Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Milsom House Care Home Cowbridge Road St Athan CF62 4NY Type of Inspection Focussed Date(s) of inspection 18 th December 2013 Date of publication 31 January 2014 You may reproduce this report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: cssiw@wales.gsi.gov.uk www.cssiw.org.uk
Summary About the service Milsom House is operated by The Manor House St Hilary Ltd. The care home is located in the quiet semi-rural village of St Athan in the Vale of Glamorgan. A small number of shops and a public house are within walking distance of the home. The care home is registered with Care and Social Services Inspectorate Wales (CSSIW) to provide care for a maximum of 39 people who require either nursing or personal care. The Responsible Individual is Mrs Susan Mary Evans and the Registered Manager is Gillian Allison. What type of inspection was carried out? We CSSIW visited the home on an unannounced basis on the 18 th December 2013 between the hours of 11:45 and 16:00hrs. This was a focussed inspection which concentrated on the quality of life theme for people using the service. We considered the following areas. Analysis of information held by CSSIW about the service which included the Statement of Purpose (SOP) We looked at care records in relation to two people who lived at the home. We also considered how risk and care assessments were translated into individual care plans in order to guide staff as to how to support residents on a day to day basis. We looked at the activities available at the home. We observed daily life and care practices at the home and how staff spoke with and interacted with residents. Conversations and information provided by several of the residents and staff working at the home Conversations with three relatives visiting the home. Observation of the home environment. We looked at the accident / incident records. What does the service do well? We spoke to relatives and residents during the unannounced inspection who told us that they were happy with the service provided. The choice and quality of the food served on the day of the unannounced inspection was well presented and residents told us how good the meals were. What has improved since the last inspection? There were no areas that exceeded the national minimum standards at the time of this inspection What needs to be done to improve the service? No non-compliance issues were identified during this inspection. We discussed during the inspection the safety arrangements for the entrance to the home. We were told by the responsible individual that a risk assessment plan had been carried out and that the main doors to the home were to be locked at 17:00hrs and that prior to 3
that time the entrance would be monitored by administration staff situated at the entrance of the home. We were also informed that CCTV monitoring was being considered for the entrances and exits of the home. 4
Quality of life Overall we (CSSIW) found that people who lived at Milsom House Care Home were able to exercise their rights and were treated with dignity and respect, this was observed throughout the visit. This view was consolidated by the people who used the service, who were complimentary regarding staff attitude and commitment. Some people living at the home are unable to offer their views on what daily life is like as they live with complex verbal communication difficulties. However we spoke with staff that had a good understanding of residents current needs. We also observed in the care records and documentation, good communication records between staff and relatives, including discussions that had taken place. We saw from the documentation when concerns had been raised relatives would be invited in to discuss these. Relatives we spoke to at the time of the inspection described positive experiences and one relative we spoke to told us that they could discuss any concerns with staff and the manager and that the staff are marvellous here. People benefit from a healthy diet and attention to nutrition. This is because we observed the lunch time meal and people enjoying the food that was served. One person told us that told the food was excellent and that an alternative choice was always offered. We observed the dining area which was pleasant and people stayed sitting chatting. We saw from the care records suitable arrangements in place to monitor individual s body weight on a regular basis. People remain healthy because their needs are appropriately anticipated by staff. This is because we looked at individual care records and saw appropriate referrals and professional advice had been sought. We saw in one persons care file where several falls were identified the appropriate risk assessments had been carried out, referrals had been made, and action taken to prevent further falls, a sensory mat had also been implemented. We observed that the records were well organised and well maintained, with care records up to date and regularly reviewed. People experience warmth, attachment and belonging. This is because communication between staff and people living at the home was relaxed. People we spoke to told us that they could choose the timing of when they got up and when they went to bed. We saw that people s individual choices with regards to daily routines such as eating meals and when they bathed/showered were respected. We observed people to be smartly dressed. 5
Quality of staffing The inspection did not focus on the quality of the staffing on this occasion. This theme will be considered at future inspections. 6
Quality of leadership and management This inspection did not focus on the quality of the leadership and management on this occasion. This theme will be considered at future inspections. 7
Quality of environment This inspection did not focus on the quality of the environment on this occasion. This theme will be considered at future inspections. However it was noted that the home was well maintained to a high standard with redecoration being carried out at the time of the visit. The home was observed to be fresh, clean and pleasant. 8
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How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focussed inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under Quality Themes. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet Improving Care and Social Services in Wales. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. 10