CQC report explained · a residential care home
What the CQC found at Middle Path
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2023
Rated Good overall; inspectors found safe care, but leadership and team stability required improvement.
This was an unannounced focused inspection. One inspector visited on 5 June 2023 and the inspection activity ran until 12 June 2023. Inspectors spoke with all four people living at the home, relatives, staff and a health professional. They also checked care records, medicines records, recruitment files and management records.
The home was rated Good for Safe. People said they felt safe, risks were reviewed, medicines records were complete and staff understood people's needs. Infection prevention arrangements were also found to be effective.
The home was rated Requires Improvement for Well-led. There had been four registered managers since the previous inspection in 2018, which had unsettled staff and affected team working. A new manager had been in post for about two months and was working on an improvement plan. The overall rating remained Good because the other key question ratings were carried over from the 2018 inspection.
People felt safe
All four people told inspectors they felt safe. Relatives and a health professional also said the home managed people's safety well.
“All 4 people were able to verbalise they felt safe.” from the report
Risks were managed
Risks covering areas such as swimming, choking, asthma, vehicles and hot water were assessed, monitored and reviewed. Staff had personalised guidance for people who could experience emotional distress.
“People's risks were assessed, monitored, and regularly reviewed.” from the report
Consistent care staff
People were supported by a familiar group of staff. This helped staff understand people's individual needs and communication.
“People were supported by a consistent group of staff some of whom had been at the home for a considerable time.” from the report
Medicines were recorded safely
Staff who gave medicines were trained and competent. Medicines administration records were complete and accurate, and medicines were stored securely.
“Staff recorded on medicines administration records when medicines were given to people. These were complete and accurate.” from the report
Good partnership working
The home had working relationships with organisations including GP surgeries, social workers and dieticians.
“The home had established and maintained good working relationships with other organisations such as GP surgeries, social workers, and dieticians.” from the report
Frequent management changes
needs fixingThere had been four registered managers since the previous inspection. Inspectors said this had unsettled staff and affected team cohesion and confidence in leadership.
“The lack of consistent management since the last inspection had been unsettling for staff.” from the report
Teamwork and staff support
needs fixingSome staff said they did not work well as a team and did not always feel supported by management. The new manager was working to improve this.
“I don't feel the staff [here] work as a team. I think some do and some don't, and it shows.” from the report
Health and safety audit was late
minorOne health and safety audit was outside its planned three-month interval. Management completed it during the inspection, and inspectors said this had not affected people.
“These were all completed regularly apart from 1 health and safety audit for the home which was outside its scheduled 3 monthly interval.” from the report
- 01What actions are included in the service improvement plan, and when will you review whether they have worked?
- 02Has the new manager's application to become the registered manager been completed?
- 03How are you improving teamwork and making sure staff feel supported by management?
- 04How will you ensure all health and safety audits are completed on schedule?
- 05How do you make sure the familiar staff group is maintained and that people's individual communication needs are understood?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings used for the overall rating were carried over from the 2018 inspection. This explanation was written from the published report of 6 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2018
Autism Wessex - Middle Path was rated Good; inspectors found kind, safe and personalised care, with a few records needing improvement.
This was an unannounced comprehensive inspection on 12 February 2018. One inspector spoke with the deputy manager, three care staff and one relative. They also observed care and checked care records, staff files, training, rotas and quality checks.
The home supports up to four people with autism. At the inspection, three people were living there. Inspectors found people appeared happy and relaxed, medicines were managed safely, staffing levels were enough and staff knew people's needs well.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. This was the same overall rating as at the previous inspection. Inspectors found no serious risks or concerns, but identified some records and decisions that needed attention.
Kind and respectful staff
Inspectors saw positive relationships between staff and residents. Staff understood people's communication, privacy and personal preferences.
“Throughout our inspection we observed staff interacted with people who lived at the home in a kind and caring way.” from the report
Safe medicines practice
Medicines were stored securely, records were consistently signed and staff had their competency checked. The home also carried out regular medicine audits.
“People's medicines were managed safely and stored securely.” from the report
Choice and independence
People were supported to make day-to-day choices, develop skills and follow interests in the community. Staff worked towards people's individual goals.
“People were supported to identify and achieve their goals and aspirations.” from the report
Personalised care
Care plans described people's needs, routines, preferences and communication. Staff knew this information and updated the plans regularly.
“The care plans we read were personal to the individual and gave clear information to staff about people's needs, important routines, what they were able to do for themselves and the support required from staff.” from the report
Ways to speak up
People could raise concerns in house meetings, through staff or through their key worker. Suggestions about meals were acted on.
“Each week people were involved in a 'House meeting' where they were individually asked if they were sad about anything, if they felt safe, if they were happy with the menu and happy with activities.” from the report
Risk assessment was missing
needs fixingAfter one incident, a risk assessment had not been completed. Staff believed the risk was minimal and no harm had occurred, but the deputy manager said this would be completed.
“We found however, following one incident an assessment of risk had not been completed.” from the report
Least restrictive option not recorded
needs fixingA best-interest decision about restricting one person's access to snacks did not explain whether the restriction was the least restrictive choice. The deputy manager said this would be reviewed.
“However, the best interest decision did not contain details about the restriction of the snacks and whether this was the least restrictive option.” from the report
Some refresher training due
minorInspectors found that some staff needed refresher training in certain subjects. Dates had been arranged for this training.
“We reviewed the staff training matrix and identified some staff required refresher training in some subjects.” from the report
Radiator risk assessment due
minorSome radiators were uncovered and switched on. Inspectors observed no immediate risk, but the deputy manager said an assessment would be completed to record this.
“We noticed there were uncovered radiators in the home that were switched on.” from the report
- 01Has the risk assessment following the incident now been completed, and what changes were made as a result?
- 02How was the decision about restricting snacks reviewed, and what less restrictive options are now available?
- 03Who is managing the home now that the registered manager has given notice to leave?
- 04Have all staff completed the refresher training identified by the inspection?
- 05What is the current position on the two pending Deprivation of Liberty Safeguards assessments?
This was an unannounced comprehensive inspection covering all five CQC areas and both the care provided and the premises. This explanation was written from the published report of 15 March 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Middle Path
3 rated inspections over 8 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 1 March 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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