Middleton Park Lodge

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 leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (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 worked on creating a shared vision, strategy and culture however, as described in this report, we found this was not always achieved.

During this assessment, we identified shortfalls in the safety of the service and the support people received. The provider had not ensured effective systems were implemented to monitor the experience of people living at the home. This had led to some elements of the culture of the service being task-based care rather than people’s personalised care needs.

The management team had a plan in place to improve the service and told us the issues found during this assessment would be added to the plan, if not already actioned.

The provider had an inclusive management team, who understood the importance of an empathetic approach, 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.

People and their relatives gave positive feedback about the management team and their relationship with the staff team. One person said, “[Name of registered manager] is brilliant, she comes to see me and brings me lollipops. She is a good person and a good manager.” A relative commented, “[Name of registered manager] is brilliant, you can talk to her and without a doubt, she sorts things out.”

The staff team gave positive feedback about the registered manager. One staff member told us, “I would say there has been a good rapport in recent times, since [name of registered manager] has been in, I hate discrimination and I was going to leave before, I have noticed bullying cases before [name of registered manager] came, this was reported to the operations manager, I know since [name of registered manager] camein the atmosphere has changed, we are now involved and many changes are taking place.”

The management team fostered a positive culture where people, relatives and staff felt they could speak up and their voice would be heard. The management team had regular meetings with people and their representatives. When people or relatives raised concerns, a plan was put in place to address these. For example, relatives from people living in the dementia unit suggested it would be beneficial for people to access more outdoor activities. We reviewed evidence confirming a plan was put in place and people were accessing more activities out in the community.

A relative told us, “I haven’t had to raise anything very serious. I went to [name of registered manager] about some admin, and it was sorted out. This was about six months ago; she dealt with it.”

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.

Staff told us they enjoyed their place of work. The provider was proactive at engaging with staff and celebrating success. Staff told us the registered manager had several initiatives in place to value and motivate staff.

The provider was in breach of the legal regulation relating to good governance.

The provider did not have clear responsibilities, roles, systems of accountability and good governance.

There were several quality assurance systems in place but these had not always been effective in identifying the areas for improvement found at this assessment. For example, medication audits were being regularly completed but these had not identified the issues with diabetes care, creams or thickeners.

During our assessment, we found examples of poor management and oversight of essential areas of delivery of care. Managers were completing walkarounds and a resident of the day audit was completed, however these had not identified that there were several people who could not access the call bell on the walls or did not have one at all.

We found examples where accurate and contemporaneous records of people’s care were not maintained which meant the quality of care could not always be monitored effectively. For example, some people’s care and medication records lacked essential details about the care people required.

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.

Healthcare professionals told us the service worked well with them to meet the needs of people.

People were involved in regular activities that improved their engagement within the community.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Although the provider’s own documentation prompted the staff and managers who completed audits to review trends and analysis, in our review of documentation we found limited evidence of this happening. For example, there was no evidence that medication audits were considering the incidents of missed medication, in particular for people who were out of the home on activities.