Milford Manor Care Home

Updated 10 April 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors. A medicines inspector and an assistant inspector supported the inspection virtually.

Service and service type

Milford Manor Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We observed some care and support that people received and were able to observe social interactions between people and staff. We spoke with one member of staff and the registered manager. We reviewed six people’s care records and multiple medication records.

After the inspection

Following the site visit we organised to carry out telephone calls to five relatives, seven members of staff and were contacted by three healthcare professionals to share their views of the service. We spoke with the operations director, business director and the two founding directors virtually. We also reviewed a range of evidence which included safeguarding and complaints logs, three staff files in relation to recruitment, quality monitoring records and policies and procedures.

Updated 10 April 2021

About the service

Milford Manor Care Home provides accommodation and personal care for up to 30 people who have mental health conditions and/or dementia. At the time of the inspection there were 20 people living at the home. Accommodation is provided over two floors accessed by stairs and a lift. There are communal areas such as lounges, dining areas and a conservatory. The building has enclosed gardens with a large decking area for people to access from the ground floor.

People’s experience of using this service and what we found

Visitors to the home were screened prior to being able to go inside the building, this included a lateral flow device test (LFD). Only those with a negative result for COVID-19 were permitted to visit. Personal protective equipment (PPE) was provided for all visitors. The home had a ‘visiting pod’ in the garden which had been used for visiting in addition to garden visits. Indoor visiting was being planned during the inspection but had been paused due to an outbreak of COVID-19.

The provider had invested in specialist equipment for use during the pandemic. This included an ‘Ultra-V’ machine which was used to decontaminate areas of the home and an air purifier which helped to filter the air. Following the recent outbreak, the provider had arranged for the whole home to be professionally cleaned and had replaced all pillows and linen. A visit from the local authority environmental health officer had taken place and resulted in a '5' rating for the kitchen. This meant there was 'very good' hygiene standards.

Staff had engaged with weekly testing as per the government guidance and been provided with PPE throughout the pandemic. Staff had collectively decided to wear scrubs which were laundered on site. Staff had been given training on safe use of PPE and infection prevention and control procedures. Staff we spoke with felt well supported generally but also felt safe working during the pandemic.

Staff had been trained to administer medicines and had checks on their competence. People had an electronic medicines administration record which demonstrated people had their medicines as prescribed. During a recent COVID-19 outbreak staff had used un-prescribed oxygen for people to help them breathe more easily. Whilst this action had not caused people harm, the provider investigated this concern in full and worked with the local authority and other agencies to review this action.

Staff were aware of the different types of abuse and how to report any concerns. They were confident the provider would take appropriate action in response to any concerns raised. There were sufficient numbers of staff deployed which the provider kept under review.

Risks had been identified and recorded and there were management plans in place. Staff reviewed them regularly and made referrals to healthcare professionals if needed in a timely way. Regular servicing and maintenance checks ensured equipment and the premises was in good repair. Accidents and incidents were recorded and reviewed to identify any action to take to prevent reoccurrences.

Relatives and staff told us the home was well managed. Staff enjoyed their jobs and told us there was opportunity for them to share their ideas which helped staff feel valued. We were told by relatives and staff that the home had a “family” atmosphere which was important to them. Staff knew people l well and the care provided was personalised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 November 2017).

Why we inspected

We received concerns in relation to the use of un-prescribed oxygen for people during a COVID-19 outbreak and concerns about a visiting ‘pod’ at the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Milford Manor Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.