CQC report explained · a nursing home
What the CQC found at Hugh Myddelton House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- One person was given more than the recommended dose of a medicine. Inspectors also saw one person waiting for support and recommended a review of staffing levels, although risk assessments, recruitment checks and infection control were generally effective.
- Effective?
- Good
- Staff had relevant training and support, and people's complex health needs were well managed. Inspectors found good links with health professionals and saw that consent and best-interest processes were being followed.
- Caring?
- Good
- Most people and relatives described staff as kind and caring. Inspectors saw people treated with dignity and respect, with their preferences, backgrounds and independence recorded and considered.
- Responsive?
- Good
- Care plans were detailed, personalised and regularly updated. The home provided activities, supported relationships and had systems for complaints and end-of-life care.
- Well-led?
- Good
- The new management team was described as effective and well organised by the time of inspection. Audits, action plans and work with health and social care professionals supported oversight and improvement.
What inspectors found, July 2021
Rated Good overall; inspectors found kind, person-centred care, but medicines safety and staffing needed improvement.
Inspectors made an unannounced full inspection visit on 15 June 2021. They spoke with people living in the home, relatives, staff and health professionals. They also reviewed care records, medicines records, staff files, audits and safety documents.
The overall rating was Good. Effective, Caring, Responsive and Well-led were all rated Good. Safe was rated Requires Improvement, as it had been at the previous inspection.
People generally said staff were kind and that they felt safe. Care plans were detailed and up to date. The home was clean, staff were trained, and health needs were generally well supported.
Inspectors found one person had been prescribed and given more than the recommended dose of a medicine. The error was dealt with straight away, but it showed that staff had not followed safety systems. Inspectors also recommended reviewing staffing levels. Concerns about people's influence over menus had been addressed after the inspection.
Personalised care plans
Care plans and risk assessments were detailed, current and person centred. They gave staff clear guidance about people's needs, preferences and risks.
“Care plans were person centred, detailed and up to date.” from the report
Kind and respectful care
Most people and relatives said staff were kind. Inspectors saw staff protect people's dignity and involve them in decisions about their care.
“We saw that staff treated people with dignity and respect.” from the report
Staff skills and health support
Staff received training and support, and inspectors found that people's complex physical and mental health needs were well managed. The home worked with health professionals when concerns arose.
“Health and social care professionals praised the skills and knowledge of the staff.” from the report
Clean home and infection control
The home was clean and odour free. Inspectors saw increased cleaning and staff using protective equipment during the coronavirus pandemic.
“At this inspection we found that the home was managing infection prevention and control well.” from the report
Improved management
There had been significant changes in management and staff during the previous year, but inspectors found the newly established management team effective and well organised.
“However, by the time of this inspection the management team had established itself as effective and well organised.” from the report
Medicine dose error
seriousOne person was prescribed and given more than the recommended dose of a medicine. The mistake was addressed immediately and did not adversely affect the person's health, but it showed that medicines safety systems had not been followed.
“This error was immediately addressed by the service; and appropriate advice was sought from health professionals.” from the report
Staffing and waiting times
needs fixingStaff were busy and inspectors saw one person waiting to be supported. Although most people and staff said staffing was adequate, inspectors recommended that staffing levels should be reviewed.
“Staff were busy on the day of the inspection, and we saw one person waiting to be supported.” from the report
Choice of food
minorFood was plentiful and freshly cooked, but some people said they could not influence the menu enough. The home introduced more ways for people who could not attend meetings to share their views after the inspection.
“But we had some concerns that not all people were able to influence the menu sufficiently.” from the report
- 01What changes were made after the medicine dose error, and how do you now check that medicines are prescribed and given safely?
- 02How do you use the dependency tool to decide staffing levels on each floor, including at night?
- 03How will you make sure people who stay in their rooms or in bed can influence the menu and share other views?
- 04What activities and support are available for someone who wants to go out of the home?
- 05How are the new management team and provider audits checking that earlier improvements have been maintained?
This was an unannounced full inspection covering all five key questions, including infection prevention and control measures under Safe. This explanation was written from the published report of 15 July 2021 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, February 2021
Hugh Myddelton House was inspected but not rated; inspectors were assured about infection prevention and control.
This was an announced, targeted inspection on 2 February 2021. It focused on how well the home was prepared to prevent and control COVID-19 infections.
Inspectors found that the home followed current infection control guidance. It had cleaning arrangements, PPE supplies, handwashing and sanitising stations, staff training, testing arrangements and an up-to-date infection control policy.
Families could visit in a specially adapted room with separate access. People were admitted after a negative COVID-19 test and supported to self-isolate for up to 14 days. Inspectors were assured about all the infection control areas they checked.
The home was inspected but not rated overall, and the Safe question was also inspected but not rated. The other four questions were not assessed in this inspection.
Infection control
The home followed current guidance and had an infection control policy and contingency plan that had been updated as guidance changed.
“The staff and management team had followed current guidance in relation to infection prevention and control.” from the report
Visiting arrangements
Although non-essential visits were restricted, families were supported to visit in a specially adapted room. Measures were in place for PPE and social distancing.
“families were supported to visit their loved ones in a specially adapted visiting room with separate access.” from the report
Cleaning and PPE
The home was clean and tidy, with designated cleaning staff, regular disinfection of frequently touched surfaces and adequate PPE supplies.
“There were adequate PPE supplies in the service.” from the report
Testing and admissions
People were admitted after a negative COVID-19 test and supported to self-isolate. People and staff were tested in line with national guidance.
“People were only admitted following a negative COVID-19 test result and supported to self-isolate for up to 14 days following admission” from the report
Inspectors raised no specific concerns in this report.
- 01How are the infection prevention and control arrangements described in this report being maintained now?
- 02How are visitors currently supported, and what PPE and social distancing arrangements are used?
- 03How are new admissions tested and supported to self-isolate?
- 04How often are frequently touched surfaces cleaned, and how is this recorded?
- 05What has changed since this inspection in testing, vaccination and infection outbreak arrangements?
This was a targeted inspection of infection prevention and control practices only; the service was inspected but not rated and the other key questions were not assessed. This explanation was written from the published report of 24 February 2021 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 Hugh Myddelton House
5 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Inspected but not ratedSafe: Inspected but not rated
- February 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2016Goodstayed GoodSafe: Requires improvementEffective: Requires improvementResponsive: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015Inspected but not ratedSafe: Inspected but not rated
- January 2015
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- July 2014Inspected but not rated
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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