Archived: The Maltings Care Home

Updated 10 August 2022

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.

Inspection team

The inspection was carried out by three inspectors, one of whom was a medicines inspector.

Service and service type

The Maltings Care Home 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. The Maltings Care Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there not a registered manager in post as they had left the service the previous week without notice.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection, including notifications of significant events which the provider is required to tell us about. We sought feedback from the local authority quality improvement team. 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 the regional manager, the regional support manager (who was in day to day charge of the service), three senior care staff, the activities co-ordinator, the chef, two care staff and two domestic staff. We also spoke with six residents and three relatives. We reviewed six care plans in detail alongside sections from others and 14 medication administration records.

Updated 10 August 2022

About the service

The Maltings Care Home is a residential care home providing personal care to up to 43 people in a purpose built building with an upper and a lower floor, each with a separate dining room and lounges. At the time of our inspection there were 19 people using the service.

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

Although there was an improvement in the oversight of many aspects of the service, some basic oversight was not in place. Food and fluid charts, repositioning charts and records monitoring people’s continence were not always completed accurately and were not effectively monitored. One person’s medicines had not been accurately entered onto the system following their discharge from hospital. This poor recording represented a failure of systems which have the potential to harm people and meant there was a continued breach of regulation relating to the monitoring and mitigating of risk.

However, we also noted that the service had improved in all other areas, despite not having a consistent registered manager in post. The provider had worked hard to ensure continuity of leadership even though this had been a challenge. People who used the service, relatives and staff were mostly positive about the service and had confidence in the provider.

The provider conducted effective health and safety monitoring of the environment. Staff were recruited safely and there were enough staff to meet people’s needs. There were good infection control practices in place and safeguarding concerns were well managed.

Healthcare needs were mostly well documented, but some records required closer monitoring. Pre-admission assessments were in place. Staff, including agency staff, were well trained and received a good induction. Consent was well documented, and staff had an understanding of the issues relating to consent. 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.

The environment was much improved and there were plans in place to encourage people to use communal spaces more. There was some mixed feedback about the food but overall people were happy with their meals.

Staff were kind and caring. Interactions were positive and people were treated with respect. People were involved in decisions about their care.

Care plans documented people's specific and individual needs well. Staff knew people well and information, except that in some people’s room folders, was well recorded and handed over from shift to shift.

Activities were varied and people were positive about them. End of life care plans were in place and people’s wishes were documented. Complaints were managed well. People had a voice and residents meetings enabled people to raise issues or concerns.

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 3 October 2020).

We placed conditions on the provider’s registration which required them to submit a monthly action plan to us so that we could monitor them more closely and ensure the required improvements took place.

At this inspection we found the provider had made significant progress but remained in breach of one regulation relating to leadership and governance.

This service has been in Special Measures since 2 October 2020. 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

This inspection was carried out to follow up on action we told the provider to take at the last 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.

Enforcement

We have identified a breach of regulation in relation to the monitoring of people’s health and inaccurate record keeping. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.