Care Home: Millings The

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What the care home does well We looked at one person`s care records during our visit. These records included an assessment of need that had been completed before the person moved into the home. We also talked to the manager about new admissions and were told that people were encouraged to visit the home and spend time there, before deciding if they wanted to move in. In our surveys we asked if people had been given enough information before moving in, to help them decide if The Millings was the right place for them. Six people said `yes`, one said `no` and one said they `didn`t know`. One person commented that they did `their best to make people feel welcome and to settle in`. People we spoke to told us that they were happy with the care they received. Comments made to us by people who live at the home included `I like living at The Millings`, `they always treat me with great respect`, `carers are very pleasant`, `friendly home and nice caring staff`, `oh I`m happy here, I can say that with absolute sincerity` and `I am very happy here and have no complaints or regrets`. A relative told us `I wouldn`t want my relative anywhere else` and `they go that bit extra`. We looked at one person`s care records. These records contained appropriate risk assessments, covering care needs such as nutrition, maintaining skin integrity, preventing falls and manual handling. They also included care plans, which had been reviewed regularly. The records showed that the person had recently been in contact with their doctor, physiotherapist and social worker. We spent some time looking at the way medication is stored and administered at The Millings. Staff were monitoring the temperature of the medications fridge and clinic room, to make sure that medication was being stored within safe temperature parameters. The medication administration records and stock balances we checked tallied correctly. We checked one person`s controlled drugs and found that the controlled drugs register was correct when checked against the stock balance. In our surveys we asked people if they liked the meals that are provided at The Millings. Six people said `usually` and two people said `sometimes`. During our visit we talked to people about the food and looked at the menus. The menu`s showed us that a variety ofmeals were provided and that people were involved in choosing what is on the menus. Comments made to us by people who live at the home included `they cook tasty meals in the kitchen and a good variety`, `food is always excellent, I enjoy my meal times` and `I have a good appetite and I`ve never suffered from lack of nourishment`. A relative commented `the meals here are just unbelievable, very, very good`. `In our surveys we asked people if there were activities provided that they could take part in. Six people said `always` and two said `usually`. During our visit we saw that there were jigsaws around that people could do. One person described the activities coordinator as `very good too`. Comments made to us included `activities every day are very good, including outings`, `we play scrabble and whist and bridge, there`s something going on every afternoon` and `perhaps set up some occupation for weekends (when activities are not good)`. In our surveys we asked people if they knew how to make a complaint. Five people said `yes` and three said `no`. When we asked if there was someone people could talk to informally if they were unhappy, seven people said `yes` and one said `no`. During our visit we saw that information about raising concerns was clearly displayed on the home`s notice boards. We also looked at the home`s complaints book. This showed that any concerns that were raised had been appropriately looked into and resolved. There have been no formal complaints made directly to CQC about the home recently. We looked around the home and saw that it was very comfortably furnished. The rooms were clean and tidy and the decor and furnishing were well maintained. People`s bedrooms were individual and comfortable. Comments made to us about the home included `the rooms are fresh and clean`, `the rooms are well furnished and comfortable`, `they`ve got very good cleaners` and `lovely grounds`. The manager told us about some of the improvements that are planned for the near future. These included a new garden gazebo, installation of new showers and a new call alarm system that would enable better use of assistive technology. We checked to make sure that the home`s lifting and fire fighting equipment had been serviced recently and found that up to date maintenance certificates were available. Staff were positive about the training and support they are given. All five staff who returned surveys told us that they are given training that keeps them up to date, helps them understand people`s needs and is relevant to their work. Comments about training included `staff training is conducted on a regular basis, staff are trained to a very high standard`, `we have refresher courses` and `all the training and courses we ask for`. The home`s self assessment told us that twenty-three out of the home`s twenty-eight permanent care staff have achieved a national vocational qualification in care. People we spoke to were all happy with the way The Millings is managed and organised. Comments made to us about the home`s management included `all the staff are supported by a management team I consider to be one of the best`, `always listens to people`s opinions and act on them`, `any staff suggestions they are willing to discuss` and `it is the best`. The home manager organises regular meetings for the staff, people who live at the home and their relatives. We saw records of some of these meetings during our visit. Senior management also carry out regular visits and quality checks, with reports on the findings of various quality audits being completed every month. What the care home could do better: The temperature records in the medication storage room showed that room temperatures were starting to creep up towards the maximum safe storage temperature for most medications. The home should monitor this regularly and if necessary take appropriate action to reduce the room temperature. We looked at the recruitment records of the home`s newest member of staff. These showed that the correct pre-employment checks hadn`t been completed before they started work. Because of this we checked some other recruitment records and found that other staff had been recruited safely, with all of the required checks and information being obtained before they started work. We discussed this with the manager and found that a misinterpretation of the current guidance on the transportability of criminal records bureau disclosures that are less than three months old had led to an isolated error. The manager is now aware of this and has assured us that it will not happen again. The home`s standard reference request forms didn`t ask referees to state their relationship to the applicant or to sign and date the reference they provided. This information would make it easier to verify the references that are provided and to ensure that appropriate references have been sought. Random inspection report Care homes for older people Name: Address: Millings The 5 North End Bedale North Yorkshire DL8 1AF three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rachel Martin Date: 2 7 0 4 2 0 1 0 Information about the care home Name of care home: Address: Millings The 5 North End Bedale North Yorkshire DL8 1AF 01677423635 01677427220 themillings@residential-homes.net www.residential-homes.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Yvonne Anderson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Clifton St Annes Personal Care Services Ltd. care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 The Millings is owned and managed by Clifton St Annes Personal Care Services Ltd. It is registered to provide accommodation and personal care for up to 40 older people. The building was originally an old rectory, which has been converted and extended for its current use as a care home. Accommodation is provided on three floors, with a passenger lift provides access these floors. The home is set in pleasant private grounds and gardens, with parking spaces available for visitors. The home is situated in the market town of Bedale and is close to the main street, with its shops and local Care Homes for Older People Page 2 of 9 Brief description of the care home amenities. Up to date information about the homes current fees, terms and conditions should be sought from the manager. Care Homes for Older People Page 3 of 9 What we found: This was an unannounced inspection of The Millings. The visit was completed on 27th April 2010 by one inspector. The homes staff and the people living there did not know that we were going to visit on this day. During our visit we looked at a selection of records, looked round some parts of the building and talked to some of the people who live at the home and the staff who work there. Before our visit we looked at all of the information we had about the service and asked the home to complete an annual quality assurance assessment. This is a self-assessment that tells us about the home. We also sent out surveys to people who live and work at the home. Eight people who live at the home and five staff completed and returned surveys to us. We used all of this information to plan our inspection visit and have included it in this report where appropriate. What the care home does well: We looked at one persons care records during our visit. These records included an assessment of need that had been completed before the person moved into the home. We also talked to the manager about new admissions and were told that people were encouraged to visit the home and spend time there, before deciding if they wanted to move in. In our surveys we asked if people had been given enough information before moving in, to help them decide if The Millings was the right place for them. Six people said yes, one said no and one said they didnt know. One person commented that they did their best to make people feel welcome and to settle in. People we spoke to told us that they were happy with the care they received. Comments made to us by people who live at the home included I like living at The Millings, they always treat me with great respect, carers are very pleasant, friendly home and nice caring staff, oh Im happy here, I can say that with absolute sincerity and I am very happy here and have no complaints or regrets. A relative told us I wouldnt want my relative anywhere else and they go that bit extra. We looked at one persons care records. These records contained appropriate risk assessments, covering care needs such as nutrition, maintaining skin integrity, preventing falls and manual handling. They also included care plans, which had been reviewed regularly. The records showed that the person had recently been in contact with their doctor, physiotherapist and social worker. We spent some time looking at the way medication is stored and administered at The Millings. Staff were monitoring the temperature of the medications fridge and clinic room, to make sure that medication was being stored within safe temperature parameters. The medication administration records and stock balances we checked tallied correctly. We checked one persons controlled drugs and found that the controlled drugs register was correct when checked against the stock balance. In our surveys we asked people if they liked the meals that are provided at The Millings. Six people said usually and two people said sometimes. During our visit we talked to people about the food and looked at the menus. The menus showed us that a variety of Care Homes for Older People Page 4 of 9 meals were provided and that people were involved in choosing what is on the menus. Comments made to us by people who live at the home included they cook tasty meals in the kitchen and a good variety, food is always excellent, I enjoy my meal times and I have a good appetite and Ive never suffered from lack of nourishment. A relative commented the meals here are just unbelievable, very, very good. In our surveys we asked people if there were activities provided that they could take part in. Six people said always and two said usually. During our visit we saw that there were jigsaws around that people could do. One person described the activities coordinator as very good too. Comments made to us included activities every day are very good, including outings, we play scrabble and whist and bridge, theres something going on every afternoon and perhaps set up some occupation for weekends (when activities are not good). In our surveys we asked people if they knew how to make a complaint. Five people said yes and three said no. When we asked if there was someone people could talk to informally if they were unhappy, seven people said yes and one said no. During our visit we saw that information about raising concerns was clearly displayed on the homes notice boards. We also looked at the homes complaints book. This showed that any concerns that were raised had been appropriately looked into and resolved. There have been no formal complaints made directly to CQC about the home recently. We looked around the home and saw that it was very comfortably furnished. The rooms were clean and tidy and the decor and furnishing were well maintained. Peoples bedrooms were individual and comfortable. Comments made to us about the home included the rooms are fresh and clean, the rooms are well furnished and comfortable, theyve got very good cleaners and lovely grounds. The manager told us about some of the improvements that are planned for the near future. These included a new garden gazebo, installation of new showers and a new call alarm system that would enable better use of assistive technology. We checked to make sure that the homes lifting and fire fighting equipment had been serviced recently and found that up to date maintenance certificates were available. Staff were positive about the training and support they are given. All five staff who returned surveys told us that they are given training that keeps them up to date, helps them understand peoples needs and is relevant to their work. Comments about training included staff training is conducted on a regular basis, staff are trained to a very high standard, we have refresher courses and all the training and courses we ask for. The homes self assessment told us that twenty-three out of the homes twenty-eight permanent care staff have achieved a national vocational qualification in care. People we spoke to were all happy with the way The Millings is managed and organised. Comments made to us about the homes management included all the staff are supported by a management team I consider to be one of the best, always listens to peoples opinions and act on them, any staff suggestions they are willing to discuss and it is the best. The home manager organises regular meetings for the staff, people who live at the home and their relatives. We saw records of some of these meetings during our visit. Senior management also carry out regular visits and quality checks, with reports on the findings of various quality audits being completed every month. What they could do better: Care Homes for Older People Page 5 of 9 The temperature records in the medication storage room showed that room temperatures were starting to creep up towards the maximum safe storage temperature for most medications. The home should monitor this regularly and if necessary take appropriate action to reduce the room temperature. We looked at the recruitment records of the homes newest member of staff. These showed that the correct pre-employment checks hadnt been completed before they started work. Because of this we checked some other recruitment records and found that other staff had been recruited safely, with all of the required checks and information being obtained before they started work. We discussed this with the manager and found that a misinterpretation of the current guidance on the transportability of criminal records bureau disclosures that are less than three months old had led to an isolated error. The manager is now aware of this and has assured us that it will not happen again. The homes standard reference request forms didnt ask referees to state their relationship to the applicant or to sign and date the reference they provided. This information would make it easier to verify the references that are provided and to ensure that appropriate references have been sought. 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 set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 All of the required 14/05/2010 information must be obtained before a new staff member starts to work in the home. One staff member had started to work before the necessary safety checks had been completed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The home should monitor the temperature of the medication storage room more regularly and if necessary take action to reduce the room temperature to safe levels. The reference request form should be reviewed so that it asks referees what their relationship to the applicant is and requires them to sign and date the reference they provide. 2 29 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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