Milton Lodge 28/10/04

Milton Lodge 11/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Milton Lodge 23-24 The Esplanade Whitley Bay Tyne & Wear NE26 2AJ Lead Inspector Karena Reed Unannounced 12 July 2005 9.00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Milton Lodge Address 23-24 The Esplanade Whitley Bay Tyne & Wear NE26 2AJ 0191 253 3730 0191 253 3730 jill@heatherington.wanadoo.co.uk Mr Alastair Craig Nurse 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) Mrs Jill Anne Heatherington CRH 10 Category(ies) of LD - Learning Disability (9) registration, with number MD(E) - Mental Disorder over 65 (1) of places Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16-2-2005 Brief Description of the Service: Milton Lodge is situated in the centre of Whitley Bay and is in close proximity to the sea front, shopping centre and all its facilities. The home is divided into two separate units. Unit 1 provides accommodation for four male service users, aged 18-65 years old. The second unit provides accommodation for six male service users, aged 18-65 years. The accommodation is over two floors and there are ten single bedrooms. There are two lounges , two dining rooms, a games room and a patio area to the rear of the premises. The home does not provide nursing care but is registered to provide personal care and support to people with learning disabilities and or mental health problems. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. Records included: 3 care plans, 2 staff files, the fire log record, the accident book, admission/discharge register, complaints record, staffing rotas, daily communication book and service users personal allowance records. The proprietor and two carers were spoken to during the inspection. Time was also spent with 1 service user during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose should include that the home teaches service users skills to help them become more independent and move to a less supported environment if they wish . The heating system should be adjusted so the temperature to the building is reduced during the periods of hot weather. Fire instructions and fire drills must be carried out within the prescribed time scales. Plastering and decorating should be carried out around the building to the first floor landing, front entrance hall and all areas around the home to make good where the old fire alarm system was removed. The laundry wall must be plastered around the light sockets. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 6 Staff files should contain a photograph of the staff member and photocopies of proof of evidence of identity. 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 B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 The home ensures that potential service users are provided with details of the services the home provides which helps them to make an informed decision about coming to stay in the home. Comprehensive information is made available when a referral is made. The home carries out their detailed assessment prior to agreeing to admit people into the home to ensure that the home can meet their needs. Staff are equipped with the necessary skills in order to meet the needs of the service users. EVIDENCE: A Statement of Purpose was available outlining the services provided by the home. The service user guide details information in an informal, interesting style to tell people who may be coming to live in the home about services available. The Statement of Purpose and service user guide are updated annually. Service users records contained written contracts between the home and the service user stating the terms and condition of residency, and also more general contracts between the home and County Council were available on individual service users’ files. Inspection of records for four service users showed that full assessments had been carried out prior to their admission. A relatively new service user said that they had visited the home and received information verbally and in writing Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 9 about the way it was run before moving in for a trial stay. The service user was also very happy with the care and attention received. Service users have the opportunity to visit the home as many times as they like to decide if they wish to live there. This may involve tea- time visits, day and overnight stays and can be adjusted to the pace of the service user. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 There are excellent arrangements in place to ensure that residents’ health and social care needs are met. Health and social care needs are clearly addressed and the staff team are fully informed. Service users are well supported by staff and the necessary levels of support are provided due to the detailed care plans that show the level of care and support that staff need to provide. Comprehensive risk assessments are carried out to assist service users to lead as fulfilled lives as possible and they are well supported by staff to take calculated risks as necessary. Service users are encouraged to be involved in decision making and they are encouraged to communicate and make their views known. EVIDENCE: Records of a recent admission showed that an assessment had been carried out prior to their admission. Information was also received from the care manager’s assessment of the resident’s care needs. The resulting care plan recorded detailed information about the health and medical needs of the service user and the amount of staff intervention required in order to provide support. Service users care and support needs were then reviewed three monthly by staff and the service user in case their care and support needs had changed. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 11 Meetings are held with service users about the running of the home. The service user spoken to stated that they were always involved and consulted about decisions involving themselves. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,16 The Home encourages and provides good support to enable service users to use and take part in community facilities wherever possible eg leisure, health, spiritual, social, educational needs. Social activities and meals are both managed creatively and provide daily variation and interest for people living in the home. Visitors are made welcome or staff support residents to maintain contact with family and friends as they wish. EVIDENCE: Care plans showed that, service users, whatever their level of need are assisted to enjoy a more independent lifestyle. Staff assist and support service users to learn skills and become more self sufficient in aspects of every day living. Service users all pursue their own individual hobbies and interests. There was also a wide range of activities and entertainment available to choose from if service users wished to take part eg parties, day trips, meals out, shopping, cinema, bowling. The service user spoken to said that they were involved in the running of the home and involved in making decisions about their life. Records also provided evidence that all service users are consulted and asked their opinion and encouraged to make decisions. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 There are excellent arrangements in place to ensure that residents’ health care needs are met. Care plans outline the needs to ensure that the staff team are fully informed and aware of the support they need to provide. EVIDENCE: The care plans and case records inspected contained relevant individual plans of care detailing care and support required for some complex needs. Records showed when service users had seen health professionals eg doctors, community nurses, etc. Service users are assisted to access dental and optical services at least annually or as often as required. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There is a suitable complaints procedure. Service users and their relatives have confidence that they can raise any issues and know that they will be dealt with. The home’s management team have a sound grasp of Protection of Vulnerable procedures. EVIDENCE: The home has a complaints procedure. There have been no complaints about the home since the last inspection. The service user spoken to stated that they would raise any issues of concern with the staff team. They also have their own complaints procedure in their bedroom to remind them of the complaints process. A procedure for responding to allegations of abuse is available. Staff are to receive training about multi-agency POVA procedures in September. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The home is becoming better maintained and decorated which creates a pleasant and homely environment for those living there. There is a good standard of hygiene around the home. Systems are in place to provide a safe environment for service users and staff. EVIDENCE: The home is continuing to being better maintained. Areas of the home have been redecorated. There are two lounges and a dining room, a second dining room has been created. Service users bedrooms are personalized to their tastes. There are an adequate number of bathrooms and separate lavatories around the home. Some issues require addressing to maintain the health and safety of service users and staff: The temperature upstairs was very hot and the atmosphere was stuffy this was due to the central heating being turned on when the temperature outside was very hot. The vestibule, first floor landing required decorating and areas around the home to make good where the previous fire alarm had been removed. The area around the light switch in the laundry room required plastering. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 16 There are adequate laundry facilities in place and staff receive training about infection control. There is a courtyard to the rear which is used for B-B-Qs and sitting out. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34 Good staffing levels are maintained which means that there are enough staff on duty to meet the needs of service users. There is a varied training programme that ensures the staff have understanding of the service users support needs. Staff receive a thorough grounding in the areas they need to know to provide good care to service users and enhance their own personal development . EVIDENCE: The home is staffed as follows: 8.00am- 5.00pm 4 5.00 pm- 10.00pm 4 10.00pm-8.00am 2 These numbers include the manager who works some supernumary hours. There is a senior staff member on each shift. The necessary checks are being carried out prior to the workers being appointed. Staff files did not contain a photograph of the staff member. There were no copies of proof of identity on staff files although they had been seen by management. There are two vacancies for staff members. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 18 Staff stated that they receive induction training. Where new inexperienced staff are employed, they work as an extra member of the shift , which is good practice. Over 75 of the care staff team have now achieved National Vocational Qualifications at level 2 and 3. Staff confirmed that they also receive advice and /or training in other areas, such as mental health, drug awareness, infection control, dual diagnosis mental health and learning disabilities, working with learning disabled offenders and learning disabilities as well as the necessary statutory training. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42 Service users and staff benefit from a well run home. The manager’s leadership and management approach ensures that service users are fully involved and at the heart of decision making in their own lives and involved in the running of the home. Record keeping showed that service users’ interests are safeguarded. Systems and procedures are in place to ensure the well running of the home and to ensure the safety of residents and staff. EVIDENCE: Service users meetings and staff meetings take place regularly. There is a system in place to ensure that the staff are given training in moving and handling skills, fire safety, first aid, infection control and food hygiene. The fire log book indicated that fire safety checks are carried out routinely apart from fire instructions and drills required to be carried out more frequently with staff and service users. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Milton Lodge Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 2 2 x B53-B03 S42077 MiltonLodge V222451 120705 Stage4.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 24 Regulation 23(2)(b)( d) 7,9,19 Schedule 2 (1)(2) 23(4)(e) Requirement To attend to decorating an dreplastering in identified areas around the home where old fre larm has been removed. To provide staff photographs and proof of identity including birth certificates on each staff file. To carry out fire instructions and drills within prescribed frequency. Timescale for action August 31st 2005 September 1st 2005 September 1st 2005 2. 3. 41 42 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 1 Good Practice Recommendations To include the rehabilitative nature of support and care provided by the home in its Statement of Purpose. Milton Lodge B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 B53-B03 S42077 MiltonLodge V222451 120705 Stage4.doc Version 1.30 Page 23 - 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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