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Inspection carried out on 5 February 2020

During a routine inspection

About the service

Milner House is a residential respite service providing accommodation and personal care for up to three people. Respite is planned or emergency temporary care. The service accommodates older people or children aged between 16-18 years old, who are living with a learning disability and/or autistic spectrum disorder, dementia or a mental health condition. On the day of our visit, only one person was using the service, but other people were due to use the service during our inspection period. Milner House accommodates people over a ground floor. People have their own bedroom and en-suite facilities. There is also a shared kitchen, living space and garden.

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

People continued to be protected from the risk of abuse because systems and processes supported this practice. Risks to the environment and people’s health had been identified, assessed and managed safely. Medicines were managed safely. The home was clean, tidy and odour free and staff followed good infection control processes.

There were enough staff to keep people safe and staff had been recruited safely. There was a regular training programme which gave staff the right knowledge and skills for their roles. Positive feedback was received about the caring nature of staff and staff were committed to providing person centred care.

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 service was committed to ensuring people who used the service continued with their usual hobbies and routines.

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.

People were referred to healthcare services where necessary, and the provider worked in partnership with other health agencies to support a smooth transition between services. A healthy lifestyle was promoted and people had free access to food and drinks of their choice.

Systems and processes monitored the quality of the service provided. This included regular checks on the safety of the environment and the quality of care people receive. We received positive feedback about the management of the service and there was an open culture where people, relatives and staff felt able to raise concerns. Any concerns were investigated thoroughly. The provider was committed to continuously improving the service.

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 01 September 2017).

Why we inspected

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 pr

Inspection carried out on 11 July 2017

During a routine inspection

Milner House provides short respite accommodation and personal care, for up to three people. It also provides a community respite service where people are supported with personal care in their own home. There was one person staying at the service at the time of our inspection and one person was receiving the community respite service. At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager 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 understood their responsibilities to protect people from the risk of abuse. The registered manager checked staff’s suitability for their role before they started working at the service and made sure there were enough staff to support people safely. Medicines were stored, administered and managed safely.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks, while promoting people’s independence. People and their families were included in planning how they were cared for and supported.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to maintain a balanced diet that met their preferences and were referred to healthcare services when required.

People told us staff were kind and caring and had the right skills and experience to provide the care and support they required. Staff treated people in a way that respected their dignity and promoted their independence. People were encouraged to maintain their interests and take part in social activities.

Staff were dedicated to providing quality care to people. The provider valued staff and promoted their development. There was an open culture at the service where staff felt well supported, able to raise any concerns and put forward suggestions for improvements. The provider worked in partnership with other organisations to make sure they followed current best practice and provided a high quality service. They had developed systems which ensured good standards of care were maintained for people.

Inspection carried out on 17 March 2015

During a routine inspection

We carried out this inspection on 17 March 2015. The inspection was unannounced.

Milner House provides a respite service for up to three people with a learning disability. There were three people staying at the home at the time of our inspection.

There was a registered manager in post at the service. 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.

People told us they felt safe living at Milner House. Staff demonstrated they understood the importance of keeping people safe and understood their responsibilities for reporting any concerns regarding potential abuse.

Staff knew how to support people safely. Risks to people’s health and welfare were assessed and care plans gave staff instructions on how to minimise identified risks. There were processes in place to ensure people received their prescribed medicines in a safe manner.

There were enough staff on duty to meet people’s needs. Staff’s suitability to deliver personal care was checked during the recruitment process. Staff received training and support that ensured people’s needs were met effectively.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). No one had a DoLS authorisation at the time of our inspection.

People were supported to maintain a balanced diet. Staff took prompt action when people’s health needs changed.

We saw staff supported people with kindness and compassion. Staff treated people in a way that respected their dignity and promoted their independence.

People and their relatives were involved in planning how they were cared for and supported. Care was planned to meet people’s individual needs and preferences, and care plans were regularly reviewed.

People were encouraged to share their opinions about the quality of the service and we saw improvements were made in response to people’s suggestions.

The registered manager maintained an open culture at the home. There was good communication between staff members and staff were encouraged to share ideas to make improvements to the service. People said the registered manager was visible and accessible.

There were effective processes in place to ensure good standards of care were maintained for people.

Inspection carried out on 21 October 2013

During a routine inspection

When we visited Milner House we spoke with the registered manager and the home leader. One person was staying at the service on the day of our inspection. They had complex needs which meant they were not able to tell us in detail about their experiences. Therefore we observed care practice and staff�s interaction with the person when they delivered their care. We read the care records for two people who used the service.

On the day of our visit, the person who used the service had been out to the local library. We observed staff supported the person to have their evening meal. We found that they understood the person�s needs and the individual ways they communicated their needs.

We found that people who used the service had agreed to the care and treatment they received.

We saw that the service was clean and well maintained. Staff we spoke with explained how they minimised the risk of infection.

We found that the provider had an effective recruitment process and appropriate checks were made on staff before they began work.

We found that the provider dealt with complaints and comments in accordance with their policy.

Inspection carried out on 24 January 2013

During a routine inspection

We spoke with one person who arrived at Milner House on the day of our inspection about their experiences of the service. The person had used the service previously. Their family member also told us about their experience of the service. We also spoke with a member of staff and the manager who supported people.

A person we spoke with told us that the care that was discussed with them matched the care that was being provided to them. We saw their family member was regularly kept up to date about the changes to their relative's care. We saw staff listened to the relatives input about their family member's care needs and their wishes.

We saw that the care plans were person centred and reflected the people�s individual needs. We saw the member of staff supported the person as detailed within their care plan. We saw care plans were easy to read and had pictures to help people understand their care plan.

A person we spoke with told us that staff were friendly and supported their needs well. We saw staff knew what people's care needs were and how they needed to be supported.

We spoke with the staff member about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse.

Inspection carried out on 13 September 2012

During a routine inspection

We visited the service on two occasions, on 24 August 2011 to meet with the manager and again on 13 September 2011 when we spoke with two people staying in the home and staff.

Milner House is a new respite service, registered in July 2011.

There were no visitors in the home on the day of the visits. We saw that the home provided a small, homely and comfortable living environment for up to three people staying there on a respite basis.

People spoken with said that they were happy to be there and saw their stay as a �kind of holiday� as well as giving a break to their home carers.

They told us that they really liked the new home, the bedrooms and the facilities available. One person said that they particularly liked the en-suite bathroom and that this enabled them to be independent and access facilities easily. They said the home was really clean.

They said that staff helped them in the way that they wanted. �they are very kind.� They said that someone had been to see them before their stay and discussed their care needs.

They told us that they liked the food provided and that staff checked to see what they liked and disliked and if some foods should not be eaten. �They have a list of what I can�t eat, I am very particular.�

People told us that staff at Milner House always spoke to them nicely and were never rude or abrupt.

They told us that they would be happy to tell staff or the manager if they were unhappy with anything about the service.