• Care Home
  • Care home

Archived: Milton House Nursing and Residential Home

Overall: Good read more about inspection ratings

Marton Road, Gargrave, Skipton, North Yorkshire, BD23 3NN (01756) 748141

Provided and run by:
Mrs Carol Shutt and Mr Winston Shutt

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Background to this inspection

Updated 31 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 June and 10 July 2018 and was unannounced.

Inspection site visit activity started on 27 June 2018 and ended on 10 July 2018. It included speaking with people, reviewing documents and charts and making observations.

The inspection team consisted of one adult social care inspector.

Before commencing the inspection, we looked at any information we held about the service. This included any notifications that had been received, any complaints, whistleblowing or safeguarding information sent to CQC and the local authority. We also contacted the safeguarding and commissioning teams at North Yorkshire County Council prior to inspection, they told us they had no present concerns.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke to the registered manager, one nurse, four staff members and a visiting health professional. We also spoke to four people who lived at the service three relatives and one visitor.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked around the service and viewed a variety of documentation and records. This included four staff files, four people’s care records, nine Medication Administration Records (MAR) charts, policies and procedures and audit documentation.

Overall inspection

Good

Updated 31 August 2018

This was an unannounced inspection carried out on 27 June and 10 July 2018. During our last inspection we rated the service 'Good'.

Milton House Nursing and Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care provider, Mrs Carol Shutt and Mr Winston Shutt are registered to provide accommodation for up to 22 persons who require nursing and/or personal care in one adapted building. At the time of our inspection there were 20 people using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a range of systems and procedures in place to monitor the quality and effectiveness of the service. However, audits were not always completed on a regular basis in line with the providers own guidance. The audit systems had not identified some areas for improvement. We saw evidence of action plans being implemented to address any issues found. We made a recommendation around managerial tasks to be completed.

We saw the service was clean and had appropriate infection control processes in place.

Each person we spoke with told us they felt safe. They expressed no concerns about their safety and they were complimentary about the level of care provided. The service had appropriate safeguarding policies and procedures in place, with detailed instructions on how to report any safeguarding concerns to the local authority. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

We saw the home had adequate systems in place for the safe administration and recording of medicines.

All staff demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We checked whether the service was working within the principles of the MCA. We found that the provider had followed the requirements in DoLS authorisations and related assessments and decisions had been appropriately taken.

Staff had been recruited in a safe way. Systems and processes showed staff had their backgrounds checked before employment. We made a recommendation about the recordings of interviews.

Staff spoke positively about the training available. We saw all the staff had completed an induction programme and on-going training was provided to ensure skills and knowledge were up to date.

Staff confirmed they received supervision with their line manager, which along with the completion of team meetings, meant they were supported in their roles. Records we saw backed up what staff had told us.

Observations of meal times showed these to be a positive experience, with people being supported to eat where they chose. Nutritional assessments were in place and special dietary needs catered for.

Throughout the inspection we observed positive and appropriate interactions between the staff and people who used the service. Staff were seen to be caring and treated people with kindness, dignity and respect. Both people who used the service and their relatives were complimentary about the quality of the staff and the standard of care received.

Care files contained completed pre-admission assessments and accurate and detailed information about the people who used the service and how they wished to be cared for. Each file contained detailed care plans and risk assessments, along with a range of personalised information which helped ensure their needs were being met and care they received was person centred.

Everyone we spoke to was positive about the variety and frequency of activities available. We saw the activity schedule catered for all interests and abilities and included involvement from external agencies.