Milton Lodge

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.

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.