Care Home: Millfield Nursing And Residential Home

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What the care home does well Millfield is a purpose built care home with good quality facilities. All of the bedrooms have en suite facilities (toilet and hand basin) and the building is spacious, well decorated and offers people the opportunity to spend time together or to spend time apart. There is a well appointed courtyard in the centre of the building, where people can sit out and enjoy the sun. There are good staffing levels, and the staff are given training to be able to do their jobs. In recent months there have been a number of improvements, and issues highlighted at the last key inspection have been addressed. What has improved since the last inspection? What the care home could do better: No statutory requirements have been made as a result of this inspection visit. However five good practice recommendations have been made, these relate to: reviewing the quality of the food on offer, dating questionnaires which form part of the quality assurance system, sending out quality assurance questionnaires on a regular basis, holding regular monthly meetings for the people who live at Millfield and ensuring that all members of staff receive six formal supervision sessions a year. Key inspection report CARE HOMES FOR OLDER PEOPLE Millfield Nursing And Residential Home Cedar Park Drive Bolsover Chesterfield Derbyshire S44 6XP Lead Inspector Rob Cooper Key Unannounced Inspection 10:00 20th April 2009 DS0000002065.V375034.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millfield Nursing And Residential Home Address Cedar Park Drive Bolsover Chesterfield Derbyshire S44 6XP 01246 825959 01246 825923 millfield@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Management Limited 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) Manager post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th May 2008 Brief Description of the Service: Millfield is a purpose built care home set within a residential area in the market town of Bolsover, which lies approximately seven miles east of Chesterfield town centre. The home provides nursing and personal care for up to forty older persons. Accommodation is provided over two floors, with all bedrooms having single room occupancy each with an en suite facility. There is disabled access throughout with a variety of environmental aids, adaptations and equipment to assist those who may have physical and/or sight disabilities, including a shaft lift and a nurse call system throughout. There is a choice of lounge and dining areas located on each floor, including a small smoking lounge and there is level access to an enclosed outdoor courtyard area with seating provided. A separate hair dressing room is also provided. People are provided with care and support from a team of nursing, care and hotel services staff, including an activities co-ordinator who organised a variety of activities for people both in and outside the home. The registered manager has worked at the home for a number of years, being well established and provided with support via external management arrangements. A copy of the most recent inspection report is available in the home’s ‘Welcome Pack’, a supply of which are openly available in the main reception area. The range of weekly fees charged by the home are as follows: Privately funded £552.00 to £700.00 Local authority funded - £353.92 for personal care only (mid band) to £487.24 for nursing care (high band). Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of the key inspection process, so that no one at Millfield knew that the inspection visit was going to take place. The visit took approximately five hours through the middle of the day, with one inspector present. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and reviewing any notifications made relating to incidents that affect the well being of people living at Millfield. The methods used during this key inspection and visit were to visit the home, where a method called case tracking was used; this involved identifying four people who live at the care home and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was followed by a partial tour, looking at the activities on offer, and talking to three people who live at Millfield, and three members of staff about the quality of the service, and their experiences of living and working at Millfield. In addition we also used a Short Observational Framework for Inspection (known as a SOFI). This involved observing a small number of people for a 90 minute period and making note of the activity and interaction between people living at the home, staff and visitors, and recording the observations made in a structured way. We also sent out an Annual Quality Assurance Assessment (known as an AQAA), which allowed Millfield to carry out a self assessment; and provide a range of information relating to their service. Information provided by the home helped to form the judgements in this report. We also sent out five surveys asking for views and information to people who live at the home and five to staff. Of these we received all ten surveys back, which also helped with the judgements that we made. Millfield does not currently have a registered manager, however Donna Smith who has been Millfield’s registered manager in the past has returned, and her application to become the new registered manager is being processed. Donna provided much of the information during this key inspection visit. On the day of this inspection there were thirty-nine people living at Millfield. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 6 People who might want to live at Millfield can obtain information about the home direct from them, and this would include seeing previous inspection reports prepared by the Commission for Social Care Inspection. In addition information about Millfield and the services it provides can be found at the following web site: www.ashbournesl.co.uk. What the service does well: Millfield is a purpose built care home with good quality facilities. All of the bedrooms have en suite facilities (toilet and hand basin) and the building is spacious, well decorated and offers people the opportunity to spend time together or to spend time apart. There is a well appointed courtyard in the centre of the building, where people can sit out and enjoy the sun. There are good staffing levels, and the staff are given training to be able to do their jobs. In recent months there have been a number of improvements, and issues highlighted at the last key inspection have been addressed. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12&3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to detailed information about the services on offer, and have contracts or a service agreement. People living at the home also have a comprehensive assessment, which allows them to make an informed decision about whether the home can meet their needs. EVIDENCE: Both the statement of purpose and service user guide for Millfield, were seen during the inspection visit. These documents contained a great deal of useful information about the care home, and were available in both an audio tape and large print format, although the audio tapes would need to be obtained from head office in Redditch. The information available would allow people living at Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 9 the care home, and those who might wish to in the future, to make an informed choice about living at Millfield. Discussions with three people who live at Millfield showed that they had been given copies of the service user guide, and copies were seen in the people’s bedrooms. The foyer of the home also has copies of the last inspection report on display. In addition anyone who is interested can visit Southern Cross’s web site at: www.ashbournesl.co.uk., which also gives details of the services on offer, and has a link to Millfield’s latest inspection report. As part of the case tracking process four people who live at the care home were identified, and their files were seen, each one contained an agreement from Social Services to fund their placement, and a copy of the terms and conditions of residence. In addition the files of three people who are privately funded were seen, and each person’s file contained a contract which identified the fees, and the terms. Each of the four files that were seen contained a formal assessment of need. Some of the assessments had been completed in-house, and were based on the ‘Activities of Daily Living’ which is an established assessment tool. There were also assessments completed by other professionals, such as a Shared Nottinghamshire Assessment Process (known as a SNAP) which is Nottinghamshire’s multi-agency assessment tool for older people, and also a Standard Community Care Assessment. The evidence showed that the information provided by these assessments had been used to draw up the care plans. In their AQAA the home said: “We always receive a Care Management assessment and copy of a social services care plan before an individual is admitted to the home, but we also do our own assessment. We complete comprehensive care plans for each individual coming into the home, and these are based on Roper, Logan and Tierney’s activities of daily living, long term goals and information given from the Care Management Assessment. Named Nurses/Carers are responsible for helping complete the care plan and evaluating it monthly. Any new or prospective residents are given the opportunity to have trial visits to the home before moving in permanently, this gives them the opportunity to decide if this is the right place for them.” Millfield does not offer Intermediate care, and therefore this National Minimum Standard was not assessed. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 & 11 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care given in a professional and caring manner by the staff, which means that individuals are having their care needs met. EVIDENCE: Each of the four files that were seen contained a plan of care, which identified personal goals and identified people’s needs and how to meet them. The care plans had been devised around the ‘Activities of Daily Living’ model, and the evidence showed that the care plans had been produced from the assessment tools in the files. Evidence was seen that care plans were being reviewed regularly, and there were daily entries by care staff, to record progress and any issues relating to individual’s care. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 11 All of the files that were seen contained health care plans. The plans included information relating to health care professionals such as visits to the doctor, or by the nurse, and any hospital visits. Three people were asked about seeing the doctor, and they all said that the staff would get them a doctor if they were unwell, and if they needed one, one person said: “The doctor comes to see me here, and the nurse too, I don’t have to go to the surgery, they come here.” Boots the chemist provides Millfield with their medication. A number of issues identified at the last key inspection related to medication have been addressed, and this has improved the safety of the medication systems. Administration records were seen and found to be complete. Two people living at Millfield currently self-medicate, and copies of care plans, risk assessments and an agreement by the individuals to self- medicate were seen. One of the people who self-medicates was spoken with, and she said that: “she feels safe, and the staff are very good at supporting me with my tablets.” All aspects of the medication procedures that were seen showed a clear audit trail for medication, and indicated that people living at the care home were safe. The Short Observational Framework for Inspection (SOFI) was used for a 90 minute period over lunch time, in the main downstairs dining room. This showed that staff were sitting alongside people to assist them with eating, making eye contact and engaging in conversation around the dinner table, which included one lady who had just been to the hair dressers, and her thoughts on her ’new hairdo’. Staff were also observed helping people make choices with regard to food, sauces, drinks and the choice of cutlery. At one point there was a lady sitting at a table on her own, and she was asked if she wanted to join the three other people who were sat at a different table. At one point the staff left the dining room, to assist a person in another room, and to collect another person from the hair dressers. While the staff were gone, there was a good conversation between people sat at the table, and there was a very relaxed and comfortable atmosphere within the dining room. This was a positive experience for the people having lunch, and at one point two people asked for assistance, which the staff gave in a quiet, friendly manner. Each person’s file had a specific end of life care plan, covering the individual’s wishes at the end of their life. Individual’s choices are recorded, together with details about contacting the next of kin. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a lifestyle that reflects their cultural, social and religious interests, and needs, and their social care needs are being met. EVIDENCE: Discussions with three people who live at the home identified that there were plenty of activities arranged, usually by the activity co-ordinator, these activities varied from activities in the home such as bingo and table topped activities (games and puzzles), and also outside entertainers who come in occasionally. In their AQAA they said: “We promote the individuals preferences on daily living and activities. It is documented in their individual care plans about which activities and social contacts they wish to join in with. The weekly plan of activities is on display on the board in reception. We have two activity co-ordinators, both with skills in different areas making for a very high quality of activities. All the residents are given the opportunity to put forward ideas for activities/outings they wish to go on. The activities coMillfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 13 ordinator’s have personally spoken to each resident and has details of all activities they are interested in. All staff are involved in activity’s not just the activities co-ordinators. Samples of artwork are on display in reception.” Millfield produce a newsletter for people living at the home, relatives, staff and visitors, a copy of the Spring 2009 newsletter was seen, and this among other things gave information about activities and developments within the home. Unfortunately, it was not possible to speak to any relatives during this inspection visit, however discussions with three people who live at Millfield brought the following comments: “My family come and see me every weekend.” “My husband comes every day.” “The staff make my family very welcome.” “There are no problems, they can come when they like.” In their AQAA the home said: “We ensure the residents maintain contact with their families, friends and the local community. We have involvement with local church groups.” Throughout the inspection visit choice was seen being offered and encouraged by the staff. During the SOFI observations over lunchtime there were plenty of choice being offered, around food and drinks. The observations showed that these were meaningful choices, with the individual being given time and support to make the choices. The records in the kitchen showed that choices made by people with regard to food had been recorded. Discussions with three people who live at Millfield about choice showed that they thought they had plenty of choice, with the following comments made: “They ask us every day what we want to eat, and there is always a choice of drinks as well.” “The staff are very good, they ask us what we want to do, yes, I think we get lots of choice.” On the day of this inspection visit there were two main choices of meal on offer plus a vegetarian option if required. Information related to people’s likes and dislikes was also seen in the kitchen, and choices are recorded. The chef had left Millfield the previous week, and a replacement chef/ cook will be starting shortly. The food was well presented, and four people were spoken with about the food and included the following comments: “The food could be better prepared and cooked, and a little more plentiful.” “It’s alright, I get enough to eat, and there’s usually a choice.” “I’ve got no complaints about the food.” “Sometimes, the food isn’t to my liking, and I don’t eat it then.” Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are safe, as a result of the policies, procedures and systems that are in place, and people living at the care home and their relatives are confident that their complaints will be taken seriously and dealt with. EVIDENCE: Millfield has received thirteen complaints since the last key inspection in May 2008, with the last one having been made in November 2008. A review of the complaints showed that they had been dealt with in line with the home’s complaints procedure, which is on display in the foyer, and also forms part of the service user guide. The Commission have not received any complaints or concerns about the home since the last key inspection. Discussions with three people who live at the home indicated that they knew who to complain to, and how to complain, although none of them had ever needed to. In their AQAA Millfield said: “All complaints are recorded and responded to within 28 days. We have the complaints procedure on all the notice boards within the home, it is also included in the service user guide which all residents and relatives receive when coming into the home.” Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 15 A review of the staff training records in relation to safeguarding adults, and a review of the statistics showed that thirty-nine out of forty-two staff had undertaken this training in the last twelve months. Evidence was seen that staff who need this training are booked on the next course to be held on 15th May 2009. The training is aimed at raising staff awareness of abuse, and issues around abuse and through raising those issues, offering people greater protection against abusive practice, while also making sure that the staff understand the correct policy and procedure to follow if abusive practice is found. Three members of staff were asked about safeguarding adults training and they said they were aware of the issues, and had undertaken this training. Millfield have not had made any safeguarding adults referrals since the last key inspection. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean, well maintained and comfortable home, with their personal possessions around them, this means that people are living in ‘homely’ surroundings that meet their needs. EVIDENCE: A partial tour of Millfield showed that it was comfortable and well maintained, with good quality fixtures and fittings. The building is spacious, with plenty of storage space, and all bedrooms have en-suite facilities. There are a number of different dining areas and lounges, which allows people to have ‘space.’ For a number of years Millfield had a room which was used as a pub, however this has fallen into disuse, and is now being converted to a sweet shop, following Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 17 discussions with people who live at the home and relatives. There is an upstairs smoke room, and the upper floor is accessed via stairs or a passenger lift. Domestic staff were seen cleaning in different parts of Millfield during this inspection visit, and discussions with staff showed that there were systems in place for cleaning, and that the home had a good supply of cleaning materials, which were seen on the domestic’s cleaning trolleys. The building was found to be clean, and smelt fresh. In relation to cleaning Millfield said in their AQAA: “Any environmental issues are acted on promptly and resolved in house or passed on to our estates department. Air fresheners around the home create a welcome environment.” Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have been recruited professionally, and are competent and have been trained to do their jobs, which means that the people who live at the care home are safe, and have staff who are able to meet their needs. EVIDENCE: The staffing rota for Millfield was reviewed and this showed that there was enough staff currently employed to meet people’s needs. Two people living at the care home were asked about staffing levels, and they both said that they thought there were enough staff. In their AQAA they said: “We always ensure there are enough staff on shift to meet the needs of the residents and form the guidance of the Department of Health. We have retained staff to ensure continuity of care for the residents. The staff are of different ages and experience which shows a great balance.” The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 19 review of the staff training records showed that currently there are twentyseven care staff at Millfield, of whom twenty staff have their NVQ level II or III qualifications, and seven staff are due to start their NVQ level II courses in June 2009. In addition there are five qualified nurses working at the care home. The files of four members of staff were seen, to check that they contained all of the information that would show that staff at Millfield had been recruited in a safe manner, namely that applicants had filled out an application form, provided two written references and had had a Criminal Records Bureau check. The documentation showed that Millfield’s recruitment policy and procedure had worked to protect the people living there. Discussions with three members of staff about their recruitment showed that they had gone through all of the pre-employment checks, and had not started working until those checks had been completed. The staff training records showed that Millfield does have a training plan for its staff. The training records also showed that staff were receiving the training to help them to do their jobs, and they were receiving the mandatory training that they should in fire, moving and handling and food hygiene. Discussions with three staff members provided evidence of the training courses staff had attended, including training in fire safety, dementia and health & safety etc. The staff training matrix and statistics showed that all training courses offered by the home had achieved over 90 staff attendance. Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a safe care home with systems for ensuring its quality in place, however some of those systems need to be reviewed to ensure that people living at the home are having their needs met. EVIDENCE: Currently Millfield do not have a registered manager, although Donna Smith who is managing the home at the moment has been the registered manager in the past, and has applied to be so again. Donna is awaiting clearance from the Commission, and this should be in place shortly as she is suitably qualified and Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 21 experienced, and she has been judged by the Commission in the past to be a fit person to run a care home. Millfield’s quality assurance system relies on a number of different audits. Southern Cross require a mixture on monthly, and quarterly audits of areas such as staff training, pressure care, complaints, accidents etc. Statistics and reports relating to these audits were seen. In addition questionnaires are filled in by people who live at the home, relatives and visitors. Copies of these questionnaires were seen together with the evaluation of the results, it was noted that the questionnaires were not date, which meant it was not possible to judge how current the comments were, and also that none had been circulated for several months. Millfield hold meetings for the people who live there, although they are rather infrequent, with the last recorded meeting having taken place in January 2009. Regulation 26 visits (these are monthly audits by a representative of the owners’ management team) are taking place, with copies of reports seen; these also form part of the home’s quality assurance system. Millfield has a system in place for managing some people’s small cash needs. This system is operated for some people by the staff (dependent on choice and their ability to manage the money, or their relative’s involvement). Four people’s finances were checked at random. All of the cash tallied with the records, and the receipts were seen, which enabled a clear audit trail of the individual’s financial expenditure to be followed. Millfield has a formal staff supervision system in place, in which staff receive supervision, either with the manager or with one of the other senior members of staff. This is usually in a one to one meeting. Formal supervision offers staff support and guidance in carrying out their work, and is seen as an essential management tool in residential care. The records show that the National Minimum Standard of six sessions a year for every member of staff have not been met, although there is now a plan in place to address this. Three members of staff were asked about formal supervision, and all three said that they felt well supported at Millfield, although formal supervision has been patchy in the past. A range of health & safety records were seen, including the fire safety records, water temperature checks and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up-to-date, which shows that people are living and working in a safe environment. Millfield Nursing And Residential Home DS0000002065.V375034.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 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Millfield Nursing And Residential Home DS0000002065.V375034.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard OP15 Good Practice Recommendations In the light of one or two negative comments from people who live at the home about the food, a review of the quality, quantity and choice on offer should be undertaken. Questionnaires sent out to people living at the home, relatives, staff and visitors as part of the quality assurance system should be dated. Quality Assurance questionnaires should be sent out on a regular cycle, for example quarterly, to ensure people’s views are received. Formal monthly meetings for the people who live at Millfield should be held, and the outcome recorded so that people have their views recorded, and the opportunity to comment on the care they are receiving. All members of staff should receive six formal supervision sessions per year. DS0000002065.V375034.R01.S.doc Version 5.2 Page 24 2 3 4 OP33 OP33 OP33 5 OP36 Millfield Nursing And Residential Home Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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