Middleton Hall Care Home

Updated 18 January 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 6 January 2022 and was announced. We gave the service one day's notice of the inspection.

Updated 18 January 2022

The inspection took place on 4 December 2018 and was unannounced. The previous inspection was undertaken in December 2017 when we found a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regard to good governance. This was because of some inaccurate documentation with regard to food and fluid charts.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question to at least good. At this inspection we found the provider had addressed this because documentation was an accurate record of care provided and regular audits ensured continued accuracy with regard to this documentation. The regulation was met.

Middleton Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Middleton Hall provides residential care for up to 24 people. At the time of the inspection there were 21 people using the service. The home is a detached building providing accommodation over two floors and is situated in the Middleton area of Rochdale. It is surrounded by a large garden. There is a small car park to the front of the property.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a registered manager in place at the service.

There were up to date safeguarding policies and staff had safeguarding training. Health and safety measures were in place with regard to environment, fire safety and equipment. People were kept safe within the home via locked doors with key pads, so that people could not just gain access to the building unseen. Accidents and incidents were recorded clearly and were analysed monthly to look at any patterns or trends.

Staffing levels were sufficient to meet people’s needs and the recruitment system was robust. General and specific risk assessments were in place and up to date.

Medicine systems were safe and there had been no medicines errors in the last 12 months. Infection control measures were in place to help prevent the spread of infection within the home. The premises were clean and clutter free and there was signage around the home to assist people with orientation.

Care files included relevant health and personal information. A thorough induction was in place for all new employees and the training matrix evidenced regular mandatory and refresher training. Staff files confirmed regular staff supervision and appraisals took place.

Nutritional and hydration information was recorded and charts, which had not been accurate at the previous inspection, were completed accurately, evidencing no continuing breach of the regulation. Food was plentiful and nutritious and sufficient drinks were offered throughout the day.

The service was working within the legal requirements of The Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Throughout the inspection day we observed staff to be kind, patient and friendly. People’s dignity and privacy was respected by staff. Information was supplied to people in the form of a service user guide. Confidentiality was taken seriously at the home and staff had received training in data protection.

Care files were person-centred and included people’s choices, likes and dislikes. Care plan evaluations were undertaken monthly and people who used the service, and their relatives where relevant, were involved in these reviews.

There was a programme of activities and outings on offer to people who used the service. However, people we spoke with said they would like more activities.

There was a complaints policy in place and complaints were addressed appropriately. We saw a number of compliments received by the service.

Consideration was given to people wishing to stay at the home when nearing the end of their lives. Staff were undertaking training in palliative care.

Staff told us the registered manager was approachable and had an open-door policy and the registered manager said he was well supported by daily contact with the provider.

There were a number of audits and checks in place to help ensure standards were maintained. These were all clearly documented and records were up to date.

We saw evidence of good partnership working with other agencies and professionals and the service had good links with the wider community.