Middleton Manor Care Centre

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• 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 service since a change to their registration. 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.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 45 (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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

We observed interactions between staff and people. Some support was delivered with care and kindness, but we also observed occasions where staff appeared task focused and did not put people’s comfort and dignity first.

We observed 1 person in an uncomfortable and undignified position on their bed, when we spoke with staff, they told us they were unable to support them alone and were waiting for another staff member to assist. We asked whether some immediate action could be taken to make them more comfortable and were told they would have to wait.

We received mixed feedback from relatives. Their comments included: “I and my family feel that most of the carers see it as a job and that they don't have the compassion to care for the residents.” And “On the whole they are very good. From my point of view staff are all very kind and respectful."

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s care plans recorded how people wished to be supported but this was not always reflected in the delivery of care. People’s communication needs were not always adequately met. Menus were required in another language, but these were not always available. We requested evidence that 1 person was supported to follow their religion as detailed in their care plan but no further information on this was received.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

During the assessment we spent time observing people in communal areas. We saw very limited evidence of any activity taking place. There was an activity schedule on display in the home, but we were told by the registered manager this was not up to date and the activities listed did not take place during our visits.

People’s individual choices and preferences were not respected when in communal areas. The television was on at a high volume but there was no sign of anyone watching or being interested in or engaged by what was on. We did not observe staff asking people what they would like to watch or whether they wanted the television on at all. A person was distressed by the noise and told us, “I just want to go somewhere quiet.”

Most relatives we spoke with felt there was a lack of activity available for their loved ones. A relative told us, “There is a notable absence of structured activities designed to promote independence among residents living with dementia.” Another said, “There is no-one to help keep the residents occupied and they rarely go outside. [People] sit in the living room with the radio or TV on at full volume which is unpleasant for visitors, and I wonder how [people using the service] feel about constant noise.”

The home had an activities co-ordinator, however, they only worked part-time and had not received any training for their role. The provider was recruiting for more activities staff and told us additional care staff resources would be dedicated to activities.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Call bells were available in people’s bedrooms, and where individuals were able to use them, staff responded in a timely manner. However, we found that not all people had access to call bells, and some were unable to use them independently due to physical or cognitive impairments. This meant that they were reliant on staff noticing them or waiting for routine checks. Due to the way staff were deployed around the home this could lead to delays in people receiving help and support.

We received mixed feedback from relatives. A relative told us, “As far as we are aware staff are doing a good job.” However, another relative said, “My [relative] has a hearing aid and can communicate so much better when they are wearing it and the battery is working. Frequently when family visit, they are not wearing it or the battery needs changing, suggesting it is not checked daily. Not being able to hear well is a significant barrier to their independence.”

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

While some staff said they enjoyed aspects of their work and had good relationships with colleagues, others reported feeling unsupported with a lack of opportunity to discuss concerns with management.

Comments we received from staff included, “As care staff my wellbeing is not promoted and there is no positive culture at the home at all.” And “I feel isolated and alone in the workplace and it is affecting my mental wellbeing.”