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 service 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 questionrequires improvement. At thisassessmentthe rating hasremainedrequires 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.

The service was in breach of legal regulation in relation to governance at the service. 

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.

The provider did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

A statement of purpose was in place and was appropriate to the service. However, during this assessment, feedback from staff indicated a negative culture. A staff member told us, “I don’t feel happy. The atmosphere in the home is not encouraging, its miserable and demotivated.”

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

There was no registered manager in post at the time of the assessment, and a new manager had recently been appointed, which meant leadership arrangements were not yet fully embedded. Concerns were raised about communication and oversight, with an external professional stating, “The communication between the staff and the managers is also lacking, with managers not aware of changes with residents that I would expect the managers to know.” Staff feedback was mixed, and some did not feel confident to raise concerns, with one stating, “I feel like if I report something nothing will happen and I will be in trouble, so I won’t report to them,” indicating a lack of an open and transparent culture.

However, some staff reported they felt able to approach management, with comments such as, “Oh yes I can raise it with the manager,” suggesting experiences of leadership and support varied across the service.

People did not always feel they could speak up and that their voice would be heard.

Forums such as team meetings were in place, which provided some opportunity for staff to share feedback. However, opportunities for staff to speak up were not fully effective, with limited evidence team meetings were consistently used to embed discussions around quality and risk. Staff engagement was variable, and some staff did not feel safe to raise concerns. One staff member stated, “Yes we do, but when you speak out, because I’m one of the people who will speak out, you will be targeted,” indicating a closed culture where people did not always feel protected or supported to raise issues.

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.

No concerns were identified in relation to workforce equality, diversity and inclusion during this assessment. Staff had received training in equality and diversity, which supported an inclusive approach within the service.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Auditing systems were in place; however, these did not provide clear evidence that actions were consistently identified, monitored, or embedded into practice. The provider had not fully addressed the concerns raised at the previous assessment, resulting in an ongoing breach of regulation. Furthermore, issues identified during this assessment had not always been identified by the provider’s audits and acted upon, indicating that oversight systems were ineffective in driving improvement and managing risk.

Several concerns identified during the assessment had not been recognised through the provider’s own governance processes. Although there was new leadership in place and plans to improve the service, these had not yet been tested or demonstrated impact.

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.

There was evidence the service worked collaboratively with external partners; however, it was not always clear how shared learning consistently led to improvements in practice.

The provider engaged with external healthcare professionals, including GPs, speech and language therapists and district nurses, to support people’s health needs. Information and learning were shared with these partners to promote joined‑up care and improve outcomes for people.

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.

Systems to drive learning and continuous improvement were not always fully embedded or consistently effective. Opportunities to reflect on feedback, incidents and outcomes were not always used proactively to improve practice or develop innovative approaches to care delivery. Staff engagement in improvement initiatives was variable, and there was limited evidence of sustained innovation or sharing of best practice to support positive outcomes for people using the service.