The Care Quality Commission
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  • Care home

Archived: Milton Court Care Centre

Overall: Requires improvement read more about inspection ratings

Tunbridge Grove, Kents Hill, Milton Keynes, Buckinghamshire, MK7 6JD (01908) 699555

Provided and run by:
Restful Homes Group Limited

Important: The provider of this service changed. See new profile

All Inspections

2 & 3 February 2015

During a routine inspection

Milton Court Care Centre is registered to provide accommodation and support for 148 older people who require nursing or personal care, and who may also be living with dementia. On the day of our visit, there were 106 people living in the home.

The inspection was unannounced and took place on 2 and 3 February 2015.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe living in the service. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report potential abuse. Systems in place had been followed and appropriate action taken to keep people safe, minimising any risks to health and safety.

Risk assessments within people’s care records were completed and reviewed. Staff understood how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks.

Staff were not allowed to commence employment until robust checks had taken place in order to establish that they were safe to work with people.

There were adequate numbers of staff on duty to support people safely and ensure people had opportunities to take part in activities of their choice.

Medicines were managed safely and the systems and processes in place ensured that the administration, storage, disposal and handling of medicines were suitable for the people who lived at the service.

Cleaning within the service was not always satisfactory and some areas of the service were not maintained to a clean and hygienic standard.

Staff were supported through a system of induction and on-going training, based on the needs of the people who lived at the service.

The registered manager did not consistently follow the legal requirements outlined in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

People had a good choice of meals and were able to get snacks and fluids throughout the day.

People had access to health care professionals to make sure they received appropriate care and treatment to meet their individual needs.

Staff talked with people in a friendly manner and assisted them as required, whilst encouraging them to be as independent as possible.

People’s personal views and preferences were responded to and staff supported people to do the things they wanted to do. Staff worked hard to maintain people’s privacy and dignity.

There were regular meetings for staff which gave them an opportunity to share ideas and give information about possible areas for improvements to the registered manager.

People and their relatives knew who to speak to if they wanted to raise a concern. There were appropriate systems in place for responding to complaints.

The service was led by a registered manager who was well supported by the provider.

We had not always received all required statutory notifications from the registered manager in accordance with their legal requirements.

Quality monitoring systems and processes were not always used effectively and had failed to identify the infection control and care plan issues that we observed during this inspection.

23 September 2014

During an inspection in response to concerns

Before this inspection the Care Quality Commission (CQC) received some information of concern regarding staffing levels within the home and the impact this had upon people's safety at Milton Court. It was alleged that people living at Milton Court were not responded to in a timely manner because of the lack of staff and that the systems in place did not maintain their safety and well-being within the home. This inspection was carried out in response to these concerns.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who lived at the home told us they felt safe. They said that staff were kind and friendly towards them and delivered the care and support they needed in a timely manner.

We found that the service had policies and procedures in place in relation to safeguarding. These policies provided staff with information about how to support people and we found that the service engaged with the local authority in addressing issues of safeguarding.

The systems in place reduced the risks to people's safety both within the home environment and the grounds outside.

Is the service effective?

It was clear from our observations that there was sufficient staff on duty on all units of the home on the day of our inspection. We found that staff had a good understanding of the needs of the people who used the service.

Is the service caring?

We observed that staff were very attentive to people's needs throughout our inspection and engaged positively with people, allowing them time to respond.

Is the service responsive?

There were sufficient staff on duty to attend to people's needs.

Is the service well led?

We saw evidence of quality assurance processes in place, including regular audits to monitor safeguarding concerns and staffing levels.

4 June 2014

During a routine inspection

During this inspection, we gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We found that risk assessments identified individual risks, to people's health, safety or welfare. People's care records and risk assessments were regularly reviewed and updated as and when their needs changed. The staff received appropriate training to ensure they had the skills and knowledge to meet people's needs.

Is the service effective?

We looked at eight people's care plans and risk assessments. We saw they were regularly reviewed and updated.

Is the service caring?

We observed friendly and positive interactions between staff and people using the service. We saw the staff were patient, kind and genuinely warm towards the people they were supporting. We noted over the lunchtime the staff provided assistance for people who required help with eating and drinking. The assistance was provided sensitively and with attention to preserving people's dignity.

Is the service responsive?

We saw that meetings took place with relatives to listen to their view and the provider took action to address people's suggestions for improvements. People's complaints were listened to and appropriately acted upon. We saw that people's health was closely monitored and appropriate action was taken in seeking the advice and guidance of health and social care professionals. We found that overall people's health and welfare needs were being met by sufficient numbers of appropriately skilled staff. However the provider may wish to note their regulatory responsibility to provide sufficient staff cover for planned and unexpected staff sickness, vacancies, absences and emergencies.

Is the service well-led?

At the time of our visit there was no registered manager in post. However a new manager had been appointed and they had submitted their application to register with the Care Quality Commission (CQC). Since the manager took up post they had set up systems to ensure that staff received regular supervision and staff team meetings were taking place. This gave staff the opportunity to discuss their self-development needs, share knowledge and receive information direct from the provider. We saw that meetings had taken place with people using the service and relatives to discuss how Milton Court Care Centre were meeting people's needs.

18, 19 July 2013

During a routine inspection

During our inspection visit we spoke with several people and four visiting relatives to ask them for their views on the service they received at the home. We also spoke to the provider and the manager and several care staff on duty. We used a number of different methods to help us understand the experience of people living at Milton Court. This was because some of the people living there had dementia, and we were not able to have meaningful conversations with them. People's relatives provided positive comments about the home and the level of care that was given by all staff to their family member. Some of the comments included 'The manager is very good and listens and the staff are very caring'. 'I am very happy with the care provided by staff'.

We observed that all staff on duty had a calm and kind manner when working with individual people. The people using the service provided positive feedback about living at the home. Some of the comments included: 'The food is very good and I love it here'. 'I have no complaints but I do know how to complain and I have done it in the past and it was resolved'. 'The home is lovely and clean and so is my bedroom'. Several people were not able to hold meaningful conversations with us, but we saw from their responses and body language that they were happy with the way staff were treating them.

10 August 2012

During a routine inspection

We spoke with 13 people who lived at the home and four visiting relatives, to ask them for their views on the service they received. Some of the people who used the service were unable to verbally communicate so we used our observation skills to help understand their experiences.

Most people we spoke with told us that they were happy with the level of care that they received from staff. However, a few people told us that they had some concerns about living at the home. They also told us that the food served at the home was good and they were given a choice of what they wanted to eat each day

One person told us that the staff had explained the call bell system to them, so they could use this when they needed assistance from staff. They also told us that the staff attended to their needs on a regular basis and often 'popped in' to find out if they needed any help.

Most people also told us that there were plenty of activities taking place in the home. One person said that they liked it when the 'singers came to the home' because they enjoyed listening to the music. On the day of the visit we observed a game of bingo was taking place at the home. We spoke with one of the people who had been to this activity and they told us that they had enjoyed the game and had won a box of chocolates that they shared with other people.

A few people raised concerns about the care they received at Milton Court Care Home. One person and their family told us they would like to receive more care from the staff. We discussed this with the family and with one of the managers and found that multi-disciplinary meetings had been held to discuss the planning of care. We also saw records and charts which showed that the person was being cared for in line with their care plan.

Another person said that the care they received from staff at night time was delivered in a rush and they would have preferred if staff 'went at my own pace'. We spoke with the manager about this and they told us that they planned to introduce more 'individualised' night time care, so people received the care they needed, at the right time and pace to suit their needs.

Two people told us that the night staff tried to get them to go to bed too early and they did not like this because they enjoyed sitting in the lounge watching the television. They said they told the night staff that they did not want to go to bed early and they listened to them and left them to enjoy the company of other people living at the home.

12 October 2011

During an inspection looking at part of the service

One person told us they had recently taken part in a residents and relatives meeting and had requested individual teapots for use at meal times. They told us they felt they were being listened to. They said they liked to stay in their room rather than join others for activities and they were able to do this.

We were told that staff were very helpful and they were happy living in the home. They said they had settled in well thanks to the kindness of the staff.

People told us they were happy with the food provided and they were always offered a choice of meal. They said they especially liked the home made cakes and puddings.

People told us that their rooms and their living accommodation were always kept clean and tidy.

One person said 'there are always cleaners around and they come into my room every day.'

11, 19 April 2011

During a routine inspection

One person using the service told us 'I like to live here, I like it here'. People told us that they had a say and were involved in making decisions. People were treated with respect. People and their families were involved in the development of care plans. We were told that food was all right, there was plenty of choice and alternatives were available. People had not had any say in the colour of the d'cor in their rooms but had been able to decorate them with personal belongings. Relatives of people using the service told us that they knew how to complain but found the manager difficult to approach. The staff were said to be good listeners.

Staff told us that training was available. They said that staffing levels were adequate to meet the needs of the service users. New staff were following an induction programme.