Middleton Manor Care Centre

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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was previously in breach of the legal regulation in relation to person-centred care. Improvements were not found at this assessment, and the provider remained in breach of this regulation. At this assessment we found the provider was also in breach of the regulation in relation to dignity.

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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People’s privacy and dignity was compromised. Charts documenting the use of incontinence products were on display in people’s rooms, in one instance on the outside of their bedroom door. We asked for these to be removed at the end of our first day on site, but they were still in place when we returned 10 days later.

We observed some positive, caring interactions between people and staff. People and relatives spoke positively of the staff team. A person told us, “The staff are nice and kind.”

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. One relative told us they had taken great trouble to ensure the things that made their relative happier were included in their care plan, but these were not always followed by staff. They told us they regularly had to ask and remind staff of the persons individual likes and preferences.

The provider had adopted a blanket approach to the management of continence products rather than reviewing individual needs and looking for person-centred solutions. A relative told us, “The home talks to me about her care and incontinence pads, although the latter is a bit of a contentious issue in that [my relative] is only allowed 3 pads in a day and 1 at night – it’s a bit ridiculous.

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

People’s individual abilities, choices and preferences were not always considered and concerns with regards to the provision of activities identified at our last assessment remained. We observed a bingo game taking place in one of the lounge areas but there was no sign the people present were interested or engaged by it. A person told us, “I would join in a party, if it’s not too noisy, but normally I wouldn’t take part. I can’t stand the bingo.”

Staff told us activities were limited due to a lack of funding which made it difficult to offer person-centred options. The provider confirmed there was no dedicated budget for activities but that any fundraising undertaken would be matched by them.

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.

Newly implemented practice of restricting people to a set number of continence products meant staff were not able to minimise discomfort without the fear of being disciplined. A number of the staff we spoke with were concerned about this. One staff member told us, “We are afraid of the disciplinary, this will compromise the care of our residents.”

We had mixed feedback from people regarding how responsive staff were to their needs. A person told us, “Carers seem to know what you require.” Whilst another said “The staffing levels can be such that carers coming to your aid may take some time.”

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.

The provider had implemented practices around the management of continence products that had impacted on staff’s ability to provide person-centred care. Some of the staff we spoke with had been upset by this.

We received mixed feedback from staff regarding morale and the support they received in terms of well-being. A staff member told us, “Staff morale is low because we don’t get to talk to each other or management together and say how we are feeling. We only get told off when things go wrong.” Another staff member said, “Staff morale is generally positive. The team works collaboratively and supports one another effectively.”