We carried out a review of the data available to us about Middleton St George Healthcare Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Middleton St George Healthcare Limited, you can give feedback on this service.
Middleton St George Healthcare Limited is a residential care home providing personal care for up to 3 people. The service provides support to younger adults with mental health conditions. At the time of our inspection there were 3 people using the service.
People’s experience of using this service and what we found
Medicines were managed safely. Infection prevention and control processes protected people from the risk of infections. People told us they felt safe. The staff team were consistent and had a good understanding of how to care for people who lived at the service. Risks to people were assessed and measures were put in place to reduce them.
Staff received regular training, supervisions and appraisals. People were supported to maintain good health and well-being. They were encouraged to maintain a balanced diet and their nutritional needs were met. The environment was adapted to meet people's needs and staff supported people to access health services where needed.
People's care was personalised. Staff knew people's needs, life histories and preferences well. People told us staff were caring and spoke positively about living at the home.
Care plans were regularly reviewed, and staff could access relevant information to ensure they continued to provide the support people needed. People were supported to follow their interests and participate in social activities.
There were effective systems in place to monitor the quality and standard of the service. People and staff were asked regularly for their feedback. The registered manager was passionate about ensuring people were at the heart of everything they did. Staff felt supported and spoke positively about the registered manager.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 19 October 2017).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We last inspected the service on 8 and 11 September 2015 and rated the service as Good overall. We found the service was meeting all of the regulations we inspected against at that time. At this visit the service continued to be rated as Good and met all required regulations.
Station Road is situated in a residential area of Darlington and provides care for up to three individuals with mental health problems. People using the service were previously patients at the Priory Hospital Middleton St George and are moving towards returning to the community. At the time of our visit there were two people using the service.
There was a registered manager in post. 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 (2014) about how the service is run.
One person told us they felt safe at Station Road. We discussed safeguarding with the member of staff on duty and the registered manager and they were knowledgeable about the procedures to follow if they suspected abuse. We saw information displayed for staff and people using the service to use to contact external agencies if they had any worries or concerns.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The service worked with people to discuss their support plans and risk assessments in a way that was meaningful to them.
We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety requirements were met.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Staff had received a range of training to meet the needs of people using the service and health and safety requirements. One person and the staff member we spoke with told us that there were enough staff on duty to meet people’s needs. There was a very consistent staff team who worked a 24 hour shift pattern that provided continuity of support for people.
There was a regular programme of staff supervision in place. Records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a programme of staff meetings where issues were shared and raised.
The service encouraged people to regain their independence. People were supported to be involved in the local community as much as possible. People were supported to independently use public transport and in accessing regular facilities such as the local G.P, shops and leisure facilities, as well as to use the facilities in the service such as the kitchen for cooking meals. We found that people were encouraged and supported to take responsible risks and positive risk-taking practices were followed. We saw from our last visit that people’s independent living skills had increased hugely with staff support and they were now cooking and shopping for themselves several days a week.
There was a system in place for dealing with people’s concerns and complaints. One person we spoke with told us that they knew how to complain and felt confident that the staff or registered manager would respond and take action to support them.
We saw people had nutritional assessments in place and people with specific dietary needs were supported. Specialist advice was sought quickly where necessary. We spoke with the consultant psychiatrist for the service who was positive in the way the service and staff supported people and their mental and physical health.
We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service on a regular basis and used any information to improve the service provided.
The inspection visit took place on the 8th and 11th September 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the service on 7th August 2014 and found the service was not in breach of any regulations at that time.
Station Road is situated in a residential area of Darlington and provides care for up to three individuals with mental health problems. People using the service were previously patients at the Priory Hospital Middleton St George and are moving towards returning to the community. At the time of our visit there were two people using the service.
There is a registered manager in post. 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 (2014) about how the service is run.
People told us they both felt safe at Station Road. We discussed safeguarding with the member of staff on duty and they were knowledgeable about the procedures to follow if they suspected abuse. We saw information displayed for staff and people using the service to use to contact external agencies if they had any worries or concerns.
There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with behaviour that may challenge. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. There was a very consistent staff team who worked a 24 hour shift pattern that provided continuity of support for people.
There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a programme of staff meetings where issues were shared and raised.
The service encouraged people to maintain their independence. People were supported to be involved in the local community as much as possible. People were supported to independently use public transport and in accessing regular facilities such as the local G.P, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals. We found that people were encouraged and supported to take responsible risks and positive risk-taking practices were followed. Those people, who were able to were encouraged and supported to go out independently or with staff support where for safety it was needed. People told us that they made their own choices and decisions and these were respected.
There was a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that the staff or registered manager would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
People told us they were involved in planning their meals and were encouraged to help prepare food with staff support if they wished. We saw people had nutritional assessments in place and people with specific dietary needs were supported. Specialist advice was sought quickly where necessary.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and risk assessments and how they had worked with staff to develop and review them.
We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.
We found that the building was clean and generally well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety requirements were met. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.
We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service and staff who worked there, and looking at records.
Is the service caring? ' Two people told us they were given choices about how their care and support was provided and that these were respected by the service. We spoke with two people who used the service who were complimentary about the staff and stated they could raise any issue with them.
Is the service responsive? - The service regularly sought views of people who used the service using the service and visitors via meetings. The home had a complaints policy and procedure that was accessible, people had access to advocates and solicitors and people told us they could raise any issue with the managers or staff. We saw that staff were prompt to seek additional support from healthcare specialists if support was required for people who lived at the home.
Is the service safe? ' The service had safeguarding policies and procedures in place and the manager and staff we spoke with knew how to respond to any concerns that were raised with them. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and appropriate assessments had been completed where required. People told us they were aware of their rights under their Community Treatment Orders and also had access to external agencies such as advocates and solicitors.
Is the service effective? ' We saw that care plans had a person centred format, and they showed how people's views and preferences about their care had been recorded. People were supported to undertake a variety of activities and community activities, and both people we spoke with said they were happy loving at the service.
Is the service well-led? ' We saw that staff had a training and supervision programme in place and there was a regular programme of staff meetings. Staff had clear roles and responsibilities and we saw the manager visited regularly and carried out checks to ensure the service was safe.
What people told us ' We spoke with two people who lived at the service, one member of staff and the registered manager.
People told us;
'I am going to Hebburn for a trip out today and last week I went to Whitby'.
'We've had it all decorated in the lounge here, I picked the colour'.
'We are also getting new carpets, beds and a new dining table and chairs'.
'We can go out when we want to here'.
'I cook a couple of times a week but I need some help from the staff to get it right'.
'I see Dr X (a psychiatrist) whenever I want'.
'I am going to see my dad today; the staff take me to see him'.
One staff member told us; 'We try to promote their independence as much a possible but it takes a lot of prompting'.
We saw care plans were up-to-date and there was evidence of people's involvement in them and their care and support.
The home was well furnished and decorated and we were told a badly stained carpet in the hall and landing was being replaced. The home undertook regular checks on safety in the home as well as having an audit system in place to check the quality of the service.
'I've got my freedom to go to the shop',
'They look after us, they are all good chefs',
'I go to the gym and the drop-in centre',
'I sweep the backyard, and we are going to plant some sweet peas in the garden. Look, I've just bought a gardening magazine'.
'My bedroom is the biggest out of the three',
'Sometimes I make myself a sandwich',
'I can use the phone when I like to keep in touch with my family',
'We go out on trips to the seaside and the garden centre',
'I'd like to move into my own place' and
'I go and see my mam and dad regular; the staff take me there'.
The people using the service appeared confident when approaching staff, and the interactions we saw were positive and respectful. Talking with staff whilst at the home, it was clear they had a good knowledge of the people living there and they gave lots of encouragement and praise. One staff told us about one individual; 'I have fought his corner for a long time as he needs a friend and I have known him for a long time