This unannounced inspection took place on 4 August 2016.Milton Grange provides residential care for up to 16 older people. There were 15 people living in the home at the time of our visit, some of whom were living with dementia.
The manager and owner had run the home for 27 years. They took a hands on approach and had built up positive relationships with people and staff. People had confidence in staff and told us that staff were caring and friendly. There was a relaxed atmosphere in the home and staff worked well as a team. People were supported by staff who took the time with people that they needed. We saw staff being kind and patient with people and offering reassurance when they needed it.
The manager had created an open transparent environment with information clearly on display and easily accessible. The manager was highly visible around the home and was able to present information to us with ease.
People told us they felt safe living in the home. Staff were aware of what constitutes abuse and the actions they would take if they suspected if someone was being abused. Staff were able to explain how to escalate any concerns about poor practice.
People were supported by enough staff who had been recruited safely. Relevant checks were undertaken before people started work. For example references were obtained and checks were made with the Disclosure and Baring Service to ensure that staff were safe to work with vulnerable adults. The manager told us the staff team were consistent and there was no use of agency. This meant people were supported by staff who knew them well.
Staff were proud of the home achieving accreditation with Gold Standards Framework at beacon status. This is a nationally recognised framework for ensuring people receive a high quality standard of end of life care. The manager told us they felt passionately about the award and they had celebrated by hosting a party for people, family and staff. There were several examples of how the home had achieved this ward such as the use of a coding system, advanced care planning. They also celebrated the memory of people who had passed away and there were photographs on display.
People had opportunity to be involved in activities that interested them. There was a lively atmosphere within the home and people told us they could do as much or as little as they liked.
Peoples risk were assessed and plans developed to ensure that they received care which minimised the risks of them coming to harm. For example people at risks of falls had a falls risk assessment which included input from a healthcare professional if necessary and recommendations how to support the person safely. Accidents and incidents were monitored by the manager so that trends or patterns could be identified and actions taken to prevent a re-occurrence.
Medicines were managed safely. Medicine Administration Records (MAR) were signed to indicate that people had received the correct medicine. Medicines were kept securely and staff who were responsible for administering medicine had undergone training and were aware of actions to take if an error occurred.
There were quality monitoring systems in place which included regular checks of care plans. Any improvements needed were highlighted and there was a process for ensuring actions were recorded and checks made to ensure they were completed. Other checks included infection control, mattresses and environmental health and safety checks.
People had access to healthcare when they needed it; peoples care records demonstrated contact with a variety of healthcare professionals. One person told us that staff recognised if they were unwell and arranged for them to see their GP. They told us “I am well looked after.”
People had personalised care plans which were took account of their likes, dislike and preferences. They were kept up to date and reviewed when needed and staff were knowledgeable about peoples care needs.