Middleton Fells

Updated 21 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Middleton Fells is a care home. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Middleton Fells is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post, however, there was a manager who had applied to register with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the service first registered with us in March 2022. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who lived in the home and visited 3 people in their own units. We spoke with 10 staff including support staff, managers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with the relatives of 5 people.

We reviewed a range of records related to the management of the home including fire safety equipment, managers audits and safety certificates. We looked at the care and medicine records of 3 people. We looked around the home and saw inside 5 individual units.

Updated 21 July 2023

About the service

Middleton Fells provides personal care and accommodation for up to 6 people who have a learning disability and/or autism. Six people were living in the home when we inspected. Accommodation is provided in individual units in an adapted older property on the outskirts of Sedburgh. There are extensive grounds and gardens.

People's experience of using his service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

People were supported by enough skilled and trained staff who were committed to supporting them to make choices and have control of their lives. People's ability to communicate and interact with staff and engage in activities had been enhanced by the involvement of other professionals to maximise people's input. Staff were able to describe the techniques and methods they followed to understand and interact effectively with people. Managers were knowledgeable about how best to support people and provided staff with support and guidance in ways that promoted people's independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

People received person-centred care because managers and staff had completed thorough assessments of people's needs in a multi-disciplinary team setting. The support people needed was described in enough detail to guide staffs' practice. Care plans were frequently reviewed which identified people's achievements and successes and considered what might be improved. This helped maintain consistent person-centred approaches.

Staff were skilled in supporting people when they experienced distress which may lead to risk for the person or others. Managers and the team reviewed all incidents to improve understanding and learning. This had improved people's quality of life because some people had reduced periods of distress. Some people had been able to access more activities in the community and/or tolerate care and medical interventions. Staff upheld people's dignity and privacy discreetly and kindly.

Right Culture

People were valued and empowered because the culture and values of the organisation focused on the impact of people's experiences of learning disabilities and/or autism and strived to promote optimum opportunities to live fulfilling lives. Managers and staff were committed to the values of the organisation and promoted a positive culture in the home. The provider's induction training enhanced staff's knowledge and understanding of the aims of the organisation and the values they promoted. Managers and staff were happy working in the home and care practice reflected the values CQC expect in relation to 'Right support, Right care, Right culture'

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The service first registered with us on 7 March 2022 and this was the first inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.