CQC report explained · a residential care home
What the CQC found at Milverton Road
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2020
Milverton Road is rated Good; inspectors found safe, kind and personalised care, with limited involvement in care planning for some people.
The inspection visit took place on 04 December 2019 and was unannounced. One inspector observed care, spoke with staff, relatives and health professionals, and reviewed care, medicines, staffing and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe, supported by trained staff, helped with healthcare and treated with kindness and respect.
The home supported people with learning and physical disabilities to make choices, build independence and take part in activities. People had limited verbal communication, so staff used gestures, facial expressions, pictures and symbols to understand and involve them.
The overall rating stayed Good, the same as at the previous inspection published on 8 July 2017. The report says CQC will continue to monitor the information it receives and may inspect sooner if concerns arise.
Safe medicines and staffing
Staff were trained and assessed before giving medicines. The home had recruited several new staff and had stopped using agency staff except in emergencies.
“Medicines administration records (MARs) were of good standard and had no gaps.” from the report
Kind, respectful relationships
Inspectors saw staff supporting privacy, dignity, choice and independence. Relatives also described staff as kind, caring and friendly.
“People received help and support from a kind and compassionate staff team with whom they had positive relationships.” from the report
Personalised communication
The home adapted information for people's communication needs, including using pictures and a speaking picture book. Staff used people's gestures and facial expressions to understand their choices.
“The provider had translated a wide range of policies and procedure in a format suitable for people's needs and level of understanding.” from the report
Activities and community links
People took part in individual and group activities, attended a local day centre and accessed the community. Inspectors observed people engaging with and enjoying a music session.
“People who used the service were offered a range of individual and group activity.” from the report
Improvement-focused management
The management team used audits, meetings and improvement plans to identify and maintain improvements. Staff said they felt supported and worked better as a team.
“The registered manager and the staff team had a strong focus on making continuous improvements to the service people received.” from the report
Limited involvement in care planning
minorBecause of people's complex needs, some people had limited involvement in planning their care. Staff and relatives were involved, and staff used pictures or symbols wherever possible.
“Due to people's complex needs they had limited involvement in the planning of their care.” from the report
No end of life care
minorThe home does not provide end of life care. Discussions about people's end of life wishes had started but were not yet complete.
“6 Milverton Road does not provide end of life care.” from the report
- 01How will you involve my relative in care planning if they have limited verbal communication?
- 02Which communication tools, pictures or symbols will you use to help my relative make choices?
- 03What arrangements would be made if my relative needed end of life care, since the home does not provide it?
- 04How often will my relative be able to go out, given that transport is shared with another home?
- 05How will you make sure improvements in staffing, activities and independence are maintained?
This was a planned, unannounced inspection of the care home covering all five CQC questions; all five ratings remained Good. This explanation was written from the published report of 8 January 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, July 2017
Rated Good; inspectors found safe, kind and personalised care, but medicines records and some quality checks needed improvement.
This was an unannounced inspection on 8 and 12 June 2017. One inspector met everyone living in the home, spoke with staff, a relative and health professionals, observed daily care, and checked care plans, medicines and management records.
The home supported six people with learning and physical disabilities. Inspectors found people were safe, treated with respect, supported to make choices, given suitable food and helped to access health services. Care plans were detailed and activities had increased since the previous inspection.
The overall rating was Good, as were all five areas: Safe, Effective, Caring, Responsive and Well-led. This means the inspectors found the service met the expected standard overall, but they also identified areas that needed attention.
Personalised care
Care plans covered people's needs and preferences in detail. They were reviewed regularly, with relatives and other people involved where appropriate.
“Care plans were of good standard and provided holistic information in regards to the person's needs and preferences in a range of areas” from the report
Kind and respectful staff
Inspectors saw staff reassuring people, supporting activities and respecting privacy. People were encouraged to make choices and do things as independently as possible.
“We saw staff treating people with dignity and respect, observed staff knocking on people's doors and covering people so they were not exposed.” from the report
Health and nutrition
People received home-cooked food based on their preferences and were supported to eat. Staff responded to health changes and helped people access health services.
“People received a varied, healthy and well balanced diet. Meals were home cooked and reflected people's likes and dislikes.” from the report
Positive new management
The new manager was viewed positively by staff and relatives. Inspectors found that changes had already made an impact.
“We saw that the new registered manager had made an impact since staring and the changes were reflected in this report.” from the report
Medicine records and storage
seriousOne medicine record was missing important information, and records for creams had gaps. The medicine fridge was unlocked on both inspection days, although its temperature was safe and a replacement lockable fridge had been bought.
“Medicines administration was mostly safe, however the registered manager acknowledged that recording of some medicines and the storage of some medicines needs to be improved.” from the report
Staff supervision
needs fixingStaff had not received formal one-to-one supervision regularly before May 2017. The new manager had started planning supervision six times a year.
“Supervisions and appraisals were not always planned frequently, but the registered manager had taken actions to resolve this.” from the report
Quality audits
needs fixingQuality checks were carried out, but some did not identify shortfalls in the service. Inspectors specifically said the medicine audits were not effective.
“Quality assurance checks and audits were occurring regularly but sometimes did not recognise shortfalls within the service.” from the report
Staffing and morning routines
needs fixingThe home used bank and agency staff to cover vacancies. Staff said mornings could be challenging, so the manager was reviewing the rota to allow more attention for people at that time.
“People would benefit from a review of the rota and more permanent staff, which the registered manager told us was currently been dealt with.” from the report
- 01What changes have been made to medicine records for creams and to the storage of refrigerated medicines since this inspection?
- 02How often do staff now receive formal supervision, and can you show me how this is monitored?
- 03How many permanent staff currently work here, and how often are bank or agency staff used?
- 04What changes were made to the rota to reduce pressure during busy morning periods?
- 05How do you check that medicine audits and other quality checks identify and fix problems?
This was an unannounced inspection covering all five key questions and the overall quality of the home; the previous inspection in March 2015 had also rated the home Good. This explanation was written from the published report of 8 July 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 Milverton Road
4 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Goodstayed GoodSafe: GoodCaring: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Registered with the Care Quality Commission on 3 July 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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