Middleton Lodge Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events.

Systems were in place to ensure learning took place when things went wrong and how this was shared with the wider staff team. Lessons were learnt to continually identify and embed good practice. The management team and provider ensured thorough investigations of accidents and incidents took place to determine the actions that may be required to reduce the risk of reoccurrence. People and relatives felt able to raise concerns and felt they would be listened to. A relative told us, ‘I have no complaints about my family members wellbeing. If I have any concerns I would speak to the registered manager.’

The provider was open and transparent about incidents and accidents that occurred, they were recorded and reported appropriately. Staff told us their learning was kept updated to ensure people’s needs were met.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed before they started using the service and they told us that they had the required equipment in place. A relative said, ‘All the equipment was in place before they came in.’ The provider worked with partner agencies to facilitate planned transitions. People had care plans and risk assessments which were based on the pre- admissions assessments completed and these were reviewed and updated as needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately with the relevant parties.

People told us they felt safe and well looked after at Middleton Lodge Care Home. A person said, “Yes it feels safe and secure.” We found effective systems in place to ensure accidents and incidents were investigated and analysed. The registered manager had taken appropriate action when safeguarding incidents had occurred. This included carrying out their duty in accordance with the duty of candour and reporting to external agencies such as the local safeguarding team and CQC. The provider also analysed and monitored events that occurred to identify any themes and trends.

Staff had received training in safeguarding and understood their responsibility in keeping people safe and reporting concerns about abuse or suspected abuse.

The provider did not always work well with people to understand and manage risks.

Risks which affected people's daily lives, were documented and known by staff. The management team monitored and regularly assessed these risks and took appropriate actions to ensure people received care in a safe and consistent way. However, we did identify some areas where risks to people’s mobility had not been fully considered, we raised this with the registered manager who took immediate action to rectify this.

We observed staff demonstrated a good understanding of how to support people positively with their known risks, for example staff were fully aware of who needed support with eating and drinking and who required modifications to their food and drink to reduce their risk of choking.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were cared for in a safe and well-maintained environment that was purpose built to support their needs by equipment, adaptations and layout. For example, corridors were wide enough to allow staff to support people to move around safely including walking or using a wheelchair. People were provided with specialist beds, hoists, and other equipment to keep them safe.The service was spacious and well maintained, there were many areas for people to use throughout the day. The ’Memory floor’ was tailored to support people living with dementia, which included dementia friendly signage to aid orientation.

The provider had systems in place to ensure the environment was regularly checked for any potential hazards. The service had an on-site maintenance person, who was able to respond to maintenance and health and safety issues. Arrangements were in place to monitor the safety of the premises through regular safety checks, which included fire safety, maintenance and equipment checks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Most people told us there were enough staff and they felt safe with them. One person said, “The staff do everything they can for us. There are always staff around and they pop in to see us and the manager does too.” Although some people did not consider there were enough staff we saw evidence to confirm people’s needs were met effectively with the necessary staff skill set. We discussed this with the registered manager, who showed us people’s individual care needs were taken into account and reviewed regularly to ensure suitable staffing levels were in place. We observed staff were available to assist people when they needed support and call bells were answered in a timely manner.

The provider operated safe recruitment practices, ensuring suitable staff were employed to work at Middleton Lodge Care Home. Staff files reviewed included appropriate checks such as references, identity and Disclosure and Barring Service (DBS) checks to help make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected from the risk of infection. The provider had systems and processes to assess and manage the risk of infection. A professional told us, ‘We have noted the home's cleanliness, with no offensive odours.’

On both days of our site visit, the home was very clean and well maintained. A relative told us, “It’s nice and clean and tidy.” Staff had completed training in both infection prevention and control and food safety. Our observations showed staff wore personal protective equipment (PPE) in-line with good practice, which helped reduce the risk of infection. Correct food hygiene practices were observed.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicines had not always been safely managed. We found medicines were not always stored safely and stock levels did not always correspond with the records in place. We found “when required” (PRN) protocols did not always provide enough information on when staff should offer or administer PRN medicine. We discussed this with the registered manager who told us they were aware of this and sent us action plans on the steps they were taking to put this right. On our second day of the inspection site visit, we found the necessary improvements had been made.