Milestones Private Limited received an overall rating of Requires Improvement, with breaches of Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) identified, relating to inadequate risk management, incomplete pre-employment checks, and ineffective governance systems. The service has now been rated Requires Improvement for two consecutive inspections, though families and staff spoke positively of the caring culture and the approachable registered manager.
Concerns (8)
criticalCare planning: “Risks were not always fully assessed to ensure people and staff were kept safe from harm. This included some risks associated with behaviours which had resulted in injuries to people.”
criticalStaffing levels: “Staff who had transferred into the service did not have completed references and a Disclosure and Barring Service (DBS) check in place before they started work.”
criticalGovernance: “Systems to monitor the quality and safety of the service did not ensure all aspects of the service were checked to drive improvement.”
criticalOther: “Statutory notifications had not been sent to us as required. This is information about important events such as police contact which the provider is required to send to us by law.”
moderateIncident learning: “During our last inspection it was identified that recruitment records were not sufficiently robust. This continued to be the case. Lessons had not been learnt.”
moderateSafeguarding: “There was a system to support the service in managing abuse to safeguard people but there was no central record of safeguarding concerns.”
moderateRecord keeping: “Daily records staff completed did not reflect the times staff arrived or times when specific care was provided to people to demonstrate this was in accordance with expectations.”
minorConsent / capacity: “Some staff were not clear in their knowledge of the MCA despite having completed training.”
Strengths
· People were supported by a consistent small staff team ensuring continuity of care.
· Families spoke positively about staff being caring, respectful of dignity, privacy, and cultural needs.
· Staff received medicines training; families were satisfied with medicines support; GPs contacted appropriately for repeated refusals.
· Staff wore appropriate PPE and had received infection prevention and control training.
· Care plans included personalised information about likes, dislikes, preferences, and communication needs.