Milford House is registered to provide accommodation, nursing or personal care for up to 80 people. On the day of the inspection there were 67 people living at the service. The registered manager informed us they consider the home to be full with 72 people and five rooms were currently closed to admissions due to building works and refurbishments.
The service provides care for people with dementia, learning disabilities, autistic spectrum disorder and older people.
Milford House consists of two floors with access to the upper floor by a lift or stairs. There are some shared bathrooms, other shower facilities and toilets. Communal areas include lounges on both floors, other smaller seating areas, two dining rooms and gardens to the outside.
A registered manager was employed by 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 2008 and associated Regulations about how the service is run.
The inspection took place on 19th and 20th July 2016 and was unannounced.
Most people and their relatives told us they felt safe when receiving care. Staff were able to tell us about people’s needs and how to care for them however, it was difficult to locate staff when people sought and required assistance. Safe recruitment practices were followed before new staff members started working at the home. People and their relatives were positive about the care they received and said staff had sufficient knowledge to provide support and keep them safe.
Administration and medicines management systems required improvement in order to fully protect people. For example, some medicines were not stored in line with storage requirements and medicines were left unattended during medicines rounds which meant they were not being managed in line with current regulations.
People’s risk assessments had been made and recorded in people’s care records however; guidance provided in people’s care plans in line with the risk was not always available.
Arrangements were in place for keeping the home clean and help reduce the risk and spread of infection. People’s rooms and sanitary ware in bath and shower rooms was kept clean however, some areas of the home had not been cleaned and required attention.
Staff received regular training in relation to their role and the people they supported. Staff received regular supervisions and an appraisal where they could discuss personal development plans. This meant staff received the appropriate support to enable them to provide care to people who used the service.
People were not always supported to have enough to eat and drink. Food and fluid charts were not always used where required or completed in order to determine whether people had received sufficient diet and fluids. Support was not always given where people required support with their meals or to drink. The weather was very hot during the two days of our inspection and not all people were offered additional fluids in response to this to help keep them hydrated.
People and their relatives told us they had access to health services and there was a GP performed weekly visits to the home with additional visits according to any changing healthcare requirements.
Most people were treated in a kind and caring way and staff were friendly, polite and respectful when providing care and support to people however, this was not consistent throughout the inspection.
The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). The registered manager and staff had a good understanding of supporting people to make decisions and choices.
Staff understood the needs of the people they were providing care for. Care plans were individualised and contained information on people’s preferred routines, likes, dislikes and medical histories.
Quality assurance systems were in place but trends were not always identified. However, when trends had been identified, they had not always been investigated effectively.
People, their relatives and staff were encouraged to share their views on the quality of the service they received.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can see what action we told the provider to take at the back of the full version of this report.