Residential, Nursing & Dementia Care

The Maltings Care Home


The Maltings Care Home CQC Review

Inspection carried out on 19 January 2021. Date of publication 11 February 2021

This was a targeted inspection looking at the Infection Prevention and Control practices the provider has in place.

The Maltings Care Home is a residential care home providing personal and nursing care to 50 people at the time of the inspection.

Is the service safe?

CQC Findings

  • We were assured that the provider was preventing visitors from catching and spreading infections.
  • We were assured that the provider was meeting shielding and social distancing rules.
  • We were assured that the provider was admitting people safely to the service.
  • We were assured that the provider was using PPE effectively and safely.
  • We were assured that the provider was accessing testing for people using the service and staff.
  • We were assured that the provider was promoting safety through the layout and hygiene practices of the premises.
  • We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.
  • We were assured that the provider’s infection prevention and control policy was up to date.

We found the following examples of good practice.

The service was only receiving essential visitors at the time of our inspection. Visitors were required to take a Lateral Flow Test (LFT). This test enables the provider to test for COVID –19 and have results within a short period of time. There were stations to wash hands and personal protective equipment (PPE) was available to everyone to keep people safe.

People living in the service had their meal times and activities staggered to support better ways of social distancing. Communal spaces had been adapted to ensure social distancing was maintained. The provider had installed a "pod" into the home to support safe visiting. Relatives accessed the pod from the garden, the provider had installed a partitioned wall with a big viewing pane for good visibility and a two-way speaker system that allowed good communication.

People were supported by staff in full PPE, this is called barrier nursing. This is to protect both staff and people living in the service from spreading infections. Staff received training in infection prevention and the correct procedure for putting on and removing PPE, this is called donning and doffing.

The registered manager told us that they had changed systems within the service to reduce the spread of infection. For example, the same staff would work in the same areas this is known as cohorting and is good infection control practice. The home had no COVID-19 cases at the time of the inspection but were still applying these good practices.

The building was clean and free from clutter. During our inspection we observed cleaning staff completing their duties. The registered manager told us that frequently touched areas were cleaned more often. The home had infection control champions they would ensure on a weekly check list that there were enough PPE in stock and that appropriate signage was in place throughout the home. Staff were also observed individually to ensure donning and doffing procedures and guidance were followed.

The registered manager told us that they were working collaboratively with the General Practitioner (GP) from the local surgery who was their clinical lead. The provider spoke highly of the GP and confirmed the GP had been very supportive and involved with the home, they had supported staff with good guidance around infection control.

The registered manager told us that they were working collaboratively with colleagues from the Local Authority and CCG (Clinical Commissioning Group) and were well supported as a result.

Download full report from CQC. Inspection report published 11 Feb 2021

The Maltings Care Home CQC Rating Good

CQC rating Good

December 2019: The Maltings Care Home latest CQC inspection receives a rating of Good.

Extracts from the report:

Summary of Findings - Good

  • People liked the staff that cared for them. Staff were kind and caring and made sure people’s privacy was respected. Staff did everything they could to make people’s lives as comfortable and fulfilling as possible.
  • People were involved in making decisions about their care. Their preferences on how staff delivered their care was recorded in their care records. This included their end of life wishes.
  • The service was well managed by a registered manager and regular input from the nominated individual and directors. The management team were passionate about giving people a high-quality service.
  • Staff used varying systems to monitor the quality of care being delivered to people. Complaints and concerns had been followed up to make sure action was taken to rectify the issue. People, staff and relatives had been given opportunities to provide their view of the service and from this feedback action was taken to change and improve areas.
  • 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.

Is the service safe? - Good

  • People and relatives told us they, and their family members felt safe with the staff supporting them. People said they could call staff to help them whenever they needed.
  • People had risk assessments and guidance in place to support staff to reduce the risk of harm occurring. Staff used information from risk assessments to help keep people safe. For example, one person’s risk assessment identified that they were able to walk short distances, however required supervision of two staff during this activity to ensure they were safe.
  • Staff were aware of how to report accidents and incidents. The registered manager and a health and safety coordinator reviewed incidents and accidents monthly and identified any trends or recurring themes. If concerns were identified action was taken to reduce the likelihood of a reoccurrence.
  • Systems were in place to ensure that medicines were stored, administered and disposed of in a safe manner. Staff responsible for giving people their medicines had received training to ensure that they received their medicines as prescribed.
  • Staff had completed training in how to reduce the risk of infection and they followed good practice guidance. They used personal protective equipment to help prevent the spread of infection.
  • The service was clean and tidy and housekeeping staff followed a schedule of cleaning, and housekeeping staff were visible throughout the inspection.
  • Staff managed incidents or accidents effectively. Staff recorded these appropriately and the registered manager took action following accidents or incidents to reduce the risk of these reoccurring.

Is the service effective? - Good

  • The management team fully assessed each person’s needs before they offered the person a place in the service. During our inspection we saw a person moving into the service greeted by staff who had familiarised themselves with what was important to that person.
  • People were allocated a named member of staff as their keyworker, this is so that people can discuss their care, or any other issues with a dedicated person. People knew about this new scheme and seemed happy with the approach, one person told us, “I get on very well with, my key worker, [they] know what to do and what I like.”
  • Staff monitored people’s weight and encouraged people to eat and drink enough to maintain their health.
  • People were very positive about the food, and the interaction they had with the chef. One person told us, “(Chef) is exceptional, they come around and ask us if the food is OK and will adapt to suit us.”
  • One of the chefs told us that they know people well, and understand people’s needs, including food allergies and likes and dislikes. They told us they made food not on the menu for people who requested it. One person told us, "When lasagne is on the menu they make me one without cheese as I can’t eat cheese.”
  • A system was in place to refer people to external healthcare professionals when required, for example dieticians and speech and language therapists. Staff followed advice and recommendations.
  • The registered manager reviewed all contact made with emergency healthcare professionals, for example ambulance staff and GP’s. This was to ensure that staff had taken appropriate action in a timely manner, and to review any trends or patterns in contacting these services.
  • The provider had made adaptations to the service to ensure people were able to move around safely. A hand rail was in place along the side of each corridor and equipment was in place in bedrooms, toilets and bathrooms to allow people to safely use these areas independently.
  • The service was decorated to a very high standard. People had access to plenty of indoor and outdoor spaces where they could choose to be alone, sit with other people or join in activities.

Is the service caring? - Good

  • People were happy living at The Maltings Care Home and staff were kind, caring and compassionate. One person told us, “They (staff) make you feel that it is ’your’ home not ’a’ home. All the staff are wonderful.”
  • Staff communicated with people in a way that that person understood best and treated people equally and without discrimination. Staff considered people’s protected characteristics under the Equality Act 2010 and supported people to have their diverse needs met.
  • Staff knew each person well and understood what was important to the individual. A relative told us, “The [staff] are quite affectionate, they are good and do whatever is asked of them.”
  • Staff supported people to make choices about their care throughout the day. For example, people told us they could choose whether to have a bath or a shower.
  • Staff encouraged people to socialise with other people in the service, regardless of which floor people lived on. One person told us they chose to eat in a dining room on another floor as they enjoyed eating with the people there. We observed lunch time, and could see people enjoying themselves, enthusiastically talking with care staff and the chef and people at their table.
  • Throughout our inspection we observed staff kneeling down at eye level when speaking to people to aid their understanding when giving people choices.
  • Staff fully respected and promoted people’s privacy, dignity and independence. Staff offered personal care discreetly and made sure that people’s dignity was respected. For example, we saw somebody being supported by staff with the use of a hoist, staff ensured that this person’s legs were covered at all times to ensure the transfer was as dignified as possible.
  • Staff supported people to maintain relationships with relatives and friends. They welcomed visitors to the home, and relatives and friends were invited to meetings and special events. One visiting friend told us, “‘We’re always made welcome and offered tea and coffee,” and another said, “We wouldn’t call them carers, they’re friends.”

Is the service responsive? - Good

  • People had care plans in place, which were personalised and written in detail. These gave staff enough guidance on how to respond to people’s needs effectively and safely.
  • The service adapted to meet people’s needs and supported people to continue to have choice and control over aspects of their life which was important to them. One person told us how staff had made it possible for their daughter to stay with them for a few days over their birthday. For them, this was important and showed how the service had appreciated the positive impact it would have on their well-being.
  • People were encouraged to take part in social activities to help manage and avoid social isolation. Care plans contained information about people’s interests and guided staff to offer different choices of interest to people if they didn’t want to join in activities.
  • People were encouraged to take part in activities and interests which they enjoyed. For example, one person had an active role in administration tasks in the office, enabling them to use their skills to support staff and fulfil their time with meaningful activity.
  • We watched as a person living in the service entertained a number of people playing a piano. People enjoyed listening to the music and were happy and relaxed. The provider told us this person had played at other services ran by the provider, including a service opening attended by a member of the Royal Family.
  • The service had an activity team who ensured that a full timetable of activities was offered responsible for coordinating different activities throughout the week. There was a full timetable of activities offered. People and relatives were very positive about the activities on offer. One person told us, “The activities coordinator is absolutely brilliant, we’d miss them. [They] really do a lot and asks us for opinions on activities. “A relative also told us that, “(The activities coordinator) is brilliant, they really go the extra mile to bring in good acts and other various things.”
  • People had a communication plan in their care records to guide staff on people’s current level of communication and understanding, and how people can express their needs, and make their choices known. It also included how people like to be addressed. People and relatives knew who to speak with if they were not happy with the care they, their family member received. A relative told us, "Everyone is very friendly and helpful. Any problems are looked into straightaway.”
  • The registered manager and staff had given people the opportunity to discuss their end of life wishes and these had been recorded in people’s care records.
  • All staff, including catering and housekeeping staff had received end of life care training. The chef we spoke to was visibly proud and passionate about their role in people’s end of life care, ensuring that whatever food people requested at this time was provided.
  • Relatives had commended and thanked the registered manager and the staff team on the support given to their family member during their end of life care. One card read, "A big thank you to [staff] who showed the greatest care and respect to [family member] in the last week of her life, it meant so much! Thank you.”

Is the service well-led? - Good

  • The provider, registered manager, and staff team were committed to developing a person-centred culture within the service. The registered manager understood their responsibilities to ensure people received the care they needed and stepped in to support staff wherever necessary.
  • Staff told us that they enjoyed working at The Maltings Care Home. Staff also told us that they would be happy for a member of their family to live in the service. This is called the ‘Mum Test’, and staff explained that this was because, “I think my family would like it, because the house is beautiful, the food is beautiful, and the care is good.”
  • People and their relatives were invited to regular meetings which gave them the opportunity to raise concerns, compliments and suggestions.
  • Staff told us that they attended regular team meetings, and daily handover meetings which ensured information was shared quickly with them. Staff also had handheld computer devises whilst on shift which contained important information they needed to know urgently.
  • People told us that their suggestions were listened to and led to changes. For example, one person told us that people had asked the activities coordinator if there was a way they could buy little things they wanted such as tissues and shampoo. The activities coordinator set up a trolley service so that people could buy what they wanted. This showed that staff listened to what was important to people.

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The Maltings is open and accepting new care enquiries. For information on vacancies please contact the Care Enquiries Team by phone or email.