Inspection on 21/08/07 for Milton Lodge

This inspection was carried out on 21st August 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milton Lodge 09/10/06

Milton Lodge 22/12/05

Milton Lodge 12/07/05

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 M Reed Key Unannounced Inspection 21st August 2007 11:00 Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 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 DS0000042077.V343970.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 Adults 18-65. 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 DS0000042077.V343970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milton Lodge Address 23-24 The Esplanade Whitley Bay Tyne & Wear NE26 2AJ 0191 2533730 F/P 0191 2533730 jill@heatherington.wanadoo.co.uk 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) Mr Alastair Craig Nurse Mrs Jill Anne Heatherington Care Home 13 Category(ies) of Learning disability (12), Mental Disorder, registration, with number excluding learning disability or dementia - over of places 65 years of age (1) Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Unit 1 - The current registered place MD(E) is for a named service user only. 8 LD places are also provided on this unit. Persons admitted to Units 1 & 2 will predominantly have learning disabilities but may also suffer from a mental disorder. 9th October 2006 Date of last inspection Brief Description of the Service: Milton Lodge is situated in the centre of Whitley Bay and is close to the sea front, shopping centre and transport systems. The home is divided into two units and provides care for male service users, aged 18-65 years old. The accommodation is over three floors and there are thirteen single bedrooms, nine of them have en-suite facilities. There are three lounges, two dining rooms 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. The fees start from £350.00 and are dependant on individual needs. Inspection reports and information about the home are readily available. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • • • • • Information we have received since the last inspection on October 9th 2006. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit • An unannounced visit was made on August 21st 2007 During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the provider what we found. What the service does well: There is a good level of staff training to ensure that staff are equipped with the skills to provide support to residents. There is a very good level of record keeping. Residents are involved in the running of the home and are involved in daily decision making about their lives. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 6 Residents are offered the opportunity to be involved in training. Residents were complimentary about the care and support provided by staff. Residents were very positive about the food available in the home. 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. The summary of this inspection report can be made available in other formats on request. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available to give to prospective residents before they move in. The home collects enough information about the needs of prospective residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Staff receive a variety of training to give them the knowledge and insight to help understand the needs of residents and to provide the necessary levels of care and support to individual residents. EVIDENCE: The Home’s Statement of Purpose and service user guide were examined and they contained the necessary information as required by the Care Homes Regulations 2001 they were easy interesting and easy to read but they had not been reviewed to ensure they contained accurate up to date information. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 9 Records for five of the residents showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew them were involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. Staff receive training so that they know how to meet the specialist needs of the residents. Staff have received the necessary statutory training: Fire Training, Food Hygiene, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; infection control, risk assessment, challenging behaviour, working with learning disabilities, health training, capacity and consent and person centred planning. Residents have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are very good arrangements in place to ensure that residents’ health and social care needs are met. There is a system of reviewing the changing care needs of residents. Residents are well supported by staff and care plans show the amount of care and support that staff are providing to residents. Residents are encouraged to be involved in decision-making and to communicate and make their views known. Staff support residents to take risks as part of independent living. Information about residents is handled appropriately, and their confidences are kept. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 11 EVIDENCE: There are detailed assessments in the residents’ care plans. Care and support needs are documented and give instructions to staff on how to support people that require support with tasks and carrying out any assessed tasks to help promote the independence of the person. Care plans are being updated three monthly or earlier if required if a resident’s care and support needs change. Residents care records showed that they have access to external health care services. GPs and Community Psychiatric Nurses were regularly consulted for advice and treatment. Records show residents are assisted to access chiropody, dental and optical services at least annually or as often as required. Residents are asked individually and consulted about decisions involving themselves and the running of the home. Meetings are held regularly with service users about the running of the home. Service users spoken to stated that they were involved and consulted about decisions involving themselves. The home supports residents to remain independent and take risks in order to live a more fulfilled lifestyle and up to date risk assessments were present in residents care records. Residents care records all contained statements of confidentiality to remind staff what information could or could not be disclosed about residents. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to take part in age, peer and culturally appropriate activities. Community facilities are used by residents wherever possible. Appropriate leisure activities are available for residents. Residents are encouraged to have appropriate personal, family and sexual relationships. Residents’ rights and responsibilities are recognised in their daily lives. Residents are offered a healthy diet. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 13 EVIDENCE: Residents agreed that they are involved in the running of the home and involved in making decisions about their lives. Residents’ records showed that all residents are consulted and asked their opinion and encouraged to make decisions about their lives. Conversation with residents showed staff support residents to acquire skills and become more self sufficient in aspects of every day living. Residents all pursue their own individual hobbies and interests: keep fit, weight lifting, bowling, camping, discos, eating out, cinema, college, etc Some residents attend day centres during the week. A caravan has been purchased by the provider for the use of residents. A mini bus is available for outings to Kielder Reservoir, the Northumbrian coast and wherever residents wish to go within reason. Residents care plans and case records detail any family involvement. Due to the needs of some residents they are supported on a one to one basis by staff and enjoy outings daily to places of interest to them. Conversation with residents also provided evidence that they are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. Residents are asked individually daily what they wish to eat. A light snack is available at lunch times and a cooked meal is served in the evening. The menus are revised with the help of the residents. Residents may often eat out. On the day of inspection shepherd’s pie or chicken curry was being served for the evening meal. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do receive support in the way they prefer and require. There are good arrangements in place to ensure that residents’ health care needs are met. Systems are in place for residents to retain and administer their own medication where appropriate. EVIDENCE: Five care plans and case records were inspected. The daily records detailed the care and support required for different needs. They reflected the changing needs of service users. The care plans accurately recorded the needs and the care and support provided by staff. Records showed when residents had seen health professionals, for example, doctors, consultants and community psychiatric nurses. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 15 Records also showed when residents had seen opticians and dentists. Staff receive training before they administer medication to residents. A system is in place to oversee the medication of residents if they should retain and administer their own medication. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. The home keeps a record of complaints. Staff have received training about Protection of Vulnerable Adults and Prevention of Abuse. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment that is becoming well maintained. There is a good standard of hygiene around the home. EVIDENCE: There is a programme of decoration and refurbishment around the home. Discussion took place about the situation of the smoking area after new smoking laws come into effect rather than residents having to go outside of their own home to smoke. The proprietor stated a conservatory was being built to provide a separate smoking area in the home to accommodate residents who smoke. As the home is rehabilitative and teaching residents new skills or helping them to relearn previous skills some residents are involved in the cleaning of the Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 18 home. Systems are in place to ensure that a good level of hygiene and cleanliness are in the home to ensure the health and safety of everyone. Residents all enjoy their own bedrooms that are personalized with their own belongings. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the numbers and skill mix of staff. Systems are in place to ensure residents are in safe hands. There are sound recruitment policy and practices in place to protect residents. Staff are trained to meet the care needs of residents. A system of supervision is in place for all staff working at the home. EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the sufficient staff are on duty to meet the care and support needs of residents. There are currently no staff vacancies. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 20 Residents may carry out some cooking and cleaning duties with the assistance and support of staff. The necessary checks are being carried out prior to the workers being appointed. CRB checks are carried out before a person is appointed. Two written references were available for the staff files examined from the most recent employers. An application form had been completed for each staff member. Photographs were available on all staff files. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Residents commented they liked living at the home. Staff said and their records showed that they also receive advice and /or training in other areas. Staff are enthusiastic about training and enjoy the opportunities provided by management. Out of the staff team member 90 have achieved NVQS at various levels 2 and 3. Staff receive training so that they know how to meet the specialist needs of the residents. Staff have received the necessary statutory training: Fire Training, Food Hygiene, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; infection control, risk assessment, challenging behaviour, working with learning disabilities, health training, capacity and consent and person centred planning. Staff receive supervision every two months from the manager. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ live in a home that is well run and managed for the benefit of residents. The standard of record keeping is very good. The health, safety and welfare of residents and staff are promoted and protected. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has worked at the home for some years. She has completed the Registered Manager’s award. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. A sample of records were inspected which included: the Home’s Statement of Purpose and service user guide, the home’s maintenance contracts, 5 care plans, the fire log, accident book, admission /discharge book, complaints record, staff communication book, staff meeting minutes and four staff files. All records as required by the Care Homes Regulations 2001 were well documented and completed. Documents detailing fire safety ,risk assessments in the environment and maintenance contracts for the building were all up to date apart from the fire log was out of date and did not show checks having been carried out since June 2007. Staff training relating to health and safety was up to date and training being planned to renew any that required updating. Staff files showed staff are supervised regularly. Staff meetings take place regularly. Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 2 3 3 3 4 4 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 x Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 24 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. 2. Standard YA1 YA42 Regulation 6(a)(b) 4(c)(v) Requirement The Statement of Purpose must be reviewed annually ad updated as required. The necessary fire checks must be carried out within the prescribed frequency. Timescale for action 30/09/07 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Milton Lodge DS0000042077.V343970.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000042077.V343970.R01.S.doc Version 5.2 Page 26 - 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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