Michdeede LTD

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always treated people with kindness, compassion and dignity. Relatives told us staff were kind and caring towards their family member and “looked after them well,” and staff spoke respectfully about people and demonstrated they knew them well. Staff described taking time to build relationships and interact positively, for example one staff member said, “I ask what do you want… I am here for you I have time,” showing a person-centred approach.

Staff respected people’s preferences and routines, such as supporting personal care when the person was ready and giving them time to eat without rushing.

The provider treated people as individuals and respected their personal preferences, although this was not always supported by consistent records. Staff demonstrated they knew people well, including their preferences and interests, and described tailoring support based on what people wanted on the day. For example, staff explained they would ask people about their choices, respect decisions about personal care, and support them to maintain routines that were important to them. The provider also supported people’s cultural and religious needs, such as enabling a person to attend religious meetings online and making adjustments to ensure this was not restricted.

However, these person-centred practices were not always reflected in written care records. Care plans were not consistently personalised, and in one case did not refer to the person by name. Staff told us they had not seen care plans and relied on verbal handovers, which increased the risk that people’s individual needs and preferences may not always be consistently understood or met.

The provider did not always support people to have control over their care. Staff described supporting people to make day-to-day choices, such as asking consent before care and respecting when people declined support. Staff also encouraged independence where possible, for example supporting people to eat independently using adapted equipment or maintaining routines important to them.

However, this was not consistently underpinned by clear information or systems. There was no evidence people, or their relatives had been consulted and involved in care planning. In addition, records stated reviews had taken place of care but relatives and people told us they had not been part of any care reviews. The registered manager made reference to a service user charter which was not available and people and their relative told us they had not seen it, which meant people may not have had full awareness of their rights and options.

The registered manager informed us they tried to provide staff that met people’s preferences and respected people’s decision to change a member of staff.

The provider did not always respond effectively to people’s immediate needs. Staff showed some understanding of how to recognise and respond to people’s needs, and communication between staff teams, such as through messaging groups and direct contact, supported day-to-day care delivery. Staff also described staying beyond their scheduled time when required, for example when services such as ambulances were delayed, which demonstrated a commitment to meeting people’s needs

For example, care plans stated what to monitor people for especially if they had accessed health services for treatment. However, staff had never seen or had access to this information.

Due to the absence of clear, accurate and accessible care plans staff did not always have the information needed to respond appropriately to changing or urgent needs.

Records did not consistently demonstrate how people’s needs were monitored or how follow-up actions were carried out, which could lead to delays or inconsistent responses. Staff reliance on verbal guidance rather than documented care information increased the risk that people’s immediate needs would not always be recognised or responded to in a timely or consistent way.

The provider did not ensure staff were supported, trained and enabled to deliver safe, effective care. Staff consistently told us they had not received appropriate induction, training or supervision, and some had not completed any training since starting their role. A member of staff said, “I need more training if I can have it,” highlighting significant gaps in development and support.

Systems to support staff wellbeing and professional development were not embedded. Supervision and appraisal processes were not carried out in line with the provider’s policies, and the provider acknowledged this during the assessment. Recruitment and induction processes were also not robust, with missing records and no oversight of staff competency.

Although staff described the registered manager as approachable and said they could make contact if needed, this informal support did not mitigate the risks associated with the lack of structured training, supervision and governance. As a result, staff were not consistently equipped, supported or enabled to meet people’s needs safely and effectively.