We carried out a review of the data available to us about New Milton House Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about New Milton House Residential Care Home, you can give feedback on this service.
New Milton House is a residential care home providing personal care to up to 39 people. The service provides support to older people and those living with dementia. At the time of our inspection there were 36 people using the service. It accommodates 39 people in one purpose built building.
People’s experience of using this service and what we found
People received safe care. People and relatives told us that New Milton House created a safe environment with staff demonstrating kindness and respect. Medication was safely managed, and those risks people faced in their daily lives were acknowledged and reviewed regularly.
The environment was clean, hygienic and well maintained. Medication systems were safe and staff responsible for administering medication had been trained to do so and had had their competency assessed.
Staff were trained in their role and received supervision to ensure good care practice was being provided. People’s nutritional needs were met, with particular attention paid to those who faced risks of malnutrition. The environment enabled people to mobilise freely both inside and outside and provided signage aiding people’s orientation.
People were supported in a caring and dignified manner with particular attention paid to respecting their wishes and preferences.
Work had been done to ensure information was presented to people in a person-centred way. Peoples’ support was reinforced by personalised care plans. Where people had reached the end of their lives; attention was paid to ensure that people experienced a dignified death and that relatives were supported.
Managerial oversight was effective with all stakeholders being involved in expressing their views about the overall quality of the service being provided. Effective quality monitoring systems were in place and when action was needed; steps were taken in a timely manner.
Staff, people and relatives were complimentary about the management team. They were approachable, supportive and informative and had created a culture of effective teamwork which people using the service benefitted from.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 28 March 2019).
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Milton House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
New Milton House is a residential care home that is registered to provide personal care for up to 39 people. Accommodation is provided over two floors. There are numerous lounges and dining rooms for people to use within the building. People also have access to secure outdoor space. At the time of our inspection there were 32 people living in the home.
People’s experience of using this service and what we found
People living at New Milton House told us they felt safe. Safeguarding systems, policies and procedures ensured people were safe and protected from abuse. Risks to people’s health, safety and welfare, were identified and managed safely with the involvement of the person or their representatives.
There were sufficient numbers of suitably trained and experienced staff on duty and safe recruitment procedures were followed.
Medicines were safely managed, and systems were in place for reporting accidents and incidents and learning from them.
We were assured by the additional measures in place to help prevent the spread of COVID-19. Risks relating to infection prevention and control (IPC), including in relation to COVID-19 pandemic were assessed and managed. Staff followed good infection, prevention and control (IPC) practices.
People’s care, treatment and support achieved good outcomes and promoted a good quality of life. Staff were seen to be consistently caring. Staff treated people with dignity, kindness and respect and, promoted people’s choice. They sought people’s consent, promoted independence and offered emotional support when needed.
People and their visiting relatives were unanimous in their praise for the staff and the quality of care provided. Their comments included: “staff have been marvellous, oh yes I feel safe, enough staff yes, only have to ring the bell and they are here” and “it is fantastic here”.
The registered manager and senior staff team were clear about their roles and responsibilities and they promoted a positive, person-centred culture. Staff worked well together as a team, and there was good partnership working with others to meet people's needs. Staff morale was good, and staff felt well supported.
Effective systems were in place for checking on the quality and safety of the service and making improvements where needed.
Rating at last inspection and update
The last rating for this service was requires improvement (published 28 March 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
A decision was made for us to inspect, examine and follow up what improvements had been made since the last inspection in March 2019. Due to the COVID-19 pandemic, we undertook a focused inspection to only review the key questions of Safe, Caring and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The ratings from the previous comprehensive inspection for the Effective, and Responsive key questions were not looked at on this occasion. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.
Although we found improvements in all key questions we looked at the overall rating for the service has not changed and remains requires improvement.
Follow up
We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People’s experience of using this service:
There were three breaches at our last inspection and the registered manager was asked to submit an action plan on how they would address these shortfalls. We received this and we saw improvements at this inspection. However, there were still areas for continued improvement and we found two breaches at this inspection in relation to staffing and dignity and respect.
People and their relatives were positive about the home, its staff and the manager. They raised issues about staffing numbers, activities and the environment. People told us that staff were kind and friendly and knew them well.
People and their relatives felt that they received safe care. They received their medication at times they needed this and by staff who were trained to administer this safely. There was scope for improvement in the management of topical creams.
There were insufficient experienced, knowledgeable staff to meet the needs of the people living in the service. We noted times when people had to wait for assistance and staff lacked awareness of how to support people who were living with dementia.
Recruitment was managed safely. The necessary checks were completed prior to staff starting work, however there were no checks on staff’s health and whether they needed any reasonable adjustments to complete their job.
Staff received inductions when they started work and received ongoing training and support and supervision to maintain and develop their skills and knowledge. However, this was not always effective as staff told us this was all on line and staff did not receive training on how to support people living with dementia even though there were two specific dementia units.
We noted that people were not always treated with dignity and their privacy was not respected as staff were often discussing people’s personal issues in communal areas.
The home was clean, however there was scope for improvement as the home would benefit from adaptions for people living with dementia. Regular checks were completed on equipment to ensure safety and staff had access to personal protective equipment to reduce risks of infection control.
People had access to activities, however these were not varied and were limited for people living with dementia.
We received positive comments about the registered manager. However we saw the systems in place to make improvements to the service had not identified all the issues we found in this inspection. Improvements which had been identified had been actioned.
The registered provider was acting within the principles of the Mental Capacity Act 2005. Where necessary, people’s capacity was assessed, and decisions were taken and recorded in people’s best interests looking at the least restrictive options.
People’s health needs were effectively assessed and monitored. Where people needed access to other health professionals, referrals were completed, and advice recorded.
People knew how to complain and were confident that that their concerns would be listened to and acted upon.
More information is in the full report below.
Rating at last inspection: Requires improvement (Report published 13 June 2018).
Why we inspected: This inspection was brought forward due to concerns that had been raised with us.
Enforcement: This is the second time the service has been rated requires improvement. We have asked the provider to send an action plan of how they will address the breaches in regulation and improve the service to at least good. Full details are at the back of this report.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
New Milton House Residential Care 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. New Milton House Residential Care Home is registered to provide care to 39 people. At the time of this inspection the home was providing care to 35 people. The building was split in to two units, one was specifically for people with dementia and the other was a residential unit.
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. The manager was going through the process of registration with the Care Quality Commission.
People we spoke with told us they felt safe at the home and people’s relatives also told us they felt people were safe. During our visit, however we identified concerns with the service.
During our inspection, we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulated Activities 2014 in respect of Regulation 9 person centred care; 11 need for consent and 12 safe care and treatment; of the Health and Social Care Act 2014 Regulations.
You can see what action we told the provider to take at the back of the full version of the report.
People received support with their health care. However care plans had not been updated accurately and contained guidance that if followed would pose a risk to people's health and safety. Care plans did not always reflect people’s up to date needs and were in some cases contradictory.
Medication management including storage, documentation, administration, and protocols for medications prescribed to be taken ‘as and when’ was not safe or sufficient.
We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had not always been followed and any conditions on authorisations to deprive a person of their liberty were not being met.
Audits were regularly carried out by the provider and the manager, however it was not always clear on the action plans whose responsibility it was to carry out any actions identified.
Staff were recruited safely, however evidence that staff received a proper induction was not in place. We saw that staff had received suitable training that the provider identified as mandatory to do their job role effectively. All staff had been supervised in their role and staffing levels were consistent and were adapted to meet people’s needs.
The staff at the home knew the people they were supporting and the care they needed. We observed staff to be kind and respectful towards people. The home provided a range of activities to occupy and interest people.
People and relatives we spoke with said they would know how to make a complaint, none of the people or their relatives we spoke with had any complaints. Care plans showed that people's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary.