Inspection on 09/10/06 for Milton Lodge

This inspection was carried out on 9th October 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 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 21/08/07

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 Anne Brown Key Unannounced Inspection 9th October 2006 11:00 Milton Lodge DS0000042077.V302804.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.V302804.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.V302804.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.V302804.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. 22nd December 2005 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. 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.V302804.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over four hours. A tour of the premises took place and a sample of records was inspected. These included four care plans, communication book, fire log, accident book, minutes of meetings and medication records. The proprietor, manager, two staff members and seven service users were spoken to during the inspection. Questionnaires were returned by four service users, one relative and two social workers. What the service does well: What has improved since the last inspection? The staff team have undergone formal training on the protection of vulnerable adults to ensure the service users are protected from abuse. A kitchen, lounge, dining area and three additional bedrooms with en suite facilities have been provided in unit 2. Minor repairs have been carried out and one bedroom has been decorated. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Milton Lodge DS0000042077.V302804.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.V302804.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): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their individual needs assessed prior to admission. This ensures that the staff are aware of all their needs and are able to meet these. Prospective service users are invited to visit and spend time in the home, which helps them to decide if it is suitable for them. EVIDENCE: The home continues to conduct a thorough pre-admission assessment. This includes obtaining the Care Management Assessment and, where applicable, information is sought from health care professionals. There is a carefully phased introduction to the resource, which includes staying for meals, and initial overnight stays. Initial care/support plans are devised as a result of an assessment of needs. These are built on during the service user’s stays. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are care plans that contain guidelines for dealing with complex needs, which explain what staff need to do. Service users are encouraged to make decisions. The care staff support the service users to take risks as part of their lifestyle. EVIDENCE: Each person has a service user plan that describes their individual needs and how the home will meet them. The plans state what staff need to do to support and care for people. Care and support needs are reviewed three Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 10 monthly by staff and appropriate professionals. The service users are involved in the reviews. The staff on duty were well aware of the needs of the service users and were observed consulting and communicating with them. The service users who were present said they were given choices and asked their opinion on matters affecting the day-to-day running of the home. Risk assessments are available on the case files. These assist the service users to lead fulfilling lives and they are well supported by staff to take calculated risks as necessary. The staff have knowledge of equality and diversity issues and these are carefully considered when writing the care plans. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 11 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the community and opportunities to participate in social and personal development activities are good. The service users are encouraged to mix with other people and participate in worthwhile activities. Visitors are made welcome or staff support service users to maintain contact with family and friends. Staff respect the service users’ rights. Well-balanced menus are in place and alternatives are offered. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 12 EVIDENCE: On the day of the inspection service users were being supported to attend day centres and leisure activities. The service users confirmed that the staff assisted them to visit places of their choice. The care plans showed that service users, whatever their level of need, are encouraged to enjoy a more independent lifestyle. Service users confirmed that staff encourage them to clean their own bedrooms and assist in preparing food. One service user was ironing his clothes during the inspection. Another service user said he enjoyed going to the local supermarket every week with the staff to do the food shopping. Service users all pursue their own individual hobbies and interests. Activities include meals out, shopping trips, cinema, bowling, paint balling and greyhound racing. Day trips are organised to local places of interest. The manager said they are planning to visit Diggerland in the near future. The older service user said he enjoyed some group activities but also spends one to one time with the staff if he prefers. Visitors are made welcome in the home and staff assist service users to maintain contact with friends and family in the community. One service user said a staff member was escorting him to visit his mother later that day. Menus are varied and nutritious and a choice is always available. Staff encourage service users to eat a healthy diet. The service users confirmed they enjoyed the food served to them and can help themselves to snacks at any time. They said they were involved in planning the menus and were always able to request an alternative meal. Two different meals were being served for lunch. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of the service users are well met and recorded in the care plans. The staff give the service users the personal support they require and according to their preferences. An appropriate system is in place for dealing with medications, which protects the health of service users. 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 basis. Other professionals are also involved where appropriate and reviews are held at Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 14 appropriate intervals. Two service users said they are supported to visit their GP when they are unwell. The service users confirmed they were always treated well by the staff and received the support they required. A random sample of medication records and the system for storage and administering medication was looked at and found to be appropriate. The staff that handle the medications have undergone formal training. The medication records did not include photographs of the service users for identification purposes. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 15 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system and training in adult protection has been provided for the staff, which helps to protect the service users from abuse. EVIDENCE: The home has a complaints procedure. There have been no complaints since the last inspection. Service users said that they felt able to discuss any issues or concerns with manager and the proprietor. They said they were satisfied that their concerns would be taken seriously. Service users also have their own copy of the complaints procedure in their bedroom to remind them of the process. The staff team have received training on the protection of vulnerable adults (POVA) run by North Tyneside Council. The policies and procedures have also been approved by the POVA Co-ordinator. Appropriate records, receipts and signatures are retained when dealing with money held on behalf of the residents. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 16 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, safe and comfortable. Some areas are showing signs of wear and tear. Service users’ bedrooms are comfortable and suit their needs. The home is clean, hygienic and free from offensive odours. EVIDENCE: The premises are homely and comfortable. Some areas on the first floor are showing signs of wear and tear. The proprietor confirmed that there is a programme in place to redecorate these areas. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 17 The second floor lounge was being used as a storage area. There is a dedicated smoking area on each unit. The service users’ bedrooms are decorated according to their individual tastes and personalised by their own possessions. The service users are able to choose their own furniture when they move into the home. They said they enjoyed spending time in their own bedrooms but also made good use of the communal areas. The home was clean, hygienic and free from offensive smells. A member of staff attends regular meetings with the infection control nurse and updates the staff team with any relevant information. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 18 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, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team are well trained and competent to support the service users. The recruitment policy and practice supports and protects the service users. The needs of the service users are met by appropriately trained staff. The staff team are well supported and supervised, so that they are able to do their job well. EVIDENCE: Over 80 per cent 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 drug awareness, mental health and learning disabilities, maintaining professional boundaries and staying safe, as Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 19 well as the necessary statutory training. Certificates are displayed in the office. The staff files confirmed that Criminal Records Bureau checks had been carried out and two written references obtained before people are employed in the home. Good staffing levels are maintained to ensure the service users’ needs are well met. The manager and five support workers were on duty. The manager said there are normally six support workers on duty during the day and one waking night staff and one sleep-in. Good relationships were observed between the manager, staff and service users. The service users confirmed that there are always enough staff on duty to offer them the support they require. Formal supervision sessions are held for all staff at appropriate intervals. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 20 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run with a focus on the service users. The management and staff team respect the service users views regarding the running of the home. The health, safety and welfare of service users are protected by the systems the home has in place. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 21 EVIDENCE: The proprietor and manager have experience in working with adults with learning disabilities and mental health problems. They show commitment to updating their skills and competence. The staff on duty and the service users confirmed that the management are supportive and approachable. The service users said they were always consulted about things affecting the day-to-day running of the home. Regular meetings are held in the home to discuss day-to-day activities, food, décor and any other matters affecting the service users Mandatory health and safety training is regularly updated. A fire risk assessment is in place. The fire logbook confirmed that tests are carried out at appropriate intervals. No safety hazards were observed. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 3 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 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 3 X Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13(2) Requirement Photographs of service users must be placed on medication records for identification purposes. Items stored in second floor lounge must be removed. Timescale for action 31/10/06 2. YA24 23(1)(a) 31/10/06 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 YA24 Good Practice Recommendations Programme to redecorate areas on the first floor should continue. Milton Lodge DS0000042077.V302804.R01.S.doc Version 5.2 Page 24 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 Text phone: 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.V302804.R01.S.doc Version 5.2 Page 25 - 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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