Milbanke Home: Preston care home rated as requiring improvement after recent inspection shows health and safety concerns

An unannounced inspection which was carried out over a seven day period from January 31 to February 6 at Milbanke Home for Older People, Station Road, Kirkham, showed medicines were not always administered safely and risks to residents were not always well managed. The inspection was prompted in part by concerns received in relation to the management of medicines, staffing levels, quality assurance systems and people’s care needs. The three keys areas the inspection focussed on were – is the service safe, effective and well led? For areas not inspected, ratings awarded at the last inspection were used to calculate the overall rating of requiring improvement.

Is the service safe?

The inspection report read: “This means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question as good. At this inspection the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.”

It found that:

• Medicines were not always administered safely. Allergy information was not always recorded on medicine administration records. This meant there was a risk people might be given medicines which they had previously reacted too. For one person prescribed a medicine to manage their anxiety it was found that staff did not always record information regarding episodes when the medicine was administered. Staff did not always record the outcome when medicine used as ''when required'' were administered.
• Risks to people were not always well assessed and managed to ensure correct information was available for staff to deliver support for people.
• Staffing levels were not always sufficient during the 24-hour period. Staffing rotas indicated three staff on duty with 33 people living at the home. This may put people at risk of not receiving support in a timely manner with one person saying, “Sometimes at night I have to wait a while if I need some attention.”

Is the service effective?

The report read: “This means we looked for evidence that people's care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At the last inspection this key question was rated as good. At this inspection the rating has changed to requires improvement. This meant the effectiveness of people's care, treatment and support did not always

achieve good outcomes or was inconsistent."

It found that:

• They could not be entirely assured The Mental Capacity Act 2005 (MCA) processes were consistently implemented. For example, one person had been identified as lacking capacity. However, there was no information within the person's care records to demonstrate capacity had been formally assessed.
• Staff were competent and confirmed they had had access to training courses relevant to their role. However, not all of them had received all their required fire safety training.

Is the service well-led?

The report stated: “We looked for evidence that service leadership, management and governance assured high-quality, person-centered care. At the last inspection this key question was rated as good. At this inspection it changed to requires improvement. This meant people's needs were not always met.”

Some records were not always an accurate reflection of a person's needs and were not updated to reflect recent changes in people's needs. Reviews of care were not undertaken consistently and in a timely way which in turn could put people at risk.

What action have the CQC told the provider to now take?

An action plan has now been requested from the provider to understand what they will do to improve the standards of quality and safety. The health and social care regulator will also work alongside the provider and local authority to monitor progress which will help inform them when they next inspect.

The care home houses up tp 45 older people who require nursing or personal care. The home supports people living with dementia and mental health needs. At the time of the inspection visit there were 33 people who lived at the home.