CQC report explained · a nursing home
What the CQC found at Mallard Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were recorded and reviewed, and staff followed instructions to reduce them. Inspectors also found safe staffing, safe medicines management, effective fire safety and infection control.
- Effective?
- Good
- People's needs were assessed and care was reviewed monthly. Staff received training and supervision, and people were supported with food, healthcare, decision-making and dementia-friendly surroundings.
- Caring?
- Good
- Staff were kind, patient and respectful. People were involved in care decisions, supported to make choices and encouraged to remain independent.
- Responsive?
- Good
- Care plans were personalised and kept up to date. Activities reflected people's interests, communication needs were assessed, complaints were handled and end of life wishes were respected.
- Well-led?
- Good
- Inspectors found positive leadership, regular checks on quality and an open culture. A new registered manager had led improvements since the previous inspection.
What inspectors found, January 2020
Mallard Court was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The inspection took place without notice on 25 November and 2 December 2019. Inspectors spoke with people living at the home, relatives, staff and a visiting health professional. They observed care and checked care plans, medicines, recruitment, training and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were managed, medicines were given as prescribed, staff were trained and people were treated with dignity and respect.
The home had improved from Requires Improvement at the previous inspection, published in November 2018. Improvements included staffing, risk management, care, leadership and quality checks.
Kind and respectful staff
People and relatives described staff positively. Inspectors saw trusting relationships and care that respected privacy, dignity and independence.
“People were cared for and supported by staff that were kind, patient and respectful.” from the report
Personalised activities
Activities were adapted to people's interests and needs. The home also supported people to keep in touch with friends and family.
“Activities were tailored to meet people's individual needs, preferences and interests.” from the report
Improved leadership
The new registered manager had worked with staff to improve the culture and care. Quality checks were used to identify and drive improvements.
“The registered manager worked collectively with all staff to demonstrate and embed a positive culture to promote a high standard of person- centred care and support for people.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure risk assessments remain up to date when a person's needs or behaviour changes?
- 02How many staff are available at different times of day, and how do you provide extra staffing when incidents show it is needed?
- 03How will you tailor activities and communication to my relative's interests, abilities and communication needs?
- 04How will my relative and our family be involved in reviewing care plans and making decisions about care?
- 05How are end of life wishes recorded, shared with staff and followed?
This was an unannounced inspection covering all five CQC questions, including the care provided and the home environment. This explanation was written from the published report of 11 January 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2018
Rated Requires Improvement; inspectors found some safe, effective and responsive care, but concerns about pressure care, dignity, staffing and management.
Inspectors made unannounced visits on 11 and 18 October 2018. They spoke with people, relatives, staff and healthcare professionals. They reviewed care records, staff files, training records, complaints and quality checks, and observed people's care.
The home was rated Good for effective and responsive care. Inspectors found that people's food, drinks, training and mental capacity needs were supported. Care plans were generally person-centred, and people had access to activities, although some relatives felt activities were not shared equally.
The home was rated Requires Improvement overall, and also for safe, caring and well-led care. Inspectors found that pressure care had not been managed properly for one person, some people waited for basic help, and some staff communication was unprofessional. The home's checks had not found all the problems identified during the inspection.
Medicines
Medicines were managed consistently and safely by staff who were judged competent.
“The provider had systems in place that ensured people's medicines were managed consistently and safely by competent staff.” from the report
Food and drink
People were offered choices, and staff gave appropriate support with meals. Drinks and snacks were available throughout the day.
“People's nutrition and hydration needs were catered for. A choice of meals was offered and drinks and snacks were made readily available throughout the day.” from the report
Staff training
New staff received a structured induction, followed by ongoing training. Staff also received regular supervision and annual appraisals.
“New staff were supported to understand their role through a structured induction.” from the report
Person-centred planning
Care plans included people's communication needs, beliefs, preferences and end of life wishes. People and relatives were involved in developing the plans.
“People and their relatives were involved in the development of their care plans.” from the report
Pressure area care
seriousOne person's skin was not monitored as required, and the pressure sore deteriorated before more frequent repositioning was introduced. The manager said an investigation would be completed.
“Staff had failed to monitor this person's skin integrity, despite a concern being highlighted to the home by a healthcare professional that the skin had started to break down.” from the report
Waiting for basic care
seriousInspectors saw a person wait 30 minutes for help to use the toilet. They also found minimal interaction and no stimulation during part of their observation.
“This person was left to wait for 30 minutes in the reception area for staff to assist them to the toilet as staff prioritised moving people from the dining room.” from the report
Staffing and deployment
needs fixingPeople and relatives gave mixed views about staffing, and some people waited when they used their call bell. The manager said staff deployment and break arrangements would be reviewed.
“Staff were not always effectively deployed to meet the needs of people.” from the report
Quality checks
needs fixingThe home carried out regular audits, but some checks did not identify the problems inspectors found. This reduced the home's ability to correct issues promptly.
“The quality assurance systems in place had failed to identify concerns we found during the inspection.” from the report
- 01What has changed in the pressure area care process since the inspection, and how do you check that repositioning and skin checks are completed?
- 02How do you make sure people receive prompt help to use the toilet, especially after meals?
- 03How do you assess and adjust staffing levels and staff deployment during busy periods?
- 04How do you ensure activities and trips are offered fairly to all residents who want to take part?
- 05What checks now identify poor staff communication, missed care and concerns that were not found by the previous audits?
This was an unannounced inspection of all five key areas, using discussions, records and observations of care. This explanation was written from the published report of 27 November 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Mallard Court
4 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- February 2017Goodstayed GoodSafe: Good
- April 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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