Middleton Care Limited

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

Staff were able to speak up and felt the service was well managed. The provider worked in partnership with others to assess, monitor and improve the quality of the service. We found a breach of the regulations in relation to good governance. The provider had a range of audits and quality assurance tools in place to monitor the quality of care being delivered, however these were not effectively implemented. The management team recognised where some improvements were needed but were yet to embed these changes sufficiently.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team told us, “As a company we have set values and a clear vision which includes a person-centred culture and involvement. At the interview process, at new staff member inductions and through training we promote the vision and values of Middleton Care Limited.” Staff told us. “I do feel supported in my role, the office and supervisor are great. We have regular supervisions and appraisals. We also have meetings once a month.”

The policies and procedures the provider had put in place were based on providing transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and local communities.

Leaders told us they have an app where staff can access 24-hour advice regarding mental health support. Staff told us the leaders were supportive. One member of staff told us, “Nothing is ever too much trouble for the management team and they have always gone out of their way to ensure that my needs are met, particularly during recent health problems.” Leaders told us how they supported staff during specific times for example, when a staff member is pregnant or coming back from maternity leave.

The registered manager had worked for the provider for a long time and had completed qualifications to support her work, as had the HR manager, who has an NVQ Level 5 in Human Resources. Management meetings did not take place formally. Leaders told us they discuss things constantly together but did not formally minute these discussions. The registered manager agreed that a separate Nominated Individual role would provide governance transparency and oversight and that they would take this under consideration.

The registered manager demonstrated they had complied with their duty of candour responsibilities which included apologising when things had gone wrong.

There had not been any reportable incidents, including unexpected deaths where staff were last people present. Where there have been deaths these were either expected or have been family present.

The provider discussed how they valued diversity in the workforce. They offered an inclusive and fair culture through improving equality and equity for people who worked for them. Staff confirmed they had a working environment which encouraged effective teamwork.

The provider had an Equality & Diversity Policy which aimed to foster a positive culture where people felt they could speak up and that their voice would be heard. However, this was last reviewed in 07/12/2021 and was due to be reviewed again 07/12/2023. This meant the policy had not been reviewed to ensure the information was still relevant.

A staff survey which was conducted in August 2022 demonstrated that 91% of staff were satisfied with their working life. satisfaction. One staff member told us, “I can make suggestions any time and do feel like I am listened to, it is not always possible to implement my ideas but I receive good feedback on why it was or wasn’t a good idea.”

The organisational structure indicated distinct responsibilities, roles and accountability of the management team members. The organisation used an electronic management system to ensure people’s visits were conducted at the right time by the right staff. A governance schedule was in place which included reviews of care needs and the competence of staff. However, where shortfalls existed these did not always lead to actions for improvement. The governance systems had not identified the shortfalls we found during this assessment. This included lack of medicine management audits, incomplete recruitment processes and outdated policies which did not match practice

People told us they felt the provider and other partner agencies worked well to co-ordinate their care and support.

Staff and leaders told us they worked well alongside other health and social care professionals who were involved in people's care. One staff member told us, “We have a great relationship with our local GP surgery and district nurses so know we can always ring them if and when we need to.”

Partners did not raise any concerns about working alongside this provider.

Staff worked in partnership with other healthcare professionals. We reviewed care plans and other documentation which demonstrated communication and joint working with others. For example, we saw evidence of involvement in Dementia Forums and the provider were involved in the setup of the dementia-friendly village along with the local GP. The local lunch clubs have contact details as first point of contact if person becomes poorly whilst attending.

Staff told us that staff meetings happened on a monthly basis, alongside regular supervision and appraisals. Staff also told us they could make suggestions to the management and received feedback.

We received records of staff meetings during the assessment. The first part of these focused on updates regarding service users and the second part included messages to staff and reminders of important information