Inspection on 17/07/06 for Milton Lodge

This inspection was carried out on 17th July 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Milton Lodge 24/05/07

Milton Lodge 10/10/05

Milton Lodge 01/06/05

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 Christopher Bond Unannounced Inspection 17th July 2006 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.V299477.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. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 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.V299477.R01.S.doc Version 5.2 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). 10th October 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. At the time of this visit, (17/07/06) the information given to the Commission showed that the fees for care at the home are from £313.00 to £352.50 per week, with added expenses for hairdressing and chiropody. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over a total of 5 hours. A tour of the home included bedrooms, lounge and dining areas, and bathrooms. All areas were clean, hygienic and pleasantly furnished. Administration records were also examined. Everyone was very friendly, welcoming and co-operative throughout the visit. What the service does well: Milton Lodge provides a comfortable, homely and pleasant environment for its residents. All five of the residents that were spoken to were complementary about the home and the support of the care staff. Visitors are made very welcome. Relations and friends of the residents spoke of their trust in the home. One visitor said, “ I always find a relaxed and friendly atmosphere here. The residents seem very happy and there’s always smiling faces.” The staff are friendly in their approach to care and the residents who were able said that the staff were all kind and caring. Observation of staff practice showed that there is a very good interaction between carer and resident. The manager was professional and competent in her role and several of the care staff spoke of the good working atmosphere and excellent support they were given. The home is well furnished in a style that is familiar and comfortable to elderly people. The bedrooms are well furnished and several of the resident commented on how nice their rooms were and how the home is kept clean and hygienic. The domestic staff member who was spoken to described her cleaning regimes and showed her pride in ensuring that the home was clean. Daily routines for the people living within the home are flexible and the residents’ personal routines and lifestyles are respected. Mealtimes are relaxed and unrushed. Menus showed that there was plenty of choice. The food that was being cooked on the day looked nutritious and appealing. Several of the residents spoke of how much they enjoyed the cooking at the home. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 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 DS0000009694.V299477.R01.S.doc Version 5.2 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.V299477.R01.S.doc Version 5.2 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): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough admittance procedures and careful assessment ensures that the home can meet people’s needs. Written information provided to prospective residents is good enabling an informed decision about admission to the home to be made. EVIDENCE: It was clear through looking at the residents’ files that good assessment had been completed before they came to live at the home. These assessments contained some good information about what the person’s current needs were. By looking at these needs the manager of the home would then decide whether or not the service could meet the person’s needs. This information would then be used to prepare a plan of care for the resident. The home’s Statement of Purpose and Service Users Guide is a set of written information that tells people about the care service that is offered, who the manager and staff are, and what the resident can expect if he or she decides Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 9 to live at the home. This has been reviewed and updated. Each resident had been given a copy of this information. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met and people are treated with dignity and respect at this home. Residents are supported and protected in their daily lives. EVIDENCE: All of the residents living at the home had a plan of care where important information was recorded. All of the plans were reviewed on a regular basis so that information was kept current and up-to –date and to see if the home was caring for the resident correctly. Evidence of this could be seen when looking through the care plans. There were records of visits by the District Nurse and the Doctor. No one within the home had pressure sores but special equipment was available to prevent this occurrence. Residents were spoken to and they all felt that they were treated with respect by the care staff, and that their dignity was maintained. One of the residents Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 11 said, I’m well looked after here, the girls are very good.” There was a very good relationship between the residents and the care staff and there were some very good examples of the care staff treating the residents with respect and dignity. Care staff were chatting to residents as they worked and speaking to them politely and respectfully. Another visitor said, “Over the six years that I have been coming here I haven’t one complaint. The staff are lovely and they take great care of the residents.” 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 expressed. Each resident had a photograph attached to his or her record sheet to help with identification. Only senior staff gave out the medication. The home had a separate room where medication was stored safely and securely. There were concerns that recent medication awareness training had not been accessed. This is important because it helps the staff to be aware of good practice in the administration of medication. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 12 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, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy planned and stimulating activities. Friends and family are made welcome within the home, which helps to maintain positive relationships. Mealtimes are planned and unhurried and residents’ preferences are respected. EVIDENCE: There were lots of planned activities within the home to help ensure that the residents were entertained and kept active. These included bingo, sing-alongs, days out to places of interest, shopping trips, coach trips and parties. Several residents were spoken to during the inspection and all of them said that there was always plenty to do. An entertainer was booked on a regular basis and some of the residents said that they really enjoyed singing along to the old tunes. There were several visitors to the home by relatives and friends and those spoken to said that they were made to feel welcome. One relative said, “ I’m always treated very well when I call and I’m always offered a drink and a quiet place to sit whilst we talk.” It was clear that people felt comfortable when calling at the home and the atmosphere was pleasant and homely. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 13 Lunch was served during the inspection and the food looked wholesome and appealing. Residents were given plenty of time to finish their meals and help was on hand from the carers when required. The home had a large dining area with place settings on the tables and table -cloths. The care plans held evidence that special dietary requirements were respected and that likes and dislikes were written down. The cook was spoken to and she described how local produce was bought and how fresh vegetables were always on the menu. Four of the residents who were spoken to said that the food was generally very good and that they looked forward to mealtimes. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints are treated seriously to ensure that the residents’ rights are protected. Training regarding safeguarding issues was poor, which could put residents at risk. EVIDENCE: There were also policy documents for the staff to read about how to recognise and report suspected abuse. Three of the staff that were spoken to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should abuse be suspected. It was some time since the care staff had received training on abuse awareness. It is important to have regular updated training regarding this important subject so that the care staff are constantly aware of their role and responsibilities. Some of the care staff had done this whilst achieving their National Vocational Qualification level 2 in care, which is a nationally recognised qualification. All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in several parts of the home. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 15 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, 20, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms were personalised. This means that residents will feel at home with their belongings around them. EVIDENCE: A tour of the home showed that the general environment was good; furnishings were very comfortable and aids and adaptations are in place to help with the residents’ mobility and personal toilet and bathing needs. Bedrooms were personalised and comfortable and three residents were able to say that they were happy with their rooms. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 16 The manager clearly took the maintenance and cleanliness of the home seriously. A member of the maintenance team visited the home during the inspection to complete small tasks. The home was well maintained throughout. One of the domestic staff for the home was spoken to during the inspection. She described her cleaning regime and the action that she took when addressing particular hygiene issues. She expressed her pride in the cleanliness of the home. The home looked and smelled clean and hygienic. Some of the rooms at the front of the building overlooked the Mount Park and had large bay windows that let in plenty of light. The manager described how some of the carpets were soon to be renewed. When a room became vacant it was usually redecorated. Some of the rooms were shared and the care staff spoke of their responsibility to ensure that everyone had privacy. There were screens available to maintain dignity. One resident said, “I really don’t mind sharing because we get on so well. I knew the person that I share with when I was a young girl, we always have plenty to talk about.” Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 17 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, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good recruitment practices meant that residents were protected from unsuitable staff working in the home. Staff were caring and competent in their roles. Training in some areas was poor, which could affect the way that the service was delivered. EVIDENCE: There were enough care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. One resident said, “The staff are busy but they always have time to sit and talk with us.” Three of the care staff were spoken to and all said that the training in the home was beneficial to their work. Over 50 of the care staff had a nationally recognised qualification in care. It is important that the care staff receive regular training in medication awareness and abuse awareness. The manager also said that she would be organising training in Dementia Care to enhance the carer’s knowledge in this particular subject. Staff records showed that new carers had been properly checked before starting their jobs. This helped to make sure that the residents were safer. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 18 There was a good induction process to help ensure that new care staff were competent before commencing their role. Some of the staff files needed updating. Any training staff have competed needs to be recorded on file with relevant certificates. Some of the files didn’t contain proof of identification or proof of address. This was particularly evident in the files of staff who had been working in the home for some years. This is to show that the care staff are trained to do their jobs properly and that the home has enough information about them. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by an competent manager and there are quality systems in place to make sure that they are protected. Training in important safety areas was inconsistent which could affect the security of the residents. EVIDENCE: The manager of the home had completed a nationally recognised qualification in care (National Vocational Qualification level 4) and was currently in the process of achieving a management qualification. She ran the home well and had the respect of all of the care staff that were spoken to. One of the visitors to the home said, “ The manager of the home is very approachable and is very good at what she does. The care staff respect her and it shows in their excellent attitude towards the ladies.” There was a good relationship between the owners of the home and the manager. The owners were involved in the Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 20 running of the home and contributed to the pleasant atmosphere created within the home. Some of the residents had small amounts of money held by the home. This was held very securely and was safeguarded by good recording and checking. Care staff had had some training in ensuring the safety of residents. This included giving first aid and ensuring that food was prepared and served hygienically. Good records were being kept of safety checks within the home. These showed that tradesmen were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. There had not been training in learning how to move people safely for some time. This, along with other core training such as fire safety, infection control and health and safety are important in ensuring a safe home. All of the care staff should periodically update training in these important areas to update their knowledge. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 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 Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation Schedule 2 12 (1) (a) (b) Requirement Staff records should contain all of the information set down in Schedule 2 of the Care Home Regulations. There must be a coherent stafftraining programme to encompass all aspects of care practice within the home. Timescale for action 30/09/06 2 OP30 30/09/06 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 OP31 Good Practice Recommendations The registered manager should complete a recognised management qualification to assist her in the running of the home. Milton Lodge DS0000009694.V299477.R01.S.doc Version 5.2 Page 23 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 © 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 DS0000009694.V299477.R01.S.doc Version 5.2 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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