Middleton Fells

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.

This is the first assessment for this newly registered service. This key question has been rated as requires improvement. This meant leaders and the culture created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 62 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The management team had the appropriate skills and experience to lead effectively, understood the risks and priorities for the service and acted with openness and honesty during this inspection. There was a clear vision and direction within the leadership structure about how the service was being delivered and overseen.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider level of management support visited the home regularly. Culture and practises under the new provider and manager were still being embedded. The registered manager led by example and was very knowledgeable about people and their needs. The staff demonstrated a positive and compassionate culture promoting trust with people in the service. People were at the centre of decisions being made about them

Relatives told us they felt the service was well managed. One relative said, “The new manager is lovely, very approachable.” Another relative said of the registered manager, “Any problems we can email and it’s always followed up. I can call anytime and she’s right on it.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The management team were open, honest and transparent and the registered manager was seen to actively encourage staff in their work. Regular meetings between the registered manager and staff took place. Staff were given opportunities to discuss performance via a supervision and appraisal process. Staff told us they could speak up about anything and were listened to and things would be acted on by the registered manager.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

A proportion of the staff team were from overseas and the provider operated a sponsorship scheme. The staff we spoke with spoke positively about their experiences of being recruited and working at the home. Management were seen to proactively working on removing any bias in practises such as the use of seclusion. Staff told us they felt very included especially when they put forward new ideas for improving outcomes for people.

The provider had systems of accountability and good governance. However, they did not act on the best information about risk and outcomes, or always share this securely with others when appropriate.

There were a range of quality monitoring and auditing processes in place. However, improvements were needed as some processes were not always effective in identifying the concerns we found during the inspection. Records about people were not always accurate or current about their needs and could put people at risk. Some records required more detail in the information.

Some concerns identified during the local authority IPC audit had not been addressed at the time we inspected, and some incidents of safeguarding had not been recognised and/or referred to the local authority.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The home worked in collaboration and partnership with other organisations. Integration into the local and wider community was not appropriate for all the people living at Middleton Fells. For those it is they have been appropriately supported to do so. Effective working was seen with other external professionals.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

There was a strive for improvement and development evident during the inspection with the determination of the registered manager to ensure their responsibilities were fulfilled. The management team had a good understanding of how to make improvements to people’s experiences, outcomes and quality of life but these were yet to be fully implemented and embed under this provider. Staff told us they felt listened to, valued and were able to influence practise.