Enter and View: Milton Court care home

The purpose of this Enter and View programme was to engage with residents, their relatives, or carers, to explore their overall experience of living in Milton Court care home. As well as building a picture of their general experience, we asked about experiences in relation to social isolation and physical activity.

Summary

In respect of demographics: 

• 23 residents took part in conversations, with 7 of the residents accompanied by family or friends.
• 5 residents were male and 18 were female.

Milton Court is a large care home. They are registered to provide residential and nursing care for up to 148 residents. At the time of this visit there were 139 people in residence, and a reasonably high proportion of their residents have a diagnosis of dementia.

What we found

Our feeling, echoed in the comments made to us by residents and their families, was that people living in Milton Court were being looked after, but not being cared for.

People told us:

"I get fed up just lying in bed. They never think to ask if I want to get up and sit in the chair."

"I would really like to see a dentist to get new dentures and for someone to cut my fingernails, and to get a new shaver as mine got broken."

"The food is usually pretty good, there is a lot of it..."

"There is no emotional connection or engagement. Her teeth haven't been cleaned in a while...she has stopped sleeping in her bed, maybe because of the cut or maybe because of the other residents coming in so she is just sat in her chair all day and all night. I have to remind them to change her towel."

Our recommendations

We made a number of recommendations, including:

• Consider reprioritising staff tasks to allow more time to provide personal care – tooth/denture cleaning and nail care was a cause for concern with many of the less mobile residents and an observation on the dementia and nursing floors. Teeth/dentures should be a daily activity, and more than an overnight soak is required for good oral hygiene. Nails need to be trimmed regularly and hands kept clean; hand gel is not sufficient.
• Hygiene or personal care when directed by medical advice needs to be adhered to in the same way medication is prescribed, and it was apparent that this is not always the case for residents.
• Consider ways of alleviating isolation for those residents that have mobility issues: more one to one time with care staff, more time in group situations, enlist the help of volunteer groups as befriending service to sit and talk with residents.
• Review the status of those currently bedbound residents and consider whether they could be helped to be more mobile through better equipment or physical therapy.
• Explore ways to improve the orientation process for new residents, this could be as simple as codesigning a new welcome pack with existing residents. Existing residents will know what information is missing or needs elaboration.