CQC report explained · a nursing home
What the CQC found at Middlesex Manor Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found appropriate pressure sore treatment, regular repositioning and suitable pressure-relieving mattresses. Infection prevention measures were also in place, but the whole Safe question was not assessed.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, December 2022
Inspected but not rated; this targeted visit found no concerns about pressure sore care, and the previous overall rating remained Good.
This was an unannounced, targeted inspection on 28 June 2022. Inspectors looked at pressure sore care because there had been a high number of reports about pressure area sores. They also checked infection prevention and control.
Inspectors found that pressure sores were treated appropriately. People had pressure-relieving mattresses, were repositioned regularly, and were supported by GPs and tissue viability nurses when needed. The home monitored treatment and acted when it found problems.
Infection controls were also found to be in place. These included hand hygiene, temperature checks, COVID-19 testing, personal protective equipment and regular cleaning. The inspection did not assess the whole Safe question or the other four questions, so it did not change the previous overall rating of Good.
Pressure sore care
People who needed pressure sore care received treatment with input from GPs and specialist tissue viability nurses. Their treatment and progress were monitored.
“People's records showed pressure area sores were treated in an appropriate manner.” from the report
Pressure prevention
The home provided pressure-relieving mattresses, checked their settings and repositioned people regularly. Changes were made to rooms where this reduced risk or improved comfort.
“Regular repositioning had taken place for people who would otherwise remain in one position, thus increasing the risk of skin tissue breakdown.” from the report
Infection controls
The home used hand hygiene, PPE, testing, visitor checks and regular cleaning to help prevent infection.
“This had helped to minimise, prevent and control the risk of infection.” from the report
Information before admission
needs fixingThe home said it was not always able to identify the severity of pressure sores during the pre-admission assessment. A full skin assessment was completed after admission.
“However, this was not always the case.” from the report
Accuracy of sore grading
needs fixingInspectors found that staff had incorrectly graded one pressure sore. The home responded by holding meetings to refresh staff knowledge.
“when staff had incorrectly graded a person's pressure area sore, meetings were held with all relevant staff members to refresh their knowledge and understanding of pressure area care.” from the report
- 01How do you check a new resident's skin condition immediately after admission?
- 02How do you make sure pressure-relieving mattresses are set correctly for each person?
- 03How often are residents repositioned, and where is this recorded?
- 04What training do staff receive after an error in grading a pressure sore?
- 05How would my relative receive visitors if there was an infection outbreak?
This was a targeted inspection of specific pressure sore and infection control concerns; it did not assess the whole Safe question or the other four questions, and the previous overall rating of Good carried over. This explanation was written from the published report of 22 December 2022 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 2022
Inspected but not rated; inspectors found strong COVID-19 infection control arrangements, but this was not a full assessment of the home.
The inspection took place on 14 January 2022 and was announced with 24 hours' notice. It was a targeted inspection during the COVID-19 pandemic.
Inspectors looked at infection prevention and control, visiting arrangements and staffing pressures. They found the home was following procedures for testing, personal protective equipment, hand hygiene, cleaning, social distancing and safe visiting.
The home was inspected but not rated. This means the report does not give an overall quality rating or full ratings for all five areas of care.
Infection control checks
People, staff and visitors were subject to testing and other checks before entering. The home also used PPE and hand hygiene measures.
“Everyone entering the home was required to wash and sanitise their hands, provide evidence of COVID-19 vaccination, where relevant, a negative COVID-19 lateral flow test, and receive a temperature check” from the report
Regular monitoring
An infection control lead worker was present on every shift in each unit to check that procedures were followed.
“An infection control lead worker was rostered on to each shift in each unit at the home.” from the report
Cleaning arrangements
Frequently touched surfaces were cleaned throughout the day, with additional cleaning by care staff at evenings and weekends.
“Members of the housekeeping team cleaned frequently touched surfaces, such as light switches, lift buttons and door handles throughout the day.” from the report
Support during isolation
People who needed to isolate could receive personalised activities. Activities were also repeated across units so people could join regular groups safely.
“Where people had been confined to their rooms, for example, due to a need to isolate, staff provided personalised activities for them, such as videos, music and chats.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing COVID-19 testing, vaccination checks and PPE for staff and visitors?
- 02How do you manage visiting when someone is isolating or there is an infection outbreak?
- 03How are staffing pressures affecting the home now, and what measures are in place if staff need to isolate?
- 04Is an infection control lead worker still available on every shift in each unit?
- 05What is the home's current overall CQC rating from any later full inspection?
This was a targeted inspection of infection prevention and control, visiting arrangements and staffing pressures; it was not a full assessment of all five questions and the service was not rated. This explanation was written from the published report of 31 March 2022 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 Middlesex Manor Care Home
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- December 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- March 2022Inspected but not ratedSafe: Inspected but not rated
- October 2020Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 1 October 2010.
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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