Middleton Park Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place and generally effective in supporting the identification and review of incidents, with themes and trends regularly monitored. We observed the provider was actively working to reduce accidents and incidents. Incidents were also discussed with staff during daily meetings.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Systems were in place to support oversight of admissions, including consideration of whether people’s needs could be safely met by the service, to help ensure safe and appropriate transitions into the service.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe using the service. One relative said, “Yes, Mum is safe and they are taking good care of her.” Staff had received safeguarding training and understood their responsibilities. Systems and processes were in place to safeguard people from the risk of abuse.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Records showed risks were reviewed regularly and updated to reflect changing needs. People, or those acting on their behalf, were involved in managing risks, with family involvement and Power of Attorney arrangements recorded. Staff generally followed guidance and escalation processes to support safe care delivery. People had personalised risk assessments in place covering areas such as falls, mobility, skin integrity, nutrition, aspiration and behaviours, with clear control measures recorded, including the use of equipment such as hoists, profiling beds and air mattresses.

However, there were inconsistencies in staff practice, with one member of staff stating, “Sometimes I see people who do their own things and I don’t agree with it. If they can’t find a slide sheet, they would do it without,” indicating that safe systems of work were not always followed.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Concerns were identified within the environment, including furniture not being securely fixed to the wall, which resulted in exposed nails and potential risk to people. An action plan had been developed to address these environmental issues, with improvements identified and measures in place to reduce risk.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

Concerns were raised about staffing levels and oversight. An external professional commented, “Staffing numbers also appear to be very poor at times, with insufficient numbers of nurses and assistants to care for the residents.” Staff also reported feeling understaffed, with one stating, “I will frankly say we are really understaffed on the ground floor, they keep telling us it’s a business.” A relative told us, “They could do with more staff at night time.” Although there was a rota in place, the rota did not evidence clear weekend on‑call arrangements.

There was mixed feedback regarding supervision, with some staff not feeling supported, for example, “No I don’t find it supportive, I feel thrown under the bus.”Staff were not always up to date with training.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Overall, staff followed infection prevention and control (IPC) processes. However, personal protective equipment (PPE) stations were not consistently replenished, and these issues had not been effectively identified or addressed through IPC audits or daily checks.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Systems and processes were in place to support the safe management of medicines. Medicines were stored securely and regular checks were carried out. Safe storage and oversight arrangements were evident.