Milestones is a residential care home for four people with learning disabilities. At the time of our inspection there were four people using the service.

At the last inspection on 30 April 2015, the service was rated Good. At this announced inspection we found the service remained Good.

We found improvements to staff recruitment procedures and to records about people’s medicines.

We heard positive comments about the service such as, “I like living at Milestones.” and “A nice place to work.”

Staff and management understood how to protect people from harm and abuse. Risks to people's safety were identified, assessed and appropriate action taken.

People were supported by a small staff team who had training and support to maintain their skills and knowledge to meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People were treated with dignity, respect and kindness and were involved in the planning and review of their care and support. People were supported to maintain and develop their independence.

People received individualised care which reflected their personal preferences, wishes and routines. There were arrangements to investigate and respond to complaints.

Quality checks were made with the aim of improving the service in response to people's needs.

Further information is in the detailed findings below.

The inspection took place on the 30 April 2015 and was unannounced.

Milestones is a home for up to four adults. People living at the home have a range of needs including learning disabilities. At the time of our inspection there were four people living at the home.

The home had a registered manager. 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.

People were not protected from the risk of being cared for by unsuitable staff because robust recruitment practices were not operated. Medicines were generally well managed although checks had not been made on the accuracy of hand written directions for a person’s medicine. People were supported by sufficient numbers of staff who received appropriate training and had the right knowledge and skills to carry out their role. People were protected from the risk of abuse by staff who understood safeguarding procedures.

People were supported by staff with the knowledge and skills to carry out their roles, including knowledge of the Mental Capacity Act 2005. People were active in choosing menus and received support to eat healthily. People were supported to maintain their health through support in accessing healthcare.

People were treated with respect and kindness, their privacy and dignity was respected and their desire for independence understood and promoted.

People received individualised care through regular review and consultation by staff. People were enabled to engage in a range of activities of their choice. There were arrangements to respond to any concerns and complaints by people using the service.

The vision and values of the service were clearly communicated to staff. Quality assurance systems taking into account the views of people using the service were in place to monitor the quality of care and safety of the home.

On entering Milestones we found the atmosphere warm and welcoming. We spoke with a number of people living at the home and observed staffs understanding of the care and support needed. The people who used the service we spoke with said that staff "are brilliant." One person told us that it was their "choice to be here" and that they liked "the freedom." We saw the rooms were tastefully decorated with their personal belongings.

We looked at people's individual files which incorporated their personal profile, care plans and risk assessments and found they encompassed the safety and well-being of people who use the service. People who used the service told us that they knew how to raise a concern or complaint and felt confident in doing. They said if they had any issues or concerns they could "talk to the staff." There were policies and procedures in place providing guidance and all staff had received safeguarding and medicines training which were identified on the training schedule. Staff told us they were supported by management and that they received regular training. The quality of the service was monitored at local and provider level through regular spot checks. People who used the service, professionals and families were provided with the opportunity to give feedback regarding the running of the service.

We spoke to one person using the service who told us that Milestones was "alright". They told us how their privacy was respected. They also told us about their favourite activities and how they were able to do their “own thing".

They also told us about the health checks they had received and what they would do if they needed to make a complaint.

We asked to speak to another person but they did not wish to speak with us.