Milestones Supported Living Service

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.

The five questions we ask about services and what we found