Background to this inspection
Updated
16 February 2023
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 3 inspectors, a member of the medicines team and a specialist advisor in learning disability care on the first day and 3 inspectors on the second day.
Service and service type
Options Malvern View is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Options Malvern View is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 29 December 2022 and ended on 26 January 2023. We visited the location on 04 and 05 January 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We also requested feedback from Healthwatch to obtain their views of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 2 people using the service, observed the care provided, and spoke with 4 family members of people using the service.
We spoke with 27 staff which included the registered manager, deputy manager, care manager, specialist speech and language therapist/clinical lead, clinical therapy assistant, activities staff, senior care staff, care staff, agency care staff, maintenance, administration staff, quality lead and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. In addition, we spoke to a visiting professional.
We reviewed a range of records. This included 5 people's care records and 5 medicine administration records, the current medicine systems for administration and the storage of medicines. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including the monitoring of incidents and restraints over the last six months, were reviewed.
Updated
16 February 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Options Malvern View is a residential care home providing personal care to 22 people at the time of the inspection. The service can support up to 33 people living with a learning disability and/or autism.
People’s experience of using this service and what we found
Right Support: Risks associated with medicines were not always monitored or managed consistently. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care: People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood and responded to people's individual needs. People who had individual ways of communicating, using body language, sounds, pictures and storyboards could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them. People’s care and support plans were up to date and current. Staff were provided with detailed guidance to enable them to to provide personalised support to people.
Right Culture: There had been changes to the way the home was run since our last inspection. Relatives told us this had started to make a difference to the quality of care. The registered manager and provider had identified some improvements were needed in the way people’s medicines were managed and checked. Steps were being taken to address these. Management were open and visible and were committed to developing people’s care further. Staff knew and understood people well and were responsive, supported their aspirations to live a quality life of their choosing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 6 July 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made and the provider was no longer in breach of regulation 12 and regulation 18.
This service has been in Special Measures since 7 July 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Options Malvern View on our website at www.cqc.org.uk.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.