CQC report explained · a nursing home
What the CQC found at Midland Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, staffing was sufficient, recruitment checks were completed and medicines were managed safely. Infection prevention arrangements were also found to be effective.
- Effective?
- Good
- People's health, nutrition and hydration needs were assessed and monitored. Staff had relevant training and worked with health professionals, and inspectors found the home was working within the Mental Capacity Act.
- Caring?
- Good
- Inspectors found that people were treated with kindness, dignity and respect. Relatives said staff were caring, responsive and consistent, and people were supported to maintain independence.
- Responsive?
- Good
- Care plans reflected people's physical, mental, emotional and social needs. People had access to activities, visitors, religious support and communication support suited to their needs.
- Well-led?
- Good
- The management team had improved its systems for monitoring quality and safety. Inspectors found an open culture, staff support, partnership working and evidence that information from incidents and complaints was used to improve care.
What inspectors found, August 2022
Midland Care Home was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors visited without notice on 10 August 2022. They spoke with people living in the home, relatives, staff and managers. They also reviewed care plans, medicine records, recruitment files and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were assessed, staffing was sufficient, medicines were managed safely and the home was clean and well maintained.
Relatives described staff as kind and caring. People had personalised care plans, support with health and nutrition, activities, family contact and religious or cultural needs.
The previous rating was Requires Improvement, published in February 2021. The home had been asked to improve its audits. Inspectors found that the management team now had a good overview of audits and that the service had made enough improvements.
Risk management
Individual risks were assessed and kept under review. The home used equipment and personalised evacuation plans to support people's safety.
“Potential areas of risk were assessed and improvements to systems and processes meant these were kept under review to reflect people's changing needs.” from the report
Kind and respectful staff
Relatives and people spoke positively about staff's kindness, commitment and approach. Inspectors also saw staff spending time talking, laughing and walking with people.
“Family members spoke well of staff about their kind and caring approach.” from the report
Personalised care
Care plans included people's health, emotional, social, cultural and communication needs. Staff were given information about people's preferences and how to support them.
“People's care was person centred, highlighting information known about the person to support a positive outcome for them.” from the report
Improved management oversight
The home had improved its audits and service development planning since the previous inspection. Managers used information from incidents, complaints and audits to identify improvements.
“The registered manager had good oversight of the provider's service development plan.” from the report
Activities and relationships
People could take part in activities at the home and in the local community. Visitors were welcomed, and staff supported religious beliefs and family relationships.
“Opportunities and the range of activities for people to engage and take part in both within the home and within their local community had increased.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you reassess my relative's risks and care plan if their mobility, nutrition, communication or health needs change?
- 02What staffing levels will be in place for my relative, and how do you check that staff have the right skills and training?
- 03How will my relative and our family be involved in decisions about medicines, including any medicine given without their knowledge?
- 04How will you support my relative's preferred language, cultural or religious needs and personal interests?
- 05How do you use safeguarding concerns, accidents, complaints and audits to make changes to care?
This was an unannounced inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 26 August 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, February 2021
Rated Requires Improvement; inspectors found safer care than before, but risk records and quality checks still needed work.
This was a focused inspection on 14 January 2021. Inspectors checked whether earlier problems with safe care and oversight had been put right. They spoke with people, relatives and staff, and reviewed care, medicines, staffing, infection control and management records.
The home had improved since its previous Inadequate rating. Medicines were managed safely, the home was clean, infection control measures were in place, and staff were safely recruited. Care was person centred, and relatives were kept informed.
However, some risk assessments and monitoring records were not up to date or consistently completed. Some equipment safety checks were not recorded, and quality audits had not found these gaps. The overall rating and the ratings for Safe and Well-led were Requires Improvement.
The home had previously been in Special Measures after an Inadequate rating. Inspectors found it was no longer in breach of regulations and it was taken out of Special Measures.
Medicines were managed safely
Registered nurses administered, stored and disposed of medicines safely. Staff were checked regularly to make sure they remained competent.
“Medicines were administered, stored and disposed of safely by staff who were registered nurses.” from the report
Clean and safer during COVID-19
The home was clean and had extra infection control measures. Inspectors were assured that PPE, testing, social distancing and outbreak arrangements were in place.
“The home was clean and free from malodour.” from the report
Learning from incidents
The home made changes after falls, including medicine reviews and referrals to specialists. Inspectors found that falls had reduced.
“Lessons had been learned when things went wrong.” from the report
Person-centred care
Care plans included people's histories, relationships, preferences and communication needs. People were supported to make choices and take positive risks.
“Care was person centred; the management team had ensured care plans contained enough information to support staff with providing person centred care.” from the report
Risk information was not always current
needs fixingSome risk assessments did not reflect people's current risks. This included a choking risk, and some emergency evacuation plans contained confusing or conflicting information.
“some people's risk assessments had not been updated to reflect current risk.” from the report
Monitoring records were incomplete
needs fixingSome checks were not completed consistently, including bowel charts for a person at risk of constipation. This meant staff records did not always show the monitoring that was needed.
“There were some inconsistencies in monitoring.” from the report
Equipment checks were not recorded
needs fixingStaff were checking some equipment visually, but there was no established system for recording and monitoring those checks. A new system had been introduced but still needed to become routine.
“Some equipment safety checks were not being recorded.” from the report
Quality audits needed strengthening
needs fixingThe home's systems had not identified the gaps found by inspectors in risk management and records. Inspectors recommended reviewing audits so all safety and quality areas were monitored.
“Systems and processes had not identified the issues and gaps we found in risk management and record keeping during the inspection.” from the report
- 01How do you make sure every person's risk assessment is updated when their health or needs change?
- 02How are emergency evacuation plans checked so room numbers and other information are correct?
- 03How do you record daily safety checks on mattresses, falls mats and other equipment?
- 04What evidence can you show that bowel charts and other risk monitoring records are now completed consistently?
- 05How are staffing numbers being reviewed in response to staff feedback about people's needs?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 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 Midland Care Home
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- August 2020Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- December 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: InadequateWell-led: Inadequate
- December 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- October 2017
Registered with the Care Quality Commission on 9 October 2017.
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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