CQC report explained · a residential care home
What the CQC found at Milton Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, effective safeguarding arrangements and safe medicines management. The building needed a complete refurbishment, although the provider had a plan for the work.
- Effective?
- Good
- People had detailed assessments, appropriate care and staff with relevant training and supervision. The registered manager immediately put some missing capacity assessments and best-interest decisions in place.
- Caring?
- Good
- Staff were kind, respectful and non-judgemental. People were involved in decisions about their care and were supported to maintain their dignity, rights and independence.
- Responsive?
- Good
- People were supported with personalised care, meaningful activities, community access and relationships. Inspectors found that the home's care-record tools had sometimes missed changes in people's physical health, and the manager corrected the gaps.
- Well-led?
- Good
- The home was well run, with regular checks and strong oversight. The manager used feedback and worked with outside professionals to improve people's care.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and person-centred care, with some records and building improvements still needed.
This was an unannounced planned inspection. Inspectors visited on three dates, spoke with seven people and several staff, and reviewed care, medicines, recruitment, training and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training and strong support for people's independence, health and daily choices.
The home was larger than current best practice guidance suggests, although inspectors said its design reduced the effect of this. They also noted that the building needed a complete refurbishment and that some assessment and care-record tools had not always identified changing needs.
Kind and respectful staff
Inspectors found that staff treated people with kindness, respect and without judgement.
“Staff consistently displayed kindness and a caring attitude.” from the report
Choice and independence
People were supported to make choices, take part in their care and develop skills for greater independence.
“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.” from the report
Safe medicines
Medicines were received, stored, given and disposed of safely. Staff had been trained and assessed as competent.
“Medicines were safely received, stored, administered and destroyed.” from the report
Meaningful activities
People took part in activities in the community and some completed voluntary work. Staff also helped people rebuild family relationships.
“People were encouraged to enjoy a wide range of meaningful activities and to access to the community.” from the report
Refurbishment needed
needs fixingInspectors said the building needed a complete refurbishment. The provider had identified this and supplied a plan for the work to be completed by summer.
“The building needed to undergo a complete refurbishment.” from the report
Care records did not always identify changing needs
needs fixingThe home's assessment tools had led staff to miss some needs, including changes in physical health. The registered manager corrected the gaps found during the inspection.
“The provider's tools had not assisted staff to undertake this work and they led to staff missing needs such as a change in people's physical health.” from the report
- 01What refurbishment work has been completed since the inspection, and what work remains?
- 02How do you now check that care records identify changes in a person's physical health?
- 03How are capacity assessments and best-interest decisions kept up to date?
- 04How will you support my relative to make choices and build greater independence?
- 05What activities, community access and family contact would be available for my relative?
This inspection looked at the whole care home, including the premises and care provided, and rated all five CQC questions. This explanation was written from the published report of 13 February 2020 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, April 2017
Milton Lodge is rated Good; inspectors found safe, kind and personalised care, with previous building and monitoring problems improved.
This was an unannounced inspection on 27 February and 7 March 2017. Inspectors spoke with people living there, a relative, staff and health professionals. They also checked care records, staff files and records about how the home was run.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable safeguarding arrangements and generally safe medicines management. People received support with food, health appointments, choices, activities and independence.
A previous inspection in January 2016 found breaches about the condition of the building and the provider's quality monitoring. This inspection found that the provider had made improvements and was meeting those requirements.
Personal choice
People were involved in their care planning and could choose their daily routines, food, activities and personal belongings.
“People were supported to be fully involved in decisions about their care and support needs.” from the report
Community activities
People were supported to take part in activities inside and outside the home, including local outings and holidays.
“People were able to choose the activities they wanted to participate in with many spending time away from the service visiting local areas with their key worker.” from the report
Improved oversight
The provider had strengthened its quality checks after problems found at the previous inspection. Inspectors saw that identified issues were followed up.
“The provider had improved their quality assurance systems, with regular checks being made on care records, infection control and the management of medicines for example.” from the report
Food date labelling
minorFour frozen food items had use-by dates that had just passed. The manager said the dates were incorrect because the food had been frozen after purchase and would be corrected.
“We found four food items which had been frozen, had a use by date which had just past.” from the report
Small maintenance issue
minorA replaced window did not initially have a suitable restrictor. The provider fitted one during the inspection and inspectors found no risk to people.
“One new window which had been replaced did not have a suitable window restrictor installed.” from the report
Some information needed updating
minorThe home's as-required medicines guidance and some information on the provider's website were being corrected. The report does not say these issues led to harm.
“The registered manager was in the process of updating their 'as required' medicines information to ensure they had full details which were in line with NICE guidelines.” from the report
- 01What changes have been made since the inspection to make sure frozen food is labelled with the correct use-by date?
- 02How is the as-required medicines guidance kept up to date, and how are staff checked on it?
- 03What regular building and equipment checks are carried out now, including checks on windows and fire safety?
- 04How are care plans and medicines, infection control and safety audits reviewed, and what happens when a problem is found?
- 05How are residents involved in choosing their activities, meals, routines and personal goals?
This was an unannounced inspection of the overall service and all five CQC questions, with visits on 27 February and 7 March 2017. This explanation was written from the published report of 27 April 2017 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 Milton Lodge
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 30 May 2012.
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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