Milton Lodge

Updated 13 February 2020

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

An inspector completed this inspection.

Service and service type

Milton Lodge is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

This was an unannounced inspection.

What we did

We reviewed information we had received about the service, which included details about incidents the provider must notify us about, feedback from the local authority and professionals who work with the service. 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 the information to plan our inspection.

During the inspection

We spoke with seven people who used the service about their experience of the care provided by the service. We spoke with the registered manager, two senior care staff and three support workers.

We reviewed a range of records. This included three people's care records, medication records and various records related to recruitment, staff training and supervision, and the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 13 February 2020

About the service

Milton Lodge is a care home which provides residential care for people who are living with a learning disability and may other needs such as mental health conditions.

Milton Lodge is a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. Twelve people were using the service. This is larger than current best practice guidance, Registering the Right Support. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The registered manager and staff consistently demonstrated they valued and respected the people who used the service. The staff were passionate about supporting people to lead lives with meaning and develop the skills they needed to become more independent.

We found staff were committed to delivering a service which was person-centred. 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 took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately and lessons were learnt, which helped to keep people safe. The registered manager ensured people's support needs were thoroughly assessed and potential risks were effectively mitigated. The staff team had received bespoke training from the local community forensic learning disability team around supporting people with complex needs and those who may have a history of offending. Staff promoted equality and diversity within the home.

Staff supported people to manage their healthcare needs and promoted their wellbeing. When necessary, external professionals were involved in individuals care. The staff supported people to eat varied appetising meals. Medicine was administered in a safe manner.

Thorough checks were completed prior to staff being employed to work at the service. Staff had received appropriate training and supervision. The registered manager had enabled staff to access a varied and extensive range of condition specific training. The staff had found the range of training they received assisted them to significantly improve people’s quality of life, support people who struggled to manage their impulse control and mitigate potential risks.

People’s voices were of paramount importance in the service. The registered manager understood how to investigate and resolve complaints.

The service was well run. Systems were in place, which effectively monitored how the service operated and ensured staff delivered appropriate care and treatment.

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

Rating at last inspection

Good (report published 27 April 2017).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.