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Manor Care Home - Middlewich Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 23 October 2021

About the service

Manor Care Home - Middlewich is a residential care home registered to provide personal care and accommodation for up to 44 people aged 65 and over. There were 40 people living at the home at the time of this inspection.

People’s experience of using this service and what we found

People did not receive their medicines safely and as prescribed. Some people had not been given their medicines because they were out of stock and one person had been given the wrong dose of a blood thinner. Medicines rounds were not always completed in a timely manner, which meant people did not receive their time-critical medicines when they needed them. The provider’s quality assurance processes to monitor the safety and quality of medicines administration were ineffective.

The provider did not have effective systems in place to monitor, assess and improve the quality and safety of service being provided. Quality assurance processes and records relating to this had not been properly maintained since our last inspection. The quality and accuracy of record keeping at the home was also inconsistent.

People said they felt there were enough staff. One person said “Always lots of staff around. I do most things for myself but they are quick when I need them.” Staff were visible around the home during our inspection and any call bells were answered promptly. Staffing levels were planned to meet people’s needs and the provider confirmed this considered the individual layout of the building. Staff were safely recruited, ensuring new staff were suitable to work with vulnerable adults.

People said they felt safe living at the home. One person said, “I do feel safe. Staff always check if I’m ok and I can say if I’m unhappy.” Staff had received safeguarding training and understood their role in recognising and reporting safeguarding concerns.

The home was clean and hygienic. Enhanced cleaning schedules were in place and cleaning products had been reviewed and amended in response to COVID-19. Staff followed the relevant guidance and best practice in relation to infection prevention and control. The home had a COVID-19 testing programme in place for people living at the home and staff. Staff and people living at the home had been supported to access COVID-19 vaccinations.

There was a caring and supportive culture amongst staff at the home. People appeared happy and comfortable. People living at the home and their relatives spoke positively about the staff. One relative commented, “Staff go above and beyond, they have a genuinely caring nature and treat people like family.” Staff were familiar with and knowledgeable about the people they were supporting.

People and their relatives said staff involved them in decisions about their care and kept them updated about any changes. One relative said, “I’m involved in all care plan reviews, staff are on top of all [Relative’s] needs.”

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 26 January 2021).

Why we inspected

We received concerns in relation to staffing levels, the management of medicines and governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.


We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicines management and governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas


Requires improvement

Updated 23 October 2021

The service was not always safe.

Details are in our safe findings below.



Updated 23 October 2021



Updated 23 October 2021



Updated 23 October 2021


Requires improvement

Updated 23 October 2021

The service was not always well-led.

Details are in our well-Led findings below.