Middleton Park Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the remained requires improvement. This meant people’s needs were not always met.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

During our assessment, we found inconsistency in the quality of people’s care plans. Some care plans were very detailed and person centred while others did not provide essential details about people’s care to guide staff in caring for people. For example, a person required more than one member of staff to support them during personal care. Their care plan had conflicting information about this and staff also reported varying numbers of staff supporting this person. We raised our concerns to the registered manager who told us they would review this person’s care plan.

Staff did not always anticipate people's needs or responded when they showed to be in distress or asking for help. During our visits, the inspection team had to ask staff to attend to people's needs.

We found there was a regular provision of activities happening at the home. People were offered support to access the community. We found examples of people being involved in activities that reflected how people used to occupy their time before living at the home.

People and their relatives told us staff treated their loved ones as individuals and care staff were familiar with their needs, preferences and daily routines. However, some people and their relatives had not seen their care plans. Their comments included, “I don’t know about any care plan. They do talk to me” and “I don’t know about that.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People received required care provisions to meet their needs and measures were in place to promote continuity of care. Feedback from healthcare professionals highlighted the service worked effectively at supporting and promoting joined up care. A healthcare professional told us, “They are actively bringing patient cases to discuss in the MDT [multidisciplinary team] where they have medical issues they need to discuss. Staff are always very knowledgeable about the patients status and what their needs are.”

We found inconsistent evidence of people and relatives being involved in planning and reviewing people’s care.

People were given opportunities to raise complaints about their care, treatment and support. Opportunities were given to people to respond at their own pace using their preferred method of communication.

There was a complaints procedure in place and people and relatives told us they knew how to use it and had used it, with satisfactory outcomes for them.

Records showed that the provider had taken action and responded appropriately to complaints when they were raised.

We found inconsistent evidence of people and relatives being involved in planning and reviewing people’s care.

People were given opportunities to raise complaints about their care, treatment and support. Opportunities were given to people to respond at their own pace using their preferred method of communication.

There was a complaints procedure in place and people and relatives told us they knew how to use it and had used it, with satisfactory outcomes for them.

Records showed that the provider had taken action and responded appropriately to complaints when they were raised.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People who choose to stay in bed or who had a clinical reason to spend most of their time in their room, did not always have access to a call bell they could use to call for staff. We observed instances that people had to shout for staff to get their attention or wait until a staff member walked the corridor. There was no evidence that the provider had considered to how people in this situation would be protected from the risk of social isolation.

We also observed, people living with dementia requiring emotional support from staff but not accessing this because there was no staff in the communal area and people were not able to use the call bell on the wall. We discussed our concerns with the registered manager and they told us they would complete additional monitoring on staff’s deployment.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We observed varied outcomes for people who mainly stayed in their bedrooms and for those living with dementia. The concerns identified during this assessment with staff’s deployment, meant that there were times where people who required additional support to communicate their needs or to have their needs anticipated by staff did not always experience the best outcome. During our visit, we observed people who lived in the dementia unit and enjoyed walking in the communal areas, were unable to move between 2 areas because a corridor door was closed and people were unable to use it. Once we raise this issue, the provider took immediate action.

People's end of life care wishes and preferences were planned for.

The registered manager and staff knew who the relevant healthcare professionals were to be involved if people required specialized care, for example, with managing their pain levels. We found medicines to supported people at this time of their lives was well managed.