Milton House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This inspection took place on 22 March 2018 and was unannounced. This was the first inspection of the service following its registration in April 2017.

Milton House provides personal care and accommodation for up to six adults with complex learning disabilities and mental health illness. Some people were also living with sensory issues, physical disabilities and behaviours that may cause harm to themselves or others. At the time of our inspection there were three people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. This service had been adapted to suit the individual complex needs of the people who lived there.

People living at the service were not socially excluded due to their behaviours because they were enabled to live their chosen lifestyles with intensive specialised care from staff. People had moved to this service within the last year from other services.

The building was spacious and airy and has been designed with input from behaviour support specialists to meet individual needs. The service had a communal kitchen, dining/lounge room and secure garden.

There was a registered manager in place. 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 safeguarded from avoidable harm. Staff adhered to safeguarding adults procedures and reported any concerns to their manager and the local authority.

Staff assessed managed and reduced risks to people’s safety at the service and in the community. There were sufficient staff on duty to meet people’s needs. Staff understood and practiced the principals of Positive Behavioural Support (PBS). A method of supporting people who display, or are at risk of displaying, behaviour which challenges.

Staff were able to recognise that harmful behaviours were also a form of communication.

The provider gave people the opportunity to share their views by training staff to understand people's communication styles, using objects of reference and collecting detailed data about people’s moods, facial expressions and body language.

Safe medicines management was followed and people received their medicines as prescribed. Staff protected people from the risk of infection and followed procedures to prevent and control the spread of infections.

Staff completed regular refresher training to ensure their knowledge and skills stayed in line with good practice guidance. Staff shared knowledge with their colleagues to ensure any learning was shared throughout the team.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff liaised with other health and social care professionals and ensured people received effective, coordinated care in regards to any health needs.

Staff applied the principles of the Mental Capacity Act 2005. 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 supported this practice. An appropriate, environment was provided that met people’s needs.

Staff treated people with kindness, respect and compassion. They were aware of people’s communication methods and how they exp