Archived: Milestone House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 45 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did treated colleagues from other organisations with kindness and respect. Registered persons had consistently failed to make improvements to the service to improve people’s lives. The service had been in breach of regulations for 5 consecutive inspections. This evidenced that the provider did not treat people with respect.

Despite the provider’s failings, we observed that staff supported people in a way which showed they were kind and respectful manner. People were praised and encouraged to engage and participate in activities and tasks and celebrate achievements. People were supported to help in day-to-day tasks such as supporting staff with clearing tables and stacking plates.

People and relatives gave positive feedback about staff. A person said, “I like the staff, they are kind.” People’s privacy was respected. A person said, “Staff knock on the door.” Relatives said, “They are a very caring and kindly staff” and “The staff are good with him and have been with him for a few years and the staff like him.” A staff member said, “Before entering I always knock and close the door behind me. I always tell them I am putting on the light and explain why we are doing something.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s care plans included likes, dislikes and preferences, including their preference to be supported by male or female staff. People’s religious and cultural needs were not documented. Staff told us people used to enjoy church services which took place regularly. They said these stopped during the COVID-19 pandemic and never started back up again. A staff member said, “No one goes to church, we used to have a church visiting regularly and coming at Easter and Christmas. This stopped in Covid, it is a shame as it was nice.” People were not supported to attend church services in their local community in place of the church groups coming to them.

The provider did not always promote people’s independence, so people did not always know their rights and had choice and control over their own care, treatment and wellbeing. The provider had not taken action to find alternative ways of supporting people to access the community to attend their chosen activities and important appointments since the vehicle had broken. This had led people to become isolated as they had not been enabled to access the community. People said they made choices such as when to get up, what clothes to wear and what to eat. Staff were able to describe what things people could do for themselves and when they needed support. When describing people’s daily routines, staff explained each person’s level of support. This included when the person required verbal prompts, physical assistance and time so the person could complete the task by themselves.

We observed staff giving a person their chosen meal. The staff member offered to cut it up and waited for the person to consider their response. The person wanted it cut up and then chose to add tomato ketchup on it. We observed they had a lipped plate on non-stick rubber mat and an adapted spoon which meant they were able to feed themselves. We observed other people independently using the bathroom to have their baths.

A person said, “I wash my own hair in the bath.” Another person told us, “I wash myself.”

Staff facilitated people having visitors to their home, and ensured people could contact their friends and family when they wished. A person told us how they had a video call with their brother on a regular basis and how important this was to them. Another person told us their parents visited them every week. People were involved in celebrating special occasions. A person said, “I have a cake and a party on my birthday.”

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People did not always have enough to do to keep them occupied and stimulated. People were unable to get out in the community as the vehicle was out of use. This meant they were restricted to short walks in the local community which was hampered by weather. There was limited choice of activities available for people. Some people went out in the community to day services. Other people stayed at home. We observed people sat watching television on our first day. On the second day some people were involved in art. There were no outside activities or events being brought into the service. A person told us, “I have done [swear] all today, I would like to do painting.” Another person said, “I go to the centre, I don’t go shopping, don’t go to pub or disco, don’t go to cinema. Sometimes I look at the beach.” A relative told us, “They do tell us of any parties if we are asked to attend. They took her out for her last birthday and sent photos.”

We observed staff responding to people’s needs in a timely manner. Staff attended call bells and listened to what the person wanted. We observed staff communicating with people to explain any delays. For example, we saw a person sign to staff they wanted to have a bath. Staff explained someone else was in the bathroom and the person would have to wait for them to finish before having their bath.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. The provider did not have systems and processes in place to promote and support staff wellbeing. Staff told us they had no well-being support. A staff member said, “There are no staff care packages, no access to discount schemes, no access to support or counselling. They used to do employee of the month, but this was stopped. We used to have an incentive to work for £1 extra per hour at weekends but that was stopped.”