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Inspection report

Date of Inspection: 9 July 2014
Date of Publication: 7 August 2014
Inspection Report published 07 August 2014 PDF


Inspection carried out on 9 July 2014

During a routine inspection

The inspection team consisted of one inspector. During the inspection, we spoke with five out of nine people living at Middleton Lodge, the manager, the deputy manager and six staff. We looked at three sets of care records. We also observed care practices within the home.

The service had a new manager in post. At the time of the inspection they were going through the registration process. The management of the home was good and we saw strong leadership in place and a positive environment for people and staff. Staff spoke highly of their manager and the support which they received.

We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Peoples care plans were person centred and provided information on what people liked/disliked, how people liked to be woken up of a morning and how staff should behave around them. Middleton Lodge uses a system called Caresys, where they update people's care plans on a monthly basis, log daily notes and any accidents and incidents.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care home. While no applications had needed to be submitted the home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and there was evidence to show that this had been followed appropriately. Staff had received training in relation to these topics along with the safeguarding of vulnerable adults and had an understanding of the actions to take. This meant that people were safeguarded as required.

Middleton Lodge was clean and tidy; although the provider may wish to note that the communal bathroom boxed in area was bare wood, majority of carpets needed replacing or required a deep clean and the settee in the main lounge had a tear.

Is it caring?

The majority of people who lived at Middleton Lodge could not communicate verbally; there was information in the care plan about �how I communicate.� Middleton Lodge had also devised a small communication booklet for one person who used the service. This was so that the person and the staff could communicate effectively. The manager stated that they are planning to do this for all people who could not communicate verbally.

Peoples care plans provided information on their medical and personal life history. The care plans detailed 'what I can do for myself,' 'what support I need' and 'how the home will meet my needs in this area.' Care plans were individualised and included people's preferences, interests, aspirations and diverse needs.

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People, who could communicate verbally, told us that they were happy with the care and support provided to them.

People who used the service were supplied with an easy read �service user guide�, Depravation of Liberties information and how to make a complaint.

Is the service effective?

Everyone had their needs assessed and had individual care records which set out their care needs. It was clear from our observations and from speaking with staff that they had a good understanding of the care and support needs of people living at the home and that they knew them well. Assessments included money management and behaviour that challenges.

People spoke highly of the staff and said that they were happy with the care that had been delivered and their needs had been met.

Is the service responsive?

There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals. People told us that they knew how to make a complaint if they needed to. The home was responsive to people's needs, wishes and preferences.

One person who used the service had a �coming home plan� for when they returned from a day centre. Every member of staff we spoke with, were aware of this plan and the reasons behind it.

People using the service and the staff, completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed with an action plan. The staff survey mentioned the need for a sensory room and money they received from a �staff excellence� award had been used to purchase items for this.

Is the service well led?

We did see a cleaning schedule, but more robust audits needed to be in place to make sure this schedule was adhered to and was working. The manager told us that they have just employed a cleaner and were waiting the return of The Disclosure and Barring Service (DBS).

The service had records of quality assurance systems in place. Therefore the manager was protecting the people who used the service and others against the risks of inappropriate or unsafe care and treatment.

What people said:

People who used the service were very happy with the care they received. One person we spoke with said, "Everything is good about living here.� And �I am going into town for lunch.� Also �They (the staff) took me to see my mum.�

Staff we spoke with said �I love working here, we are like one family,� and �I get good job satisfaction,� �I get loads of support,� and �I get on with them all, I am very calming when people show behaviours that challenge.�