Milton Court Care Home

Updated 8 July 2023

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 3 inspectors, a nurse specialist advisor and 2 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.

Service and service type

Milton Court Care Home 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. Milton Court Care Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post, the manager had been in post for 3 months and had submitted their application to register with CQC.

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 sought feedback from the local authority. 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 13 people who used the service and 15 relatives of people using the service. We also spoke with 16 staff members, including the managing director, home manager, regional support manager, deputy manager, unit managers, nurses, care assistants and kitchen staff.

We reviewed a range of records. This included 9 peoples care records and multiple medication records. We looked at 4 staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance records, policies and procedures, training records, meeting notes, governance information and risk assessments.

Updated 8 July 2023

About the service

Milton Court is a care home providing personal and nursing care to up to 148 people. The service provides support to older people who are living with physical disabilities, mental health, and dementia. At the time of our inspection there were 98 people using the service.

The service comprises of 6 units, 5 units were in use at the time of the inspection, 2 of these provided nursing care. Each unit has its own communal areas which includes a lounge, dining room and kitchenette. All bedrooms have en-suite shower rooms.

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

The provider did not always support people to follow their interests or provide sufficient engagement opportunities. Records were not always person centred. At times staff were task led. People’s communication needs were not always fully met. Complaints were managed appropriately.

Systems to assess and monitor the service were not always effective. When things went wrong the provider ensured appropriate actions were taken in line with the duty of candour. There was a positive attitude to learning from mistakes.

There were enough staff to keep people safe. People were protected from the risk of harm and abuse. The provider had suitable risk assessments in place to keep people safe. Medicines were managed safely. People were protected from the risk of infection.

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.

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 requires improvement (published 08 December 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Milton Court care home on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified a breach in relation to person centred care at this inspection. We have made a recommendation in relation to the providers governance systems.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.