• Care Home
  • Care home

Milton Ernest Hall Care Home

Milton Ernest, Bedford, Bedfordshire, MK44 1RJ (01234) 825305

Provided and run by:
Ross Healthcare Limited

Report from 5 December 2023 assessment

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Updated 9 January 2024

Effective systems, processes and practices were in place to make sure people are protected from abuse and neglect. Risks were assessed, and mitigating actions put in place. There were appropriate staffing levels and skill mix to make sure people receive consistently safe, good quality care that meets their needs.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Learning culture

Score: 3

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safe systems, pathways and transitions

Score: 3

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.


Score: 3

People confirmed they felt safe and were supported to understand and manage any risks. One person told us they were, “Feeling very safe and welcomed by staff.” Staff were familiar with people and their needs. They were observed checking people were comfortable and supporting them safely, in line with guidance from their care plans.

Staff had training on how to recognise and report abuse and they knew how to apply it. They told us they felt confident to speak up if they had any concerns.

People were safeguarded from harm and abuse. The provider had systems in place to report, record and review any concerns raised. The provider was working in line with The Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding (DoLS).

Involving people to manage risks

Score: 3

People told us knowing staff were nearby made them feel safe. A professional added, “This is a well-managed place; residents are well looked after and the whole team is working well…staff are following our routine and listening to our recommendations.”

Where required people had specialist equipment in place. Staff spoke confidently about the use of equipment such as sensor mats; to minimise the risk from falls. They had received training and annual refreshers on how to operate equipment required to meet people’s assessed needs.

The provider assessed risks to ensure people were safe and took action to mitigate any identified risks. Staff liaised with relevant external professionals to ensure changes in people’s needs, such as health or behavioural, were reviewed and supported appropriately.

Staff were observed using equipment safely. There was no evidence of restrictive practices in place. Staff understood how to support people who communicated a need through expressing their feelings or an emotional reaction. We observed occasions when staff successfully and calmly refocused someone’s attention on other activities, in line with their risk management support plans.

Safe environments

Score: 3

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safe and effective staffing

Score: 3

Staff were encouraged to complete training relevant to their roles, including vocational training and training to meet people’s specific needs. Staff told us they felt able to ask for more if needed. For example, one staff member had been appointed as a dementia coordinator and was in the process of completing a dementia ‘train the trainer’ course. This would enable them to become a subject matter expert and in turn share their knowledge with other staff. Staff commented on the support they received from the provider and management team. Records we saw showed the wellbeing of staff was important to the provider. Staff felt confident to raise issues and concerns and felt they would be listened to, with action taken where needed. One staff said, “[Name of acting manager] is very supportive and 100% approachable. Her door is always open. She makes me feel valued and encourages me to succeed.”

All staff observed appeared to be happy in their roles and worked cohesively together as one team. Staff had enough time to spend individual time with people as well as meeting their essential needs.

One person told us, “I have an alarm around my neck and on a cord, staff come pretty quickly when I buzz…I think they are all pretty much perfect from my point.” People unanimously praised the care and support provided by staff. They also commented on the low turnover of staff and low use of agency staff. A relative told us, “The acting manager is brilliant…there is hardly any agency staff because she plugs in if she can.”

The manager used a dependency tool, reviewed monthly, to ensure adequate numbers of qualified, skilled and experienced staff were employed to meet people’s needs safely and appropriately. The provider carried out checks on new staff to make sure they were safe to work at the service. Required checks were in place for the staff records we looked at including a DBS check. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Infection prevention and control

Score: 3

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Medicines optimisation

Score: 3

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.