Milton Ernest Hall Care Home is a residential care home and provides accommodation, nursing and personal care for up to 29 people, including people living with dementia. Milton Ernest Hall Care Home opened in December 2010. The home has four double bedrooms, which were each occupied by a single person.

This inspection took place on 31 October 2017. The visit was unannounced and at the time of this inspection there were 24 people in residence.

At our last inspection the service was rated as good. At this inspection we found the service remained good overall.

The service continued to keep people safe because staff understood their roles and responsibilities in relation to keeping people safe from harm and abuse. Potential risks to people had been assessed and staff had the information they needed on how to minimise risks. Medicines were managed safely. There were enough staff on duty to meet people’s needs and staff recruitment ensured that only people suitable to work at the home were employed.

The service was effective because people’s needs were met by staff who were trained and supported to do their job well. People were supported in the least restrictive way and were given as much choice as possible. People were helped to eat and drink enough. People’s health and wellbeing was maintained and provided through a range of health and social care professionals who visited the home.

The service was caring because staff treated people with kindness, compassion, dignity and respect. People had choices in all aspects of their daily lives, were supported to be as independent as possible and knew that the staff created a homely atmosphere.

The service was responsive because staff knew people’s care needs and helped them to make the lifestyle choices they wanted. People and their relatives were involved in their personalised care plans. These gave staff the information they needed to provide the care each person needed. People were given opportunities to take part in a wide range of activities to keep their minds and bodies healthy. Any complaints were recorded, listened to and addressed to people’s satisfaction.

The service was well led because there was a registered manager in post who was dedicated, approachable and provided good leadership. Quality assurance systems were in place to check that the service provided quality care and make improvements where necessary. People, their relatives and other people visiting the home were encouraged to share their views about the service being provided.

Further information is in the detailed findings below.

During our visit to Milton Ernest Hall Care Home we spoke with, or observed the care provided to, most of the 25 people living at the home at the time of our inspection. People told us they were happy living at the home. One person said, "It is just what I need." They told us they were particularly grateful that the size of their bedrooms meant they had been able to bring a number of personal possessions from home with them, including pieces of furniture. Anoher person said, "I am grateful to be with my wife." We noted that because of the size of some of the bedrooms it was possible for married couple to remain together if they wanted.

We looked at four care plans and observed care was delivered in line with them and that people were asked to consent to any care before it was delivered.

We saw that medication systems were robust and staff would help people to remain as independent as possible by supporting them to self-medicate where possible.

Throughout we observed a friendly, inclusive and homely environment. Staff interacted well with the people using the service. One person said, "The staff are wonderful, so kind and caring." Staff were offered a variety of training opportunities and as a result were qualified and experienced to provide care to the people using the service.

The home had systems in place to effectively manage complaints.

When we visited Milton Ernest Hall Care Home during the afternoon and early evening of 17 July 2012 we spoke with five of the 21 people living at the home and three visitors. People told us that the staff were always polite when they spoke with them. Visitors told us that they felt involved in their relatives care and were kept informed of any changes to their care and their condition. One person said, “if there is a problem, it gets sorted immediately.”

One person who used the service told us that their daughter had visited a number of homes and chosen Milton Ernest Hall because the bedroom was so big and there was room for personal possessions.

We also spoke to people about the care they received and observed how the care staff responded to peoples’ needs and expectations.

People using the service told us that the care staff were all very good. One person said, “all the staff are wonderful”. Another person said “everyone looks after me well” and a relative said, “I have seen the care plan and the care they give is how it is written”.

People that we spoke with about the food told us that it was very nice. One person said, “the food is always good, I look forward to my meal”. Another person said, “there is always something on the menu that I like and if there wasn’t I think they would make something different”. A visitor told us that they had eaten with their relative at times and the food was good.

When we visited Milton Ernest Hall Care Home during the afternoon and early evening of 17 July 2012 we spoke with five of the 21 people living at the home and three visitors. People told us that the staff were always polite when they spoke with them. Visitors told us that they felt involved in their relatives care and were kept informed of any changes to their care and their condition. One person said, “if there is a problem, it gets sorted immediately.”

One person who used the service told us that their daughter had visited a number of homes and chosen Milton Ernest Hall because the bedroom was so big and there was room for personal possessions.

We also spoke to people about the care they received and observed how the care staff responded to peoples’ needs and expectations.

People using the service told us that the care staff were all very good. One person said, “all the staff are wonderful”. Another person said “everyone looks after me well” and a relative said, “I have seen the care plan and the care they give is how it is written”.

People that we spoke with about the food told us that it was very nice. One person said, “the food is always good, I look forward to my meal”. Another person said, “there is always something on the menu that I like and if there wasn’t I think they would make something different”. A visitor told us that they had eaten with their relative at times and the food was good.

We met with fourteen of the nineteen people at our visit on 20 December 2010 who were staying at the home.

All the people with whom we spoke stated that they enjoyed their meals most of the time. Two people did explain that the meal options were not always to their taste. However most comments were positive and included, "there is always plenty to eat" and "the food is lovely". At lunch most people went to eat this in the dining room. People had been offered two choices and their selection had been written down on a menu sheet. Fresh vegetables were served with the main meal and a range of drinks were on offer.

Nutritional risk assessments had been undertaken for people, although not all were up to date.

People living at this home had a suitable homely environment in which to live that was well maintained, management had plans in place to ensure further improvements were carried out to maintain these standards. Processes were in place for regular safety checks, and records showed that these were being carried out. Additional heating equipment and checks were in place to make sure adequate temperatures were maintained to provide adequate warmth.

The provider had invested resources into the home, which meant that there was the staff compliment needed to maintain adequate standards of care. The availability to resource additional staff when staff report in sick was in place, but was dependant on senior staff responding to staff shortages to make sure people using the service are not put at risk through not covering absences.

This inspection took place on 2 and 3 September 2015. It was unannounced.

Milton Ernest Hall Care Home is registered to provide a service for up to 29 people, who may have a range of nursing and care needs, including old age and physical disabilities. During this inspection, 24 people were living in the home. The home had four double rooms which were all occupied by a single person.

A registered manager was in post. 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.

Staff had been trained to recognise signs of potential abuse and keep people safe. People felt safe living at the service.

Processes were in place to manage identifiable risks within the service, and ensure people did not have their freedom unnecessarily restricted.

There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs.

The provider carried out proper recruitment checks on new staff to make sure they were suitable to work at the service.

Systems were in place to ensure people’s daily medicines were managed in a safe way, and that they got their medication when they needed it.

Staff had received training to carry out their roles and meet people’s assessed needs.

We found that the service worked to the Mental Capacity Act 2005 key principles, which meant that people’s consent was sought in line with legislation and guidance.

People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

People’s healthcare needs were met. The service had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.

Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.

We saw that people were given regular opportunities to express their views on the service they received and to be actively involved in making decisions about their care and support.

People’s social needs were provided for and they were given opportunities to participate in meaningful activities.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.

There were effective management and leadership arrangements in place.

Systems were also in place to monitor the quality of the service provided and drive continuous improvement.