Inspection on 22/12/05 for Milton Lodge

This inspection was carried out on 22nd December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milton Lodge 21/08/07

Milton Lodge 09/10/06

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 Anne Brown Unannounced Inspection 22 December 2005 1:30 Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 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.V252330.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 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.V252330.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Milton Lodge Address 23-24 The Esplanade Whitley Bay Tyne & Wear NE26 2AJ 0191 2533730 0191 2533730 jill@heastherington.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 10 Category(ies) of Learning disability (9), Mental Disorder, registration, with number excluding learning disability or dementia - over of places 65 years of age (1) Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Unit 1 - The current registered place MD(E) is for a named service user only. 5 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. 12th July 2005 Date of last inspection 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 transport networks. The home is divided into two units. Unit 1 provides accommodation for six male service users, aged 18-65 years old. Unit 2 provides accommodation for four 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 DS0000042077.V252330.R01.S.doc Version 5.0 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 records was inspected. These included three care plans, communication book, fire log, accident book, minutes of meetings and medication records. The manager, one staff member and six residents were spoken to during the inspection. What the service does well: What has improved since the last inspection? Since the last inspection redecoration has taken place in some areas of the home and a renewal programme is in place. The staff team have completed training on professional boundaries and staying safe. The staff files have been updated to include all necessary information and the statement of purpose has been reviewed and updated. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 6 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 DS0000042077.V252330.R01.S.doc Version 5.0 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.V252330.R01.S.doc Version 5.0 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 the following standard(s): 5. Each service user has a statement informing them of the terms and conditions of the home. EVIDENCE: All residents have been issued with and signed a copy of the statement of terms and conditions. The manager was advised to retain a copy of the documents on the case files. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6 and 10. There are excellent arrangements in place to ensure that residents’ health and social care needs are met and the staff team are fully informed. Residents are well supported by staff and the necessary levels of support are provided due to the detailed care plans. Confidentiality is respected in the home. EVIDENCE: The care plans contain 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 are reviewed three monthly by staff and appropriate professionals. The service users are involved in the reviews. A comprehensive confidentiality policy is in place and is part of the staff induction training programme. Staff members all sign a statement on confidentiality. All personal records are held in a secure location in the home. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 11, 15 and 17. The management and staff in the home encourage and provide support for service users to use and take part in community facilities. This includes leisure, spiritual, social and educational needs. Social activities are 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. Menus are varied and nutritious and mealtimes are flexible. EVIDENCE: On the day of the inspection service users were being assisted to attend day centres and leisure activities. Four service users confirmed that the staff assisted them to visit venues of their choice. Two service users were planning their night out with a staff member. The care plans showed that service users, Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 11 whatever their level of need, are assisted to enjoy a more independent lifestyle. Service users confirmed that staff encourage them to learn skills and become more self sufficient in aspects of every day living. Service users all pursue their own individual hobbies and interests. Activities include meals out, shopping trips, cinema, bowling and greyhound racing. Visitors are made welcome in the home and staff assist service users to maintain contact with friends and family in the community. The manager stated that three service users were spending Christmas with their relatives. Menus are varied and nutritious and a choice is always available. Staff encourage service users to eat a healthy diet. Five service users confirmed they enjoyed the food served to them and said they are offered plenty of choice. They also said they enjoyed ‘take-always’ on a regular basis. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19 and 20. There are excellent arrangements in place to ensure that service users’ 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. The system for administering, recording and storing medications is adequate. EVIDENCE: The recordings in the care plans indicated that the staff team seek advice and support from relevant professionals in respect of the service users’ health and wellbeing. Health checks are carried out on a regular for each service user. Other professionals are also involved where appropriate and reviews are held at appropriate intervals. A random sample of medication records and the system for storage and handling medications was looked at and found to be appropriate. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 22 and 23. There is a suitable complaints procedure. Service users 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 Adults procedures. EVIDENCE: The home has a complaints procedure. There have been no complaints about the home since the last inspection. One service user stated that they would raise any issues of concern with the manager or staff team. Service users also have their own copy of the complaints procedure in their bedroom to remind them of the complaints process. A procedure for responding to allegations of abuse is available. This procedure has not yet been approved by the local authority POVA Co-ordinator. The manager is awaiting dates for staff to receive training about multi-agency POVA procedures with the local authority. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 24 and 30. The standards of the facilities and décor within the home are adequate, providing residents with an attractive and homely place to live. Bedrooms are personalised and provide the residents with the necessary facilities. The service users live in a clean and hygienic environment. EVIDENCE: The home was homely and comfortable and a renewal and maintenance programme is in place. All bedrooms are individualised and contain the personal effects of the service users. The mechanical ventilation system in the upstairs toilet was not working properly and the carpet in one bedroom was in need of cleaning. A hole in the plasterwork was apparent in the dining room in unit 2. The home was clean, hygienic and free from offensive odours. Eight members of staff have completed a 12 week training course on infection control at Northumberland College. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 and 36. Good staffing levels are maintained to ensure the service users’ individual needs are met. There is a varied training programme that ensures the staff have understanding of the service users support needs. The staff team receive adequate support and formal supervision. 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 supernumerary hours. There is a senior staff member on each shift. 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, professional Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 16 boundaries and staying safe, as well as the necessary statutory training. Certificates are displayed in the office. Good relationships were observed between the manager, staff and service users. Formal supervision sessions are held for all staff at appropriate intervals. The manager is booked to attend a training course on appraisal and supervision in the near future. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. The service users benefit from a well run home and staff encourage them to express opinions. Health and safety of the service users is promoted by well-trained staff and appropriate risk assessments are in place. EVIDENCE: Monthly meetings are held to consult service users about all aspects of the day-to-day running of the home and this information is recorded in minutes of meetings. The service users confirmed that they are consulted on issues concerning the running of the home. Risk assessments are carried out on the premises and for each individual service user. 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. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 18 The fire log book indicated that fire safety checks are carried out routinely. No record was available to confirm when staff members are updated on fire instruction. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 19 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 X X X X 3 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Milton Lodge Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 X DS0000042077.V252330.R01.S.doc Version 5.0 Page 20 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 YA23 YA24 Regulation 12(6) 23(2)(b) Requirement Timescale for action 31/03/06 3 YA42 23(4)(e) Staff team to undergo formal training on Protection of Vulnerable Adults. Mechanical ventilation system to 31/01/06 be repaired in upstairs toilet, carpet to the cleaned in room 5 and plasterwork to be repaired in dining room in unit 2. Records to be held to indicate 31/01/06 when staff receive updates on fire instruction. 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 YA23 Good Practice Recommendations Protection of Vulnerable Adults policies and procedures to be approved by local authority POVA Co-ordinator. Milton Lodge DS0000042077.V252330.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Cramlington Area Office 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 DS0000042077.V252330.R01.S.doc Version 5.0 Page 22 - 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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