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Milton Grange Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 April 2020

About the service

Milton Grange is a residential care home providing short term rehabilitation, including personal care to up to 37 older people. At the time of the inspection there were 34 people using the service. The service is split into two areas, one provides support for people living with dementia or other mental health issues, there were nine people in this area during our inspection. The remaining 25 people received support in the generic unit. In the past 12 months approximately 450 people had used the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Documentation in care plans relating to care plans were poor. NICE guidelines had not been followed and little information was included about intervention and treatment. In addition, although a pain chart was included which identified increased pain being experienced, no ongoing monitoring was shown. You can see what action we have asked the provider to take at the end of this full report.

The service had not correctly recorded complaints. Several incidents that by definition fell under the service complaints definition had been included in a minor incident folder. Some investigation had taken place but no analysis of trends was possible due to incorrect recording. Several people we spoke with did not know the process of making a complaint. The complaints policy had written on the front, ‘next review 2015.’ We have made a recommendation about the management of complaints.

Some care plans lacked detail. Some areas of personal details were missing, consent forms had not consistently been completed and use of the MUST tool was inconsistent. One plan lacked detail about the reasons for a fall that had resulted in the person being at the service and therefore no specific detail was available to focus the reablement plan on. Another plan failed to highlight a unique characteristic of a person which directly impacted on their support. The registered manager lacked oversight on these issues with no effective auditing process in place for care plans.

Staff had received training in safeguarding and were able to describe to us what action they would take. People told us that they felt safe. Accidents and incidents had been recorded and lessons learned taken forward. Risk assessments bespoke to people had been completed and medicines were stored and administered safely. Fire and other safety checks had been completed. Staff had been recruited safely with all required checks having been completed.

Staff training was up to date and a training plan showed us how training was managed and refresher training organised. Staff training was relevant to people’s needs. Induction for new staff was thorough and ongoing supervision and appraisals ensured staff were supported. The service provided rehabilitation for people preparing them to return home safely and this was supported by access to health and social care professionals. 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.

Staff were kind to people and people were treated with dignity and respect. Staff had a good understanding of people and their day to day needs, likes and dislikes. People’s privacy was respected and they could choose whether to spend time in their bedrooms or to socialise with others. Independence was a key element of the service and people were encouraged and supported in all areas in preparation for their return home.

A range of activities were readily available for people and these could be enjoyed in groups or one to one with staff in their own rooms. People’s communication n

Inspection areas

Safe

Requires improvement

Updated 1 April 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 1 April 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 1 April 2020

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 1 April 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 1 April 2020

The service was not always well-led.

Details are in our well-Led findings below.