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CQC report explained · a residential care home, run by Ivolve Group

Middleton

485 Rochdale Road, Middleton, Manchester, M24 2GN

Requires improvementpublished 21 February 2024, 2 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
Medicine records did not always match stocks, some entries were not checked and signed, and controlled drug procedures were not always followed. Other safety arrangements, including safeguarding, risk assessments, fire checks, recruitment and infection control, were generally in place.
Effective?
Good
Staff had training and understood people's individual needs. People received support with nutrition and healthcare, although staff meetings and supervision had not been held regularly and some care records needed more detail.
Caring?
Good
People were treated with kindness, dignity and respect. Staff knew people well, supported their independence and helped them make choices about their daily routines.
Responsive?
Good
People followed activities and routines of their choice, maintained relationships and accessed the local community. Care files needed updating, and a new electronic care planning system was being introduced.
Well-led?
Requires improvement
Audits did not identify all the medicine problems found by inspectors. Relatives were not always involved or kept informed, and there was no registered manager in post at the time of the inspection.
The latest report, explained

What inspectors found, February 2024

Middleton rated Requires Improvement; inspectors found kind, responsive care, but medicines were not always managed safely and management oversight was not effective.

Inspectors visited on 28 November and 7 December 2023. One inspector, a medicines specialist and an Expert by Experience looked around the home, observed care, spoke with people, relatives and staff, and reviewed medicines, care plans, recruitment and safety records.

The home was caring, effective and responsive. People were treated with respect, supported to make choices, helped to stay independent and supported to follow their interests. Staff understood people's needs and relatives generally felt people were safe and well cared for.

There were important problems with medicines. Records did not always match medicine stocks, some entries were not checked, and staff did not always refer to records before preparing medicines. The home also needed better care records, stronger audits and clearer involvement of people and relatives.

The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement, while effective, caring and responsive were rated Good. The previous overall rating was Good, published on 2 July 2018.

What inspectors praised
  • Kind and respectful support

    Inspectors saw friendly interactions and found that staff knew people well. People were supported with dignity, privacy and independence.

    People's privacy, dignity and independence were respected and promoted.from the report
  • Activities and relationships

    People were supported to keep in touch with family and friends and to take part in activities, trips and routines they chose.

    People were supported to maintain relationships, follow their interests, and take part in activities that were relevant to them.from the report
  • Staff skills and training

    Staff had completed induction and relevant training, including training related to learning disabilities, autism and distress behaviours.

    The service made sure staff had the skills, knowledge, and experience to deliver effective care and support.from the report
  • Safeguarding and general safety

    Staff understood how to report concerns. Risk assessments, fire safety checks, recruitment checks and infection control arrangements were in place.

    People were safeguarded from abuse and avoidable harm.from the report
What inspectors were concerned about
  • Medicine safety

    serious

    Medicine records did not always match stocks, handwritten entries were not properly checked, and staff did not always use the medicine record before preparing medicines. Controlled drug records and guidance for as-needed medicines also had problems.

    People were supported to receive their medicines in a way that was not always safe.from the report
  • Weak management checks

    serious

    The home's audits did not identify all the medicine problems found during the inspection. Systems for checking and improving the service were not effective enough.

    Systems needed to be improved to evidence more effective management and oversight of the service for the purposes of continually evaluating and improving such services.from the report
  • Care records and family involvement

    needs fixing

    Some care records needed updating, and records did not always show who had been consulted. Relatives said they were not always involved in care planning or kept informed about the home.

    People and their relatives were not always included in discussion about the home and their care and support.from the report
  • Management arrangements

    needs fixing

    There was no registered manager in post during the inspection. Management support was being provided and a new manager was to be appointed, but relatives were not always clear about who was responsible.

    At the time of our inspection there was no registered manager in post.from the report
Questions to ask them, based on this report
  1. 01What changes have been made to medicine records, controlled drug checks and as-needed medicine guidance since the inspection?
  2. 02Has a new registered manager been appointed, and who is currently responsible for the home?
  3. 03How will you make sure care plans are reviewed and kept up to date?
  4. 04How are people and relatives now involved in care planning and decisions about the home?
  5. 05How often are staff meetings and supervision sessions now held?

This was an inspection of the care home covering all five CQC questions, with particular checks on medicines, care plans, staffing, safety records and management systems. This explanation was written from the published report of 21 February 2024 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.

The story over the years

Every inspection of Middleton

4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.

  1. February 2024Requires improvementcurrent rating
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at Middleton

  2. June 2021Inspected but not rated
    Safe: Inspected but not rated

    We are reading this report · the original is on cqc.org.uk

  3. June 2018Goodstayed Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. February 2017Goodup from Requires improvement
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  5. November 2015Requires improvement
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  6. December 2014

    Registered with the Care Quality Commission on 18 December 2014.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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