Middleton Lodge

At our last inspection this key question was rated inadequate. At this assessment the key question has been rated good. This meant people were safe and protected from avoidable harm. People were supported to remain safe and staff showed a good understanding of the safeguarding process. One relative we spoke with told us, "[Name] is in a safe place and the staffing has improved. Staffing was provided by a consistent and well trained team who told us they were well supported. Recruitment was carried out safely and involved people who used the service. Medicines were stored and administered safely. The service was clean and equipment was well maintained. One relative told us, "I wander around the service, and it is clean and hazard free." The registered manager had good oversight of accidents and incidents and we saw learning was shared via meetings and handovers. Staffing was provided at safe levels. One staff member told us, "Staffing levels are really good we are never short staffed."

At our last inspection this key question was rated requires improvement. At this assessment it is now rated good. This meant our evidence showed people's care, treatment and support achieved good outcomes and promoted a good quality of life. The registered manager maximised the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them. Social workers supplied the registered manager with their assessments and these were used as the basis for the care records. The care records clearly detailed people’s needs. Staff planned and delivered people’s care and treatment with them, including what is important and matters to them. This was in line with legislation and current evidence-based good practice and standards. Staff supported people to manage their health and wellbeing in ways which maximised their independence, choice and control. The staff routinely checked people were satisfied with the service and whether any needs had changed. The registered manager ensured people experienced positive outcomes from the support the service offered. Staff worked with local healthcare professionals and sought advice when required. Staff worked as a team to ensure people’s support needs were met. The service had worked with Speech and Language therapy to improve the safety and quality of people's mealtime experience. One therapist told us, "The chef has gone to a lot of trouble to make meals look and taste appetising, I am hugely impressed." Staff made people aware of their rights around consent and respected these when they delivered person-centred care and support. Staff had received training around the Mental Capacity Act 2005 and associated code of practice. People had their rights upheld and advocacy services were actively involved with people. Staff had received mandatory and person specific training.

At our last inspection this key question was rated requires improvement. At this assessment it is now rated good. People received care and support from consistent staff who knew them well and had a kind, caring and respectful approach which maintained people’s dignity and independence. People were supported to choices and advocacy services were well utilised to enable peoples voice to be heard.

At our last inspection this key question was rated requires improvement. At this assessment it is now rated good. The staff and management team had improved people's social isolation and positive action had been taken to integrate people with the local community. People’s health care needs were well understood and staff worked well with other professionals to make sure people received appropriate and timely health care.

At our last inspection this key question was rated inadequate. At this assessment the key question has been rated good. This meant that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. The management team had driven improvement across all areas of the service and had worked with partner agencies to deliver an action plan and embed positive change. Staff were motivated and were committed to maximising positive opportunities for people. People told us they were happy and feedback from relative also reflected a much improved service.