CQC report explained · a residential care home
What the CQC found at Milford Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that infection prevention and control arrangements were generally safe. They found that PPE outside some people's rooms was not always restocked and that some open doors lacked a risk assessment.
- Effective?
- Good
- This question was not rated or assessed in the report.
- Caring?
- Good
- This question was not rated, although staff were seen and heard engaging well with people.
- Responsive?
- Good
- This question was not rated. The report says visits continued for people at the end of life.
- Well-led?
- Requires improvement
- This question was not rated. The report says managers worked with local health authorities and had policies and procedures for managing COVID-19.
What inspectors found, February 2021
Milford Lodge Care Home was inspected but not rated; inspectors found strong infection-control arrangements, with issues around PPE restocking and room-door risk assessments.
This was an unannounced, targeted inspection on 28 January 2021. It looked at infection prevention and control during the coronavirus outbreak, rather than the home's overall quality.
Inspectors were assured that visitors, admissions, testing, shielding, social distancing, hygiene, staff training and PPE arrangements helped reduce infection risks. Staff checked people who were isolating, and end-of-life visits continued.
The inspection also found two issues. PPE stored outside some people's rooms was not always restocked. Some people isolating after a positive test had their doors open without a risk assessment to reduce the spread of infection.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating for the home overall.
Staff support
Staff checked people who were isolating and continued end-of-life visits. Inspectors saw and heard staff engaging well with people.
“Staff frequently checked on people isolating in their rooms to ensure their health needs were met.” from the report
PPE and training
Staff used appropriate PPE and had extra training in PPE, infection control and COVID-19. The home also had suitable areas for putting on and removing PPE.
“Staff had received additional training with how to put on and take off PPE, infection control and COVID-19.” from the report
Testing and outbreak response
Inspectors were assured that the home accessed testing and had working arrangements to manage a recent outbreak.
“We were assured that staff training, working practices and staff deployment helped to minimise the transmission of the infection and manage a recent outbreak.” from the report
Management links
Managers worked with local health authorities and used an established support network when needed.
“The registered manager worked in partnership with local health authorities to manage infections in the home.” from the report
PPE supplies not always restocked
needs fixingInspectors found that individual PPE supplies stored outside some people's rooms were not always replenished. Ask what checks are now in place.
“However, we noted that individual supplies of PPE stored outside people's rooms were not always restocked.” from the report
Missing risk assessments
needs fixingSome people isolating after a positive test had their doors open without a risk assessment to help limit infection spread.
“We also noted that people who were isolating in their rooms following a positive test result had their door open but a risk assessment was not in place to minimise the spread of infection.” from the report
- 01What action was taken to make sure PPE supplies outside people's rooms are always restocked?
- 02Have risk assessments now been completed for people isolating with their doors open?
- 03How often are PPE stocks and infection-control practices checked?
- 04What is the home's latest full inspection rating, since this inspection was not rated?
This was an unannounced, targeted inspection of infection prevention and control during a coronavirus outbreak; it did not rate the home's other key questions or its overall quality. This explanation was written from the published report of 27 February 2021 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, July 2019
Rated Good overall, but inspectors found weaknesses in management, care records, staffing at weekends and pressure ulcer prevention.
Inspectors visited unannounced on 15 May and 14 June 2019. They spoke with people living at the home, relatives and staff. They observed care and checked care plans, medicines records, staff files and management records.
The home was rated Good for safe, effective, caring and responsive care. People generally felt safe and well cared for. Staff were described as kind, respectful and knowledgeable. People had activities, support with meals and drinks, and access to health professionals.
The well-led rating fell from Good to Requires Improvement. Inspectors found repeated problems with care records, daily monitoring, refresher training, competency checks and quality improvement. They also found that staffing felt thinner at weekends and that pressure care was not managed consistently.
Kind and respectful care
People and relatives said staff were kind and caring. Inspectors saw staff offering reassurance and treating people with dignity.
“We saw caring interactions between care staff and people in the home.” from the report
People felt safe
Safeguarding systems were in place and staff knew how to report concerns. People said they felt safe living at the home.
“People felt safe and were happy living in Milford lodge.” from the report
Health support
Staff recognised changes in people's needs and involved GPs, dieticians, physiotherapists and other professionals when needed.
“Staff working at the home were able to identify when people`s needs changed and seek professional advice.” from the report
Activities and interests
The home offered a varied programme across seven days, including games, yoga, films, outings and religious services.
“The activity programme covered seven days a week and was varied, with religious services, games, yoga, films in the in-house cinema, an outing, a birthday party, quizzes and hairdresser.” from the report
Care records were incomplete
needs fixingCare plans and daily records did not always contain enough information. Inspectors said this was a repeated issue and recommended more frequent reviews.
“The care plans and daily monitoring records we checked were not always detailed or completed with enough information.” from the report
Pressure care was not consistent
needs fixingPeople at high risk of pressure ulcers did not always have the same type of pressure-relieving mattress. Inspectors recommended a more proactive approach.
“Staff had not had a consistent approach towards managing people`s pressure care.” from the report
Training and competency checks
needs fixingSome refresher training was overdue and competency assessments were not completed as often as required by the provider.
“Refresher training for staff was not up to date and they were working on booking staff on training as a matter of urgency.” from the report
Falls were not fully analysed
needs fixingMost recorded falls in the period reviewed happened overnight, but the home had not analysed whether staffing, lighting or other environmental factors contributed.
“Records showed that the majority of falls (37) from February 2019 to March 2019 happened between 8pm and 8am, however this had not been analysed to establish if more staff were needed during the night to keep people safe.” from the report
- 01What has changed to make care plans and daily monitoring records more complete and accurate?
- 02How many staff are usually working at weekends and overnight, and how is cover arranged when someone is absent?
- 03How do you identify people at risk of pressure ulcers, and when do you provide pressure-relieving equipment?
- 04Have all staff completed overdue refresher training and competency checks?
- 05How are falls now analysed, especially those occurring overnight?
This was an unannounced inspection covering all five CQC questions, including both the care provided and the home premises. This explanation was written from the published report of 26 July 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 Milford Lodge Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- February 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- July 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Registered with the Care Quality Commission on 30 May 2014.
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.
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