Milton Lodge

Updated 13 December 2019

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.

Inspection team

The inspection was conducted by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 14 November 2019 and ended on 22 November 2019. We visited the office location on 14 November 2019.

What we did before the inspection

Before the inspection we reviewed the information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided and one relative. We spoke with the registered manager, the quality control manager and an office staff member. We reviewed a range of records. This included five people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke to four care staff and sought feedback from four relatives of people using the service by telephone. We received feedback from four professionals who have contact with people using the service.

Updated 13 December 2019

About the service

Milton Lodge is a domiciliary care agency providing care and support to people living in their own homes who have a range of needs, including people with a learning disability and autism. Some people lived in homes at the same place the office was located, whilst others lived off site. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection nine people were receiving personal care.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Some people being supported by Milford lodge were not able to have fully verbal conversations with us. However, when asked if they felt the staff treated them kindly, people responded with smiles. Comments included, “Yes”, “Yes, I like it here” and “Staff help me.”

People were supported to be safe. There were systems and processes in place to ensure people were protected from the risks of avoidable harm. The provider had a policy and procedure for safeguarding adults and the registered manager and staff understood the potential signs of abuse to look for.

People were supported to manage their medicines safely by staff who were appropriately trained.

Risk assessments were completed for people and they were supported to manage risks in their home environment, to ensure safety. There was a system to manage accidents and incidents to reduce them happening again.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff completed regular training and understood their responsibilities. The staff demonstrated that they knew people well and told us they were proud to work for the service. Staff were motivated, and continuous learning was embedded in the service’s culture.

People's needs were assessed to ensure these could be met by the service. The registered manager and staff worked with other external professionals to ensure people received effective care.

People were supported to engage in meaningful activities and the provider actively looked to develop new opportunities that enhanced people’s wellbeing. Staff supported people and showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and their relatives were involved in the planning and review of their care and people were supported to be involved in making decisions about their own lives.

There was a clearly defined management structure and regular oversight and input from the provider. The registered manager and provider carried out regular checks on the quality and safety of the service. Staff felt supported by the management and told us the registered manager and provider were approachable.

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 8 May 2017). This was a planned inspection based on the previous rating.

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.