CQC report explained · a residential care home
What the CQC found at Milbanke Home for Older People
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found unsafe medicines management, incomplete risk assessments and concerns about night staffing. They also found effective safeguarding processes and appropriate infection control measures.
- Effective?
- Requires improvement
- People generally received support with healthcare, food and their choices. However, mental capacity records and mandatory training were not consistently complete.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- The new management team was described as open and approachable, but audits and care records were not consistently accurate or effective. There was no registered manager in post at the time, although an application had been submitted.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found serious gaps in medicines, risk management, staffing at night and oversight, although the new management team had begun making changes.
This was an unannounced focused inspection. Inspectors visited from 31 January to 6 February 2023. They spoke with people living at the home, relatives, the manager and staff. They observed care, checked records, medicines, recruitment files, training records, the building and infection control.
The home was not always safe or effective. Medicines were not always managed safely. Some risks were not properly assessed or recorded. There were concerns about night staffing, recruitment checks, staff refresher training and care records. Audits had not found problems identified during the inspection.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were all rated Requires Improvement. Caring and Responsive were not inspected during this visit, so their previous ratings were used in the overall rating. The previous overall rating was Good, published on 14 October 2019.
Safeguarding
People said they felt safe. Staff understood how to recognise and report abuse, and safeguarding training was provided.
“There were effective safeguarding processes in place.” from the report
Food and choice
People and relatives spoke positively about the quality and choice of meals, snacks and drinks.
“People were provided with meals of quality and choice.” from the report
Infection control
Inspectors were assured that the home was using protective equipment, maintaining hygiene and supporting safe visiting.
“The provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
New management approach
People, relatives and staff described the new manager and management team as approachable, open and supportive. The team had identified areas needing improvement.
“People and relatives told us they had confidence in the new manager and management team who were open and transparent.” from the report
Medicines
seriousInstructions for medicines given when needed were sometimes missing or lacked personal information. Allergy records and records showing the effect of medicines were not always complete.
“Instructions for medicines that were given when required were not always available and when they were present, they did not always contain any person- centred information.” from the report
Risk assessments
seriousSome assessments did not explain clearly what staff should do to reduce risks. Records about falls, pressure care and behaviour were not always complete or up to date.
“Some risk assessments lacked detail about the actions to take and control measures to lessen risks.” from the report
Night staffing
needs fixingRotas showed three staff working at night for 33 people. Inspectors said this could mean people did not receive help quickly enough.
“Sometimes at night I have to wait a while if I need some attention.” from the report
Training and care records
needs fixingNot all staff had completed required refresher training, including fire safety training. Some care records did not accurately reflect people's current needs.
“However, records looked at identified gaps in their mandatory training schedule.” from the report
Quality checks
needs fixingAudits did not identify several problems found by inspectors. Reviews of care were not always completed promptly.
“However, we found auditing systems were inconsistent and not always effective.” from the report
- 01What has changed in the medicines system, including checks of allergies, as-needed medicines and controlled drugs?
- 02How are risks such as falls, pressure areas and behaviour now assessed, reviewed and communicated to staff?
- 03How many staff are planned for each night shift, and how do you check that this is enough for residents' needs?
- 04Have all staff completed the required refresher training, including fire safety and medicines competency checks?
- 05How do your audits now identify missing records, unsafe medicines practices and changes in people's care needs?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 7 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Milbanke Home for Older People was rated Good; inspectors found safe, kind and personalised care across all five areas.
Inspectors made an unannounced visit on 2 October 2019. They spoke with people living at the home, a relative and staff. They observed care and checked care records, medicines, staffing, meals, training, complaints and management checks.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, received their medicines safely and lived in a clean and maintained environment.
People told inspectors staff were kind, respectful and available when needed. Care was planned around people's needs and choices, with support for meals, communication, activities, healthcare and end of life care. The previous inspection had also rated the home Good.
Safe staffing and medicines
Inspectors found staff were available when people needed them, recruitment checks were completed and medicines were safely administered and recorded.
“People told us staff were available when they needed them and they felt safe in their care.” from the report
Kind and respectful care
People described staff as kind and attentive. Inspectors observed respectful care and found that privacy, dignity and independence were supported.
“People were supported by caring and respectful staff.” from the report
Personalised support
Care files reflected people's individual needs, preferences, routines, interests and communication requirements.
“Care files were person-centred and individualised documents reflecting each person's assessment of needs.” from the report
Good management checks
The manager and provider used audits and other checks to monitor care quality and safety, and acted on their findings.
“The provider had systems in place to ensure the quality of service was regularly assessed and monitored.” from the report
Support with activities and end of life care
People were offered varied activities, and staff supported people to remain at the home where possible at the end of life.
“We saw people had been supported to remain at the home where possible as they headed towards end of life.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and update my relative's care plan if their needs or risks changed?
- 02What support is available for people who need help with communication, including picture cards or other aids?
- 03What is the current position on the Deprivation of Liberty Safeguards applications mentioned in the report?
- 04What activities are currently available, and how are they matched to each person's interests?
- 05How are medicines, care records and other quality checks reviewed, and what improvements have been made since this inspection?
This was an unannounced planned inspection covering all five CQC questions, including the care provided and the home environment. This explanation was written from the published report of 16 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Milbanke Home for Older People
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Milbanke Home for Older People →
- October 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Milbanke Home for Older People →
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 2 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.