The inspection of Milton Lodge took place on 27 March 2017 and was announced. We gave the provider 48 hours' notice because this was a domiciliary care serviced and there were times when the manager was out of the office supporting staff or visiting people who used the service. We needed to be sure that someone would be in the office.

Milton Lodge is based in Bognor Regis and is registered to provide personal care to people in their own homes. When we inspected the service there were 19 people receiving support in five properties. 18 of which, received personal care. There was a main building containing five flats, two studios and two bungalows. The office was based on the same site as people’s homes. Each person held a tenancy with their landlord. The service is registered to support people who have a learning disability and people who live with autism.

At the time of the inspection, there was no registered manager at the service. However, there was a manager in post, who commenced in January 2017; they had submitted an application to register with the Care Quality Commission (CQC). 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.

Risks to people's wellbeing and safety had been effectively mitigated. We found individual risks had been assessed and recorded in people's care plans. Examples of risk assessments relating to personal care included moving and handling, nutrition, falls and continence support. Health care needs were met well, with prompt referrals made when necessary.

People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.

Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. There were sufficient levels of staff to protect people's health, safety and welfare in a consistent and reliable way.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.

The management team and staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had made appropriate applications to the relevant authorities to ensure people's rights were protected.

People chose their own food and drink and were supported to maintain a balanced diet where this was required.

People said staff were caring and kind and their individual needs were met. Staff knew people well and demonstrated they had a good understanding of people's needs and choices. Staff treated people with kindness, compassion and respect. Staff recognised people's right to privacy and promoted their dignity.

We looked at care records and found good standards of person centred care planning. Care plans represented people's needs, preferences and life stories to enable staff to fully understand people's needs and wishes. The good level of person centred care meant people led independent lifestyles, maintained relationships and were fully involved in the local community.

Staff felt supported by management, they said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service.

There was a complaints policy and information regarding the complaints procedure was available. Complaints were listened to, investigated in a timely manner, and used to improve the service. Feedback from people was positive regarding the standard of care they received.

The manage

Milton Lodge provides personal care and support to people in four independent living services in addition to supporting people in their own homes. The service had recently relocated the office that dealt with the domiciliary care service and as a result of additional space had expanded a drop in centre that all people they were supporting from all parts of the service could access. At the time of the inspection 90 people were being supported by Milton Lodge.

We visited and spoke with four people who were receiving support in the independent living services. They told us that that staff helped them with things they found difficult like cooking or managing their money. One person said that “staff really help me live my life.”

People told us that staff were “very friendly” and cared about us. They showed us that they had been involved in building their support plans and told us that staff looked after their health.

People felt safe. Staff demonstrated appropriate knowledge and understanding of the different types of abuse and processes were in place to safeguard people.

Staff had received relevant training to help them support people’s needs and were supported to continue their development and skills through regular supervision.

Systems and processes were in place to monitor the quality of the service to ensure that people’s needs were met. People's views and experiences were sought and considered in the development of the service.