Milestones Supported Living Service

Updated 15 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out by one adult social care inspector, who visited on 31 October, 1 and 6 November 2018. We last visited the service in August 2016 and found no breaches of regulations.

We used a variety of methods to obtain feedback from those with knowledge and experience of the service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make.

We reviewed the information included in the PIR along with information we held about the service. This included notifications, which is information about important events which the service is required to send us by law.

We contacted the local community learning disability team and commissioners. We asked them for some feedback about the service. You can see what they told us in the main body of the report.

During the inspection we talked with five people using the service. We visited people at four different locations. In two services people lived on their own and, in the other two people shared with others. These were supported living services. This means they were people’s own homes. The provider had asked people if they were willing to speak to us prior to our visit.

We talked with seven staff including three project managers, two project co-ordinators, three support staff, the head of service, an area manager and the registered manager.

We looked at the care records of five people, staff duty rotas and other records relating to the management of the service. After the inspection we spoke with two relatives to gain their views.

Updated 15 December 2018

The inspection took place on 31 October, 1 and 6 November 2018. The provider was given 48 hour notice as the location provides a community based service and we needed to be sure that a member of the management team would be available on the day. We spent time in the office and a day visiting people. We then returned to the main office on 6 November 2018 and provided feedback to the senior management team.

Milestones Supported Living Service provides personal care and support to people with a learning disability and/or mental health needs to live in their own homes either on their own or sharing with others in supported living services. A supported living service is one where people receive care and support to enable them to live independently. People have a tenancy agreement with a housing provider and receive their care and support from Milestones Supported Living Trust.

As the housing and care arrangements are separate, people can choose to change their care provider and remain living in the same house. At the time of the inspection the service was supporting 244 people across 186 locations across Bristol and South Gloucestershire. Of the 244 people they were supporting, 43 people were receiving support with personal care, as defined in the Health and Social Care Act 2014 regulations. They also provided and supported people to access leisure and day care services. This part of the business does not fall within the scope of registration.

There were two teams that worked separately from each other in supporting people with either a learning disability or a mental health condition . The registered manager had the legal responsibility to support and manage both teams. 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.

The service was not always responsible for people’s accommodation, however we found they had ensured people’s homes were safe and comfortable, through effective liaison with the landlords and other relevant agencies. The Care Quality Commission’s role in these settings was to focus on the regulated activity of personal care and we had no regulatory responsibility to inspect the accommodation for people living in these settings. Environmental risk assessments had been completed.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes. There were policies in place for lone working for staff.

Staff were extremely caring and supportive and demonstrated a good understanding of their roles in supporting people. People were very much the centre of their care and involved in the recruitment of their staff teams. Where people shared a service a compatibility assessment was completed to ensure living in shared accommodation was right for them. Staff were committed to providing a service that was tailored to each person they supported. Staff were enthusiastic and worked with people to enable them to achieve positive outcomes. They understood their roles in relation to encouraging people’s independence whilst protecting and safeguarding people from harm.

Systems were in place to ensure open communication including team meetings and one to one meetings with their manager. Staff were trained and supported in their roles.

People were involved in the day to day running of the service. People were valued and supported to be as independent as possible. People’s rights were upheld, consent was always sought before any support was given. Staff were aware of the legislation that ensured people were protected in respect of decision making and any restrictions and how this impacted on their day to day roles. Staff strongly advocated for people to live the life they wanted whether that was on their own or in shared housing schemes. This was kept under review as people’s needs or wishes changed.

The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people felt included and their views were sought. Systems were in place to monitor the quality of the care and continually making improvements by listening to people.