Milestone House

Updated 18 August 2022

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 Health and Social Care Act 2008.

Inspection team

One Inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Milestone House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Milestone House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

The service had a manager 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manger and two staff members. We reviewed two care plans, medication records and staff recruitment files. We observed interaction between people and staff. We reviewed records associated with the management of the service, which included policies, procedures, audits, and checks.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with one care staff, two people in receipt of care and support at the service and five family members. We reviewed environmental home maintenance checks, and additional information used to manage and improve the service.

Updated 18 August 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Milestone House is a residential care home providing personal care to four people at the time of the inspection. The service can support up to seven people providing short breaks for adults with learning disabilities and people on the autistic spectrum.

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

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximised people's choice, control and independence.

People and their relatives were involved in their care planning to ensure they were supported to live their best lives, as independently as possible. Support was provided which promoted people to develop their daily living skills and access a range of activities and events. People and their relatives told us they received care and support from staff who they knew and had their preferences respected.

Right care: Care was person-centred and promoted people's dignity, privacy and human rights.

Records were up to date and decisions made on behalf of people under the Mental Capacity Act 2005 were consistently applied or reviewed to ensure they continued to be the least restrictive option and in the persons best interest. Care records included person-centred information for staff to follow.

People told us staff were respectful, caring and understanding around their emotional and physical needs.

The service worked closely with a range of health professionals to ensure people received the most up to date care which promoted their health and wellbeing; enabling them to live as normal lives as anyone else.

Right culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using the service led confident, inclusive and empowered lives.

The culture of the service was open and were responsive to people who they empowered to express their views. People spoke positively about the service they received and the way the service was managed. The registered manager and staff team were passionate about providing people with a personalised service which promoted their independence.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published January 2020) and there was a breach of regulation in relation to quality assurance at the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

We recommended the provider consider best practice guidance on the prevention and control of infection and update their practice accordingly.

At this inspection we found the provider had made improvements.

We recommended the provider consider best practice guidance to review staffing using an accredited staffing tool to ensure people receive a person-centred service.

At this inspection we found the provider had made improvements.

Recommendations

We have made a recommendation for the provider to review guidance about the management of CQC notifications.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Milestone House 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.