Background to this inspection
Updated
3 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
The Maltings is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service since the last inspection.
During the inspection-
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. The people at the service was not able to tell us about their experiences of the care they received. We spoke with two members of staff and the registered manager,
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We spoke with a relative and made efforts to contact professionals who regularly visit the service.
Updated
3 April 2020
About the service
The Maltings is a residential care home providing personal care to three people with learning disabilities. At the time of the inspection three people were living at the service.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People’s experience of using this service and what we found
Risks assessments and support plans were combined and included the measures to reduce the risk of harm to people. For example, for one person textured meals were served to reduce the risk of choking. Support plans were not always person centred and for some people the reviews had not been updated since 2017. Some support plans were task focused and the language used was not always in line with a person centred approach. The registered manager had identified in the improvement plan that the quality of support plans needed to improve.
Where people became distressed or anxious the staff knew how to manage the situations. The registered manager had agreed to review the behaviour plans. This was to ensure there was detailed guidance to staff on how to support people when they were asked to go to their bedroom to regain control of their emotions. We recommended the registered manager seek guidance on developing behaviour support plans that have detailed guidance to staff.
Although communication plans were in place and acknowledged people’s sensory needs. The actions did not include developing records in formats that helped people understand the support to be provided. For example, picture formats and audio recording will help people understand the care being delivered.
Quality assurance systems were in place and effective. The areas identified at the inspection were already set for action by the registered manager.
There were in-house activities and staff told us people were supported with in-house or community activities.
People were not able to tell us about their experiences of living at the home or on how the staff supported them. People did not show signs of distress while staff were present. We saw people accept staff support and interaction.
We saw examples of good engagement between people and staff. The staff told us how they ensured people were treated with kindness and compassion. The relative we spoke with gave positive feedback about the care and support delivered by the staff.
The staff had attended safeguarding of adults from abuse training. They knew the procedure for safeguarding people which included the types of abuse and reporting their concerns.
There were sufficient staff on duty to meet the needs of people. The recruitment procedures followed ensured suitable staff were employed.
Medicine systems were safe. The registered manager acted promptly and added the person’s ability to express pain to the “when required” protocols.
New staff received an induction which included the Care Certificate. Staff attended mandatory training set by the provider. Staff were supported with the responsibilities of their role which included regular one to one supervision.
Mental capacity assessments were in place for specific decisions. The staff were knowledgeable about the day to day decisions people made. People at the service were subject to continuous supervision and restrictions and appropriate Deprivation of Liberty Safeguards applications were made.
People were supported with their ongoing health. People had access to community health such as therapists, dentists and opticians.
People’s dietary requirements were catered for.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published on 27 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.