Archived: Middle Path

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led.

Leaders and the culture they created promoted high-quality, person-centred care.

People were able to tell us or express they were all very happy living at the home. Relatives were happy with the care and support provided to their family member.

Professionals who supported people's care were very complimentary about people's care and support, the staff team and their approach in providing care.

People, relatives, staff and professionals had improved confidence in the management of the service since the new manager had been in post.

The provider carried out regular audits and visits to review quality. The provider’s serviceimprovement plan was being worked through when we visited. Many improvements identified had already been completed by the new management team.

There was a clear ethos for the service going forward. The home was going through a period of significant cultural change. The manager had worked hard to foster a culture where people could speak up and their voice would be heard.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We had received concerns the management of the home had been inconsistent. It was also reported staff had felt unsupported during a time of significant change in the service.

We found the current management team understood the context in which they delivered care and support and embodied the culture and values of the organisation. They had the skills, knowledge and experience to lead effectively and did so with integrity, openness and honesty.

There was a new permanent home manager who was applying to register with the CQC. They had been in post for several months and had made many improvements to the quality of people’s care and to the culture, involvement and morale in the staff team. They had been closely supported by 1 team leader.

Staff we spoke with were positive about the support they now received. Staff felt they were now empowered, but had not always felt this way in the past and the service had been allowed to 'drift'. Staff acknowledged both their involvement and input had improved under the new home manager and hoped this would continue. One staff member said, “[The manager] is approachable, experienced, happy for staff to take initiative and suggest ideas and takes on feedback.”

Communication and engagement with relatives had also significantly improved; they had renewed confidence in the management of the home. One relative said, “Under the previous management phone calls, emails and agreed actions were ignored. Following the appointment of [the current manager] things have improved [and this must continue].” Another relative told us, “Previously, I never heard from management. [The current manager] was very proactive when he came on board. He called me to introduce himself and I get regular emails.”

People were enabled to live a fulfilled, ordinary life, as part of their community. Some people had lived at Middle Path for many years. They were clear this was their home and they felt happy secure, comfortable and settled.

We had received concerns that during the cultural change in the home, staff had felt they were not listened to or consulted as part of this process. The concerns also suggested staff had been reluctant to speak up and, if they did, they were not listened to. We therefore spent time talking with staff about this topic.

Some staff told us this had been an issue in the past, but the culture had significantly improved since the new manager had started working at the home. It was evident the manager had worked hard to foster a culture where peopleand staff could speak up and their voices would be heard. One staff member said, “I definitely feel supported. Team meetings, we have every month. We can all speak up and feel listened to.” Another staff member told us, “Team meetings have been regular the last few months. We can speak up and are listened to. Everyone has a say.”

Staff we spoke with were aware of the provider’s policy on whistleblowing and knew how to whistle blow should the need arise.

People were clearly able to express their views and they were listened to. We saw staff listened to people and acted on what they said. There was a very good rapport between people and staff.

Relatives told us they were involved in their family member’s care and their views were taken into account. One relative told us, “Yes, most definitely I feel involved; they’re very good at keeping me in the loop.” Another relative said, “Yes, they listen to concerns. The [one issue I raised] they listened to and took on board, so I don’t have to worry.”

The provider had a complaints process in place. The manager shared how staff had explained the complaints procedure to people which took each person’s communication needs into consideration.

We had received concerns that not all staff had been treated equitably or been empowered in their roles.

We found the provider worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. It was evident the manager had worked hard to improve things for the staff team and restore trust between staff, managers and the wider organisation.

Staff told us they thought everyone was now treated equally.

We had received concerns that the provider did not have good oversight of the home and the quality of care was declining.

We found the provider had clear responsibilities, roles and good governance. They used these to manage and deliver good quality care and support and promote improvement.

The provider carried out regular quality audits on the service. We reviewed the most recent audit completed in February 2025. This identified many improvements were required. These were then added to a ‘service improvement plan’. Most of the improvements had been completed throughout February and March 2025.

People were able to tell us or express they were all very happy living at the home. Relatives were happy with the care and support provided to their family member. One relative said, “[Name’s] settled there which is good and has always been happy there which is really good.”

The model of care is in line with current best practice guidance, ‘Right support, right care, right culture’. The management team and the staff team had a strong focus on good outcomes for people, enabling them to live the life they chose.

The house had a very family oriented, homely and relaxed feel. There was a part of the house used as a self-contained annex. This enabled 1 person to live more independently, as this was their preference and met their individual needs.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.