27 November 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.
This inspection took place on 10 November 2020 and was announced.
27 November 2020
Milford House 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. Milford House accommodates up to 80 people in one adapted building. At the time of our inspection 57 people were living at the home.
The home was last inspected in July 2016 and we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was not meeting the requirements of the regulations relating to staffing, medicines management and support for people to eat and drink. At this inspection we found the registered manager had taken action necessary following the last inspection and was meeting the requirements of the regulations.
This inspection took place on 7 November 2017 and was unannounced. We returned on 9 and 13 November 2017 to complete the inspection.
There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.
People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I’m quite happy. They are all kind”; “I am well treated by staff. They treat us with compassion and kindness” and “The staff are very good to me. They’re lovely”. A relative told us, “I am very happy with the care provided. We have a good laugh with the staff.” We observed staff interacting with people in a friendly and respectful way. Staff respected people’s choices and privacy and responded to requests for assistance.
People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. Medicines were stored safely in the home and staff had received suitable training in medicines management and administration. People received the support they needed to take their medicines.
There were sufficient staff available to provide safe care. People told us staffing levels had improved since the last inspection and most people said staff responded promptly when they called them. Nurses and care staff said they were able to provide safe care for people. A relative told us “Sometimes they are busy but there has been a definite improvement since about a year ago. Being short staffed is occasional now rather than regular like it was before. There has not been a time when [my relative] has not received the care they should”.
Staff understood the needs of the people they were providing care for and had the knowledge and skills to meet their needs. Health and social care professionals who had contact with the service were positive about the care people received and skills of staff. Comments included, “I have been very impressed with the standard of care, clinical competence and engagement of the staff. They exercise very effective and safe clinical judgement” and “Staff have had a couple of very complex wounds to deal with during the past year and have managed things very well. One resident had a fantastic outcome with healing of a chronic wound by the dedication and determination of the staff at the home.”
Staff received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.
The service was responsive to people’s needs and wishes. People had regular meetings to provide feedback about their care and there was an effective complaints procedure. People enjoyed the group social activities that were arranged. The registered manager had identified that work was required to improve the opportunities for people who were not able to, or didn't want to participate in group activities. Plans were in place to make these changes.
The provider regularly assessed and monitored the quality of care provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service. The registered manager had a good understanding of improvements that were needed in the service and had plans in place to implement them. Staff and visiting professionals were confident in the skills of the registered manager and their ability to continue to make improvements to the service.