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Inspection Summary

Overall summary & rating


Updated 24 February 2018

Milward House is a residential care home registered to provide accommodation and personal care for a maximum of 28 people. The home specialises in providing care to older people, with a strong Christian faith. Some people at Milward house were living with dementia. At the time of our inspection there were 26 people living in the service. Milward House is located in Tunbridge Wells and is arranged over three floors.

Milward 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.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

People were kept safe from abuse and harm and staff knew how to report suspicions around abuse. Risks were minimised through the use of effective control measures. There were sufficient numbers of staff deployed to meet people’s needs and ensure their safety. People received their medicines when they needed them from staff who had been trained and had their competency checked. Staff understood the best practice procedures for reducing the risk of infection and audits were carried out to ensure the environment was clean and safe. The service used incidents, accidents and near misses to learn from mistakes and drive improvements.

People had effective assessments prior to a service being offered. This meant that care outcomes were planned and staff understood what support each person required. Staff were trained in key areas and had the skills and knowledge to carry out their roles. People were supported to receive enough to eat and drink; staff used food and fluid charts to record intake for people at risk of malnourishment or dehydration.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The principles of the Mental Capacity Act were being complied with and any restrictions were assessed to ensure they were lawful and the least restrictive option.

The service worked in collaboration with other professionals such as district nurses and people’s GP’s to ensure care was effectively delivered. People maintained good health and had access to health and social care professionals. Environments were risk assessed to ensure people were safe in their homes and staff could work without the risk of danger.

Staff treated people with kindness and compassion in their day to day care. Staff knew people’s needs well and people told us they valued and liked their care staff. People and their relatives were consulted around their care and support and their views were acted upon. People’s dignity and privacy was respected and upheld and staff encouraged people to be as independent as safely possible.

People received a person centred service that was supportive of their needs. People’s needs were fully assessed and care plans ensured that personal details were carried through to care delivery. There was a complaints policy and form and complaints were used to improve the service offered to people.

Staff were open to any complaints and understood that responding to people’s concerns was a part of good care. End of life care had been planned for people who wished to do so. The service had end of life care plans but these did not make it clear how people would be supported to prepare for the end of life phase.

There was an open and inclusive culture that was implemented by effective leadership from the registered manager. People and staff spoke of a

Inspection areas



Updated 24 February 2018

Milward House was safe.

People felt safe and were protected from the risk of potential harm or abuse.

Risks to people, staff and others had been assessed and recorded and control measures were effective in reducing potential harm.

There was a sufficient number of staff to ensure that people�s needs were consistently met. Safe recruitment procedures were followed in practice.

People who received support with their medicines did so safely.

The risk of infection was controlled by staff who understood good practice and used protective equipment.

Lessons were learned when things went wrong and accidents and incidents were investigated and learning fed back to staff.



Updated 24 February 2018

Milward House was effective.

People received extensive assessments that ensured effective support outcomes were set and worked towards.

Staff received effective training to meet people�s needs. An induction and training programme was in place for all staff.

People were supported to eat and drink enough to maintain good health and this was monitored where needed by staff.

Staff members worked effectively with other agencies and organisations to ensure the care people received was effective.

People were supported to remain as healthy as possible and had access to healthcare professionals.

Staff understood their responsibilities under the Mental Capacity Act and used these in their everyday practice. Staff understood the importance of gaining consent from people before they delivered any care.



Updated 24 February 2018

Milward House was caring.

People were supported by staff who were caring and respected their privacy and dignity.

People were involved in the development of their care plans and their personal preferences were recorded.

Staff had access to people�s likes and personal histories and used the information to support people in a way that upheld their dignity and protected their privacy.



Updated 24 February 2018

Milward House was responsive.

People�s needs were assessed, recorded and reviewed.

People received personalised care and were included in decisions about their care and support.

A complaints policy and procedure was in place and available to people.

Where people received end of life care this was planned and provided sensitively.



Updated 24 February 2018

Milward House was well led.

There was an open culture where staff were kept informed and able to suggest ideas to improve the service.

There were effective systems for assessing, monitoring and developing the quality of the service being provided to people.

Staff understood their responsibilities and knew who the management team were, and felt able to approach them.

The views of people and others were actively sought and acted on.

The service continuously learned and improved and staff were given opportunity to progress.

The service worked in partnership with other agencies.