• Services in your home
  • Homecare service

Milestones Support Services

Overall: Requires improvement read more about inspection ratings

101 Lockhurst Lane, Coventry, West Midlands, CV6 5SF (024) 7507 0350

Provided and run by:
Milestones Private Limited

All Inspections

28 April 2023

During an inspection looking at part of the service

About the service

Milestones Private Limited is a domiciliary care agency which is registered to provide personal care and support to people in their own homes. The service offers daytime and night-time care and support. The service is registered to provide support to children from 4 to 18years old, older people, younger adults, people with mental health needs, a learning disability or autistic spectrum disorder, and a physical disability. At the time of our inspection the service was supporting 8 people with 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.

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 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.

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

Right Support:

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. People were supported by staff who understood and were trained in recognising the signs of abuse. Risks associated with people’s care were assessed but the management of risks was not always sufficiently recorded to demonstrate people had received the right support. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Arrangements were in place to ensure a consistent group of staff supported people. Families said staff usually arrived at the times agreed to provide the support needed to people. Staff knew people’s preferred communication needs and relatives confirmed staff were able to communicate effectively with people.

Right Care:

People’s needs were met through the delivery of care and support tailored to meet their needs and preferences although some areas of risk management needed improvement. People's needs were assessed prior to them using the service to ensure these could be met. Care plans been completed involving people and their family members where appropriate. Staff supported people’s privacy, dignity, and cultures. Relatives told us staff were respectful to their family member. Staff told us they had completed regular training and had the skills and knowledge required to meet people's specific needs. Staff were aware of people’s nutritional needs and supported people to eat and drink where this was required. People’s preferred method of communication was established and respected by staff.

Right Culture: The registered manager promoted an open and inclusive culture which had created a welcoming, warm, and friendly approach. People’s families spoke positively about the way the service was managed and the quality of service provided. Records across the service were not always clear to demonstrate effective systems were in place to capture people’s feedback and demonstrate any issues for improvement had been acted upon. Staff recruitment checks had not been fully completed before they started to work for the service to confirm they were safe and suitable to work with people. Some reportable incidents had not been notified to CQC as required. Staff were positive in their views of the service and support they received and confirmed the registered manager was approachable and available when they needed them.

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 requires improvement (published 13 February 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Milestones Private Limited on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

27 January 2020

During a routine inspection

About the service

Milestones Private Limited is a domiciliary care service which provides care for six young people with a learning disability and or/autism living in the community. 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.

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.

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.

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

Relatives and healthcare professionals were unanimously positive about the staff and the management of the service. However, as the service was quite new and only provided care to a small number of people, it was not possible to fully assess if the systems to learn, improve and ensure sustainability were fully effective. Improvements were required to staff employment records.

People received support from a small team which ensured they received consistency and continuity of care. Risks to providing people’s care and support had been identified and care plans included the actions staff should take to minimise the identified risks. Staff understood their responsibility to keep people safe from abuse and avoidable harm.

Relatives had confidence in the ability of staff to deliver effective care. People were supported to be in the best possible health and staff worked with other agencies to ensure people accessed all the support they needed. Staff had information about people’s nutritional likes and dislikes and the level of the support they needed to ensure they ate and drank enough to maintain their health.

The nominated individual demonstrated a thorough understanding of their legal responsibilities under the Mental Capacity Act 2005. 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.

Staff were caring because they took time to understand people’s behaviours, routines and motivation. People's care plans reflected any diverse needs which helped staff to recognise and understand aspects of people's life which were important to them. People's care was planned in partnership with them and their families and they were involved in choosing the staff who supported them.

The care people received reflected their individual needs and preferences and was flexible to accommodate people’s plans and routines. People’s social and cultural interests were considered and there was a proactive approach to encouraging people to try new experiences.

Rating at last inspection

We did not rate the service at the last inspection as it had only been providing support for one person for a short time. (Published 30 July 2019).

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 programme. If we receive any concerning information we may inspect sooner.

22 July 2019

During a routine inspection

About the service

Milestones Private Limited is a service which provides care for one person living in the community.

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.

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.

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.

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

There was a registered manager who had been in post since the service was registered. Prior to this the service had been ‘dormant’ as no people were receiving personal care support.

There were enough staff to ensure people were safe. Where risks associated with people's health and wellbeing had been identified, plans were in place to manage those risks while ensuring people could remain independent.

Staff understood their responsibility to safeguard people from harm and knew how to report concerns.

People received care which was responsive to their individual needs. Staff had a good understanding of how to support them well.

Care records provided information in relation to people’s backgrounds, interests and care needs.

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; systems supported this practice.

The provider ensured care was based upon good practice guidance to help ensure people received an effective service.

Staff were caring in their approach and had good relationships with people. Promoting independence was encouraged, people were supported to improve their daily life skills and offered choices.

Staff prompted people to have pre-prepared meals. The provider and staff team worked closely with external healthcare professionals to ensure people's health and wellbeing was maintained.

Positive feedback was received in relation to the management of the service. Quality checks were in place to monitor the care provided.

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

Rating at last inspection

This service was registered with us on 22 April 2018 and this was the first inspection as prior to this, the service was not supporting any people. We did not rate the service as it had been providing support for one person for a short time.

Why we inspected

This was a planned inspection.

Follow up

We will return to visit as per our re-inspection programme which is six months for a service inspected, but not rated. If we receive any concerning information we may inspect sooner.