Milkwood House Care Home

Updated 7 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on the 22 and 23 January 2018 and was unannounced; this meant that the staff and provider did not know we were visiting. The inspection team consisted of two inspectors and two experts 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.

Before the inspection we reviewed information we had about the service, including previous inspection reports and notifications the provider sent to us. A notification is information about important events which the provider is required to tell us about by law.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke to the registered manager, the operations director, the providers, twenty four people, ten relatives, nine staff members and three health professionals. We observed staff interactions with people and responsiveness to their needs.

We looked at six care files which included initial assessments, risk assessments, care plans and any relevant information about the person. We also looked at policies and procedures; audits; infection control; medication management; activities programmes; staff rotas staff files including training and recruitment and minutes of staff meetings and supervisions.

Updated 7 April 2018

This inspection took place on the 22 and 23 January 2018 and was unannounced. During our previous inspection on 30 June 2016 we found 2 breaches, of which one was a continuing breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. The other was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to write an action plan to show how they would address these concerns anrd the provider identified 30 November 2016 for the completion of these actions. During this inspection we checked whether the provider had completed their action plan to address the concerns we had found. We found the provider had made the required improvements.

Milkwood House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Milkwood House accommodates up to 38 people including those who are living with dementia. The home is set in secure grounds near to the town of Petersfield. People are accommodated in either a bedroom with en suite facilities or have the use of a communal bathroom. Other facilities included a dining room and a lounge. At the time of our inspection there were 35 people living in the home.

The home has a registered manager. 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.

There was guidance in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely. The provider had an effective recruitment process in place to make sure the staff they employed were suitable to work in a care setting. There was a new electronic medicines management system in place and medicines were safely administered and as prescribed.

Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their need Staff were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. People were supported to eat and drink enough and they had access to healthcare services, such as GPs and district and practice nurses when their health care needs changed.

Care workers had developed caring relationships with people they supported. People were encouraged to take part in decisions about their care and support, and their views were listened to. Staff respected people's independence, privacy, and dignity. The care and support given was based on assessments and care plans which took into account people's abilities, needs and preferences. People were able to take part in activities which reflected their interests and preferences. The provider had a complaints procedure in place, and any recent complaints had been responded to and actions taken to learn from them.

People said that they thought the service was well led and that the registered manager listened to them and acted upon what they said. Staff told us they felt the registered manager was good, supportive, and approachable and felt able to raise any concerns with them. The registered manager demonstrated a good understanding of the needs for the service.

Audits were used to drive improvements in the service. The operation manager’s visits were used to identify areas of the service for improvement and these were actioned. People’s records were accurate, completed in a timely manner and stored securely.