Care Home: Milkwood House

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What the care home does well The manager has established a dedicated staff team who are committed to providing a good quality of life for the people who live at Milkwood House. There is a low turnover of staff so residents receive care from staff who know them well. Staff spoken with said they work very well together and understand people`s needs; they said they feel well supported by the manager.There is an excellent programme of training including specialist training in dementia care. The management team encourage and support staff in their personal and career development. The home is well decorated and furnished and there is an ongoing development plan for improving the building and facilities. The gardens are well cared for and people said they enjoy using them in good weather. The food is home cooked and meals are provided in a pleasant dining room. People who returned surveys said: "They always make my wife happy which is a very good thing"; the home is good at "Making the life here feel homely. Always smells fresh and clean. Offers visitors tea and cake during visiting our relative", "I think the total care seems to be excellent", " I enjoy very much mini coach outings", " I think it provides good care in a warm and understanding environment" and " Milkwood House continually strive to ensure all working practices are relevant to client group they deliver care to". One person spoken with on the day said: "I couldn`t ask for kinder or better staff. They are always available when needed". What has improved since the last inspection? Risk assessments are now carried out and documented for people who need bedsides for their safety and consent to this is recorded. The manager has set up a new format for care plans and they are all typed so that staff can read them easily. A minibus has been purchased so that people can go on outings more often. A refurbishment plan has been introduced and bedding, carpets, furniture and curtains have been purchased for some areas of the home. A new carpet cleaner and tumble dryer have been purchased. What the care home could do better: The manager and provider have a development programme so that people will continue to experience a good quality of life at Milkwood House. CARE HOMES FOR OLDER PEOPLE Milkwood House Hill Brow Liss Hampshire GU33 7PB Lead Inspector Annette Campbell-Currie Unannounced Inspection 19th March 2008 10:20 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 Milkwood House DS0000014630.V359596.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. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milkwood House Address Hill Brow Liss Hampshire GU33 7PB 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) 01730 895485 Milkwood Care Limited Mrs Linda Walker Care Home 43 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (43) of places Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total of 43 persons at any one time, one of whom is under 65 years of age. 4th October 2006 Date of last inspection Brief Description of the Service: Milkwood House provides accommodation and care for forty-three older people including those with dementia. The home is located on the West Sussex/Hampshire border a few miles from Petersfield with its shops and other amenities. The building consists of a large converted 3-storey house with an extension to the rear. In addition a more recent purpose built extension to the side of the building provides additional rooms to the ground and lower ground floor. The accommodation consists of thirty-one single and six double rooms, some of which have en-suite facilities. There is a large landscaped garden to the rear of the property and parking facilities are available at the front. Mrs Linda Walker is the registered manager responsible for the day-to-day running of the home. The current fees are from £410 to £625 per week. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is Two Star. This means that the people who use this service experience good quality outcomes. Annette Campbell-Currie carried out the site visit over four hours. The registered manager and one of the directors assisted with the inspection and all the information and documents that were needed were available. There were thirty-nine people staying in the home at the time. The manager had completed an annual quality assurance assessment form (AQAA) before the inspection and this provided some information that was used in the planning of the site visit. During the visit four people living in the home were spoken with and two members of staff. The gardens, communal areas and a number of bedrooms were seen. The case records of four people living in the home were read, four staff recruitment records, training records, quality assurance documents, environmental health report, key policies and other relevant documents. The lunchtime medication round was also observed. Comment cards had been sent out to people living in the home, relatives, staff and healthcare professionals. Replies were received from six residents, four relatives, eleven staff, three health care professionals and a care manager. Comments were positive and the information gathered has been used to help make an assessment of the service. The outcome for people living in the home has been assessed in relation to twenty-three of the thirty-eight National Minimum Standards for the care of older people, including those considered to be key standards to ensure the welfare of people living in the home. The requirement made at the previous inspection, that risk assessments should be carried out for people who need bedsides for their safety at night has now been addressed. What the service does well: The manager has established a dedicated staff team who are committed to providing a good quality of life for the people who live at Milkwood House. There is a low turnover of staff so residents receive care from staff who know them well. Staff spoken with said they work very well together and understand people’s needs; they said they feel well supported by the manager. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 6 There is an excellent programme of training including specialist training in dementia care. The management team encourage and support staff in their personal and career development. The home is well decorated and furnished and there is an ongoing development plan for improving the building and facilities. The gardens are well cared for and people said they enjoy using them in good weather. The food is home cooked and meals are provided in a pleasant dining room. People who returned surveys said: “They always make my wife happy which is a very good thing”; the home is good at “Making the life here feel homely. Always smells fresh and clean. Offers visitors tea and cake during visiting our relative”, “I think the total care seems to be excellent”, “ I enjoy very much mini coach outings”, “ I think it provides good care in a warm and understanding environment” and “ Milkwood House continually strive to ensure all working practices are relevant to client group they deliver care to”. One person spoken with on the day said: “I couldn’t ask for kinder or better staff. They are always available when needed”. 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 Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 8 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 Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 9 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. 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. People have the information that they need about the home to make an informed choice about where to live. People who move to the home have their needs assessed so they can be assured that they will receive the care that they need. EVIDENCE: There is a Statement of Purpose and Service User Guide that provide all the information required to help people make a decision about moving to Milkwood House. All new residents are given a welcome pack that includes details of the terms and conditions of their stay. People who returned surveys said that they had received the information that they needed. The manager carries out a monthly review of the information to make sure it is kept up to date. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 10 The manager or one of the deputy managers carries out an assessment of the person’s needs before a decision is made about them moving in. Relatives and health care professionals are involved in the assessment where appropriate. The case records for someone who had recently moved to the home were seen and the manager explained how the assessment had been carried out. The completed forms included details about all aspects of the person’s life. The manager said that the home does not accept people who have an advanced dementia and that the community psychiatric nurse is involved in the assessment and introduction process. The manager explained how the staff were informed at the handover meeting about the arrival of the person who recently moved to the home, the care they would need on arrival and the plan that was in place to help them settle in; however it was not clear that this had been documented. There should be a clear plan for the introduction process for someone who has a dementia to make sure they are assisted in their move and that there is a plan in place to keep them safe and to help them settle in. These issues were discussed with the manager who said she would review the way the decisions and the planned moves are recorded. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 11 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. 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. People’s health, personal and social care needs are set out in a plan of care and are fully met. People are protected by the home’s policies and procedures for dealing with medicines. People feel that they are treated with respect and their right to privacy upheld. EVIDENCE: There is a care planning and review process in place. The manager has recently updated and typed the care plans using a new format to make them more accessible to staff. The case records for four people were seen and included details of the care needed in all aspects of the person’s life including health, personal and social care needs. There were details about people’s life history, cultural and religious needs as well as the social interests and activities they enjoy. There was clear guidance to staff about the way that care should be provided and the staff spoken with said they know and understand the care that people need. A health care professional said: “Staff at Milkwood appear to Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 12 fully embrace what being person-centred (within the care of people with dementia) means”. Risk assessments had been carried out in all aspects of health and daily care needs with guidance about how to minimise risks. The care plans included memory and orientation assessments so that the level of confusion for people who have a dementia can be monitored and steps taken to support them. The care plans and risk assessments are reviewed monthly. People who need bedsides to keep them safe have a risk assessment and consent to their use is obtained. The manager said that the home has a good relationship with the local primary health care team and psychiatric services. The GP is called when required and one was visiting the home during the afternoon. The manager said there is a long wait for physiotherapy services unless people can afford a private service. It was clear from the care plans seen that people’s health care needs are closely monitored and any changes are noted. A record is kept of any contact with a health care professional and any guidance given is recorded. District nurses provide advice and guidance on continence problems. People have access to the services of opticians and chiropodists. One health care professional said of the home: “It is very well managed. Residents come first and everything is aimed at making life better for them. Very professional and organised. Probably the best managed home I look after”. There are medication policies in place. All the staff who administer medication have attended training to ensure that they are competent. People who are able to hold their own medication have lockable facilities in their room. The lunchtime medication round was observed. Two senior staff were working together to make sure that there were no errors. The recording was in order. A local pharmacy provides advice and guidance on medication. Staff are given guidance about the way to provide personal care as part of their induction. People who were spoken with and those who returned surveys said that staff listen to what they say and provide care in the way they prefer. During the day staff were observed to be communicating well with residents and providing support in an unhurried and sensitive manner. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 13 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. 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. People find the lifestyle experience in the home matches their expectations. People are supported to maintain contact with their friends and relatives and encouraged to make choices in their lives. People are provided with a nutritious and balanced diet and meals are provided in pleasant surroundings. EVIDENCE: There is a programme of activities available. The care plans that were seen included details about people’s life history, interests, personal and social relationships so that staff can provide the lifestyle that people prefer. There is currently no dedicated member of staff to coordinate activities and the manager said that someone would be appointed soon. One of the managers from another home in the group has completed a five-day activity programme course and will be cascading her knowledge to all the other managers so that they can use the ideas that she has learnt. The course was helpful in providing ideas about working with people who have a dementia. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 14 Activities available include arts and crafts, exercise and movement, games, and one-to-one quality time with a member of staff. Massage, hairdressing and manicures are also available. On occasions staff take people out to do their personal shopping. A mini bus has been purchased and is used on Thursdays to take people out to places of interest. A harpist had been to the home recently and theatre trips are arranged from time to time. There were no activities during the day and in the morning care staff were busy with domestic tasks. People were sitting in the lounges reading the paper or watching television. The manager said that when the activities coordinator is in post they would be able to spend time with people to make sure they have company or things to do if they wish to. People are supported to maintain contact with their friends and family. The feedback from surveys returned by families indicated that they are kept informed about their relative’s wellbeing. There are no restrictions to visiting times and people said their visitors are made to feel welcome. People are supported in their religious and cultural observances and people’s wishes were noted on the care plans seen. People are able to choose their preferred daily routine and this is also noted on their care plan. People are able to bring their pet to the home if they wish and two people have recently been supported to have a cat and a dog with them. There is an advocacy service available if needed. The manager has attended a course on the Mental Capacity Act and is keen to make sure that where people do not have capacity to make choices or give their consent to care that the correct procedures are in place. People are provided with a home cooked meal and the menu is varied. A choice of meal is available and special diets are catered for. One person said that she prefers to have a main meal in the evenings and this is catered for. Most people take their meals in the dining room and lunchtime was a relaxed and social occasion. People were being assisted with their meals in a sensitive way. Nutritional needs are noted on the care plans and people are weighed every month to make sure that they are in good health. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their complaints will be listened to and acted upon. There are policies and procedures in place to protect people from abuse. EVIDENCE: There is a complaints policy and everyone is provided with a copy so that they know how to make a complaint. There is a system for recording complaints so that timescales for a response and outcomes are documented. No complaints have been received in the past twelve months. The manager said that she likes to resolve any problems quickly; there had been concerns about people’s laundry and a laundry assistant has now been appointed to make sure that these problems do not occur again. Residents meetings are held regularly and people can discuss any concerns they have. There are safeguarding adult policies in place and the West Sussex multi disciplinary policy and procedure for protecting people from abuse is available. All staff have attended training in preventing adult abuse and those spoken with were clear about reporting procedures. The community psychiatric nurse or the psychiatrist are available for advice and support about helping people with behaviour management. Separate guidance had been provided for staff in supporting someone with some Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 16 behavioural issues relating to personal care and eating. There is a restraint policy and those needing bedsides for their safety have risk assessments and there are consent forms in place. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe and well-maintained home that is clean, pleasant and hygienic. EVIDENCE: Milkwood House is well maintained and there is an ongoing programme for developing the facilities. There are several lounge and quiet areas for people to enjoy. The bedrooms are well decorated and furbished and people spoken with said they are very happy with their rooms. The double rooms have curtains to divide the room and to provide some privacy. There is a full time member of staff for maintenance work and there are procedures in place for ensuring that all equipment is serviced as required. The building meets the requirements of the fire officer and the environmental health department. The gardens are well Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 18 maintained and several people said they enjoy spending time in the grounds when the weather is good. There are handrails on stairways and corridors in the older part of the building; there are no handrails in the corridors of the newly built part of the home. The provision of handrails would help people who have problems with mobility; the manager said that this has not been a problem for people currently staying in that part of the home. The manager has to walk around the outside of the building to access her office without going through the kitchen; there are plans to move the office to the main part of the building so that she is more accessible. The home is registered to accommodate twenty people who have a dementia and the use of pictures or symbols was discussed with the manager so that people who are confused could more easily find their way around the building. Mrs Walker said that there are systems in place to help one resident and that a colleague has recently completed a course in working with people who have a dementia so she has some ideas that could be considered. The laundry facilities in the home are only used for personal laundry. A member of staff has recently been appointed for laundry duties to make sure the laundry systems are efficient and to take the strain away from care staff. There are domestic staff who keep the home clean, hygienic and bright. All staff have attended courses in infection control and disposable gloves and aprons are readily available for staff to use to prevent the spread of infection. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are met by the numbers and skill mix of staff and are protected by the home’s recruitment procedures. Staff are very well trained and competent to do their jobs. EVIDENCE: The staffing rotas were seen and showed that there are sufficient numbers of staff to meet the needs of people living in the home. The manager said that additional staff are on the rota at busy times, for example when there is a trip out on Thursdays there is additional staff cover. There is a very low turnover of staff so that people are cared for by people they know and who know them well. During the morning staff were very busy with tasks such as changing beds and making sure people had a drink. The manager said that when an activities coordinator is appointed they would be able to spend more time in the communal areas making sure people have company or activities if they wish. The staff spoken with said there is more time in the afternoons for one-to-one sessions with residents and the manager said this is written in to the timetable to make sure that staff have time with each person. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 20 All staff are encouraged and supported in their professional development. Twenty-one of the twenty-seven care staff have achieved the National Vocational Qualification (NVQ) award at level two or above. One member of staff said that the manager is very good at supporting staff in their career development and that there are opportunities for promotion within the company. There is a recruitment policy and a sample of recruitment records for four recently appointed members of staff were seen. All applicants complete an application form and gaps in employment are explored with them during the interview with the manager. All the required checks including two written references and Criminal Record Bureau (CRB) checks are carried out before people begin work. There is a structured induction programme in line with the Skills for Care guidance. Staff who responded to the surveys said the induction process gave them the information and knowledge that they needed. There is an excellent training programme within the company. All staff have an annual appraisal and regular supervision to identify their training needs. The manager is very committed to staff training and said that most staff are very enthusiastic about attending courses. One member of staff said: “There is continuous staff training for better services”. The staff spoken with said that they are well supported and encouraged to attend training that will help them in their career as well as the mandatory training. Training records showed that all staff have attended mandatory training and updates as required. Some staff have attended additional training topics include: dementia care, palliative care, counselling course, guardianship training and team building. Training topics are included on staff meeting agendas and the training material is very detailed. Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 21 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. 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. Milkwood House is well managed and run in the best interests of the people who live there. People’s financial interests are safeguarded and the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: Mrs Walker has achieved the NVQ level four in care and the Registered Manager’s award. She has five years experience in a senior management position and is committed to her ongoing development and training. Courses she has attended recently include: Mental Capacity Act training, a ‘training the trainer’ course on dementia care and team building. The manager is available on weekdays and one of the two deputy managers is on duty at weekends to Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 22 make sure the guidance and leadership is carried on for staff at all times. Mrs Walker has established a very dedicated and enthusiastic staff team. The staff spoken with said they feel well supported in their work and encouraged in their personal development. One person said: “ Our managers are always available to give guidance and help when needed”. There is an open and inclusive atmosphere in the home. Mrs Walker is herself well supported by the providers who are available for advice and support. The managers of all six homes in the group meet on a regular basis and provide each other with peer support. There is a quality assurance system in place and questionnaires are circulated to residents, relatives and health and social care professionals so that all views can be assessed as part of the development of the service. Residents meetings are held regularly and minutes taken. There is an annual internal audit of the service and the providers carry out Regulation 26 visits monthly and provide a written report of their findings. The home does not get involved in supporting people with their finances; family members or solicitors do this where people are unable to manage their own affairs. There are policies to ensure that staff do not get involved in any financial transactions with people who live in the home. There are health and safety policies and procedures in place. All staff have attended the mandatory training sessions so that they know how to keep themselves and other people safe. Equipment is serviced as required and fire precautions are in place. Accidents are recorded and monitored so that preventative measures are taken where possible. Milkwood House DS0000014630.V359596.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 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 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X X 3 Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Milkwood House DS0000014630.V359596.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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