Milner House

Updated 23 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Milner House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Milner House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and four relatives about their experience of the care provided. We observed the interactions between people and staff. We spoke with 13 members of staff including the registered manager, the clinical lead nurse, provider’s senior managers supporting the home, care staff, chef, the housekeeper and customer relations manager. We received feedback from two social care professionals working in partnership with the home.

We reviewed a range of records. This included multiple people's medicines records and care documentation for five people. We looked at two staff files in relation to recruitment and staff supervision and agency staff checks and induction records. A variety of records relating to the management of the service, including quality monitoring records, risk management records, staff training and meeting records as well as policies and procedures were also reviewed.

Updated 23 June 2022

About the service

Milner House is a nursing home providing accommodation, nursing and personal care to up to 46 people. The service provides support to older people with physical and health related care needs, most of who also live with dementia. At the time of our inspection there were 36 people using the service.

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

People, their relatives and staff told us the overall atmosphere in the home as well as the quality of care provided had improved since our last inspection. People felt safe in the home, received support to keep well and manage their individual risks and were supported with their medicines by safe and competent staff.

People received personalised care which considered their preferences, wishes and rights and created opportunities for meaningful engagement. People’s home environment was meeting their needs, although we discussed with the provider it could be more friendly for people who lived with dementia. We made a recommendation around dementia friendly environment which we will follow up on our next inspection. The provider addressed our feedback straight away.

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 treated people with kindness and respect.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence;

People’s care was tailored to their individual needs and abilities and their wishes were included in the planning of their future care and what they wanted their support to achieve. At the time of the inspection a learning disability was not anyone’s primary care need.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights;

People’s rights and wishes as well as their individual needs were clearly assessed so staff provided them with individualised support. People were treated with dignity, respect and kindness.

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The management of the service ensured people’s care was regularly reviewed and people received ongoing support from staff, as well as external health and social care professionals to meet their changing needs. People were involved in their care and listened to.

The registered manager knew the home well and there were clear systems in place for monitoring quality and safety of the care provided which they used effectively. Staff felt supported and involved. The management took action to improve people’s care, to resolve complaints and to complete actions identified from the provider’s quality and safety audits.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 October 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.