CQC report explained · a residential care home
What the CQC found at Maltreath Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. There were enough staff, recruitment checks were completed, medicines were managed safely and infection control arrangements were in place.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating carried over.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating carried over.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating carried over.
- Well-led?
- Requires improvement
- Management checks had not identified gaps in risk assessment records. Some important events had not been reported to CQC promptly, although new systems were in place.
What inspectors found, March 2023
Maltreath Residential Care Home is rated Good overall, but well-led Requires Improvement because care records and some CQC notifications were not always handled properly.
This was an unannounced inspection on 2 March 2023. One inspector spoke with three people, five staff members and two relatives. They reviewed care records, medicines records, staff recruitment files and management records.
The home was rated Good for Safe. People said they felt safe. Inspectors found enough staff, safe recruitment, suitable medicines systems and good infection control. Staff understood safeguarding and knew how to respond when risks or incidents arose.
The home was rated Requires Improvement for Well-led. Some risk assessments did not explain clearly what staff should do when a risk happened. The registered manager had also not always told CQC about important events promptly, although this had been corrected by the time of the inspection.
The overall rating remained Good. This was because only Safe and Well-led were inspected, while the other ratings carried over from the previous inspection. The home had an improvement plan for records and for upgrading the building.
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report abuse or neglect.
“People told us they felt safe living at Malreath.” from the report
Enough staff
Inspectors found enough staff to provide personal care, one-to-one support and activities or visits when people wanted them.
“There was enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted.” from the report
Medicines managed safely
People received their medicines on time. Records were complete, and staff training and checks were regularly updated.
“The electronic medicines administration records (MAR) were complete with no gaps or errors in recording.” from the report
Learning from incidents
The manager reviewed accidents and incidents, looked for patterns and took action to reduce the chance of problems happening again.
“All significant events were reviewed and analysed by the registered manager.” from the report
People's views were heard
People were involved in discussions about how the home should develop. Staff supported people's choices and independence.
“People had a 'voice' and their views were listened to and acted on.” from the report
Incomplete risk guidance
needs fixingSome risk assessments did not give staff full, step-by-step instructions about what to do if a person's mental health, skin condition or another risk worsened. Staff knew what to do in practice, but this was not always recorded clearly.
“Some risk assessments did not include full step by step guidance for staff on what action to take if the risks occurred.” from the report
Late notifications to CQC
needs fixingThe registered manager had not always told CQC about notifiable events promptly. The events were reported retrospectively and systems had been introduced to prevent this happening again.
“Prior to the inspection the registered manager had not done this in a timely way and on one occasion had not informed the CQC until prompted.” from the report
Building still being improved
minorThe home needed upgrading and refurbishment. An action plan was in place, and significant work had already been completed, but improvements were continuing.
“People lived in an environment that needed upgrading and refurbishment.” from the report
- 01What changes have you made to risk assessments so staff have clear step-by-step guidance if a person's mental health or skin condition worsens?
- 02How do you make sure all events that must be reported to CQC are notified promptly?
- 03What refurbishment work is still outstanding, and how will it affect residents during the work?
- 04How will you check that the improvements to care records and reporting are being maintained?
- 05What were the ratings for Effective, Caring and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led; the Effective, Caring and Responsive ratings were not inspected and carried over from the previous inspection. This explanation was written from the published report of 23 March 2023 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, December 2018
Rated Good overall, but inspectors found that the home needed to improve the safe use and recording of some medicines.
Inspectors visited unannounced on 12 and 13 November 2018. They looked at care plans, risk assessments, medicine records, staff training and recruitment records, complaints, accidents and other information. They spoke with four people and three staff members.
The home was rated Good overall. Effective, caring, responsive and well-led were all rated Good. Inspectors found a friendly and respectful home where staff knew people well, supported independence and worked with health professionals.
Safe was rated Requires Improvement. Medicines were stored and given safely, but there was not enough written guidance about when some as-needed psychoactive medicines should be used. Records did not always explain why these medicines had been given. The home also needed to improve recording people's end-of-life wishes.
Kind and respectful care
The home had a calm, friendly atmosphere. Staff knew people well and treated them with respect.
“There was a feeling of mutual respect between people and staff.” from the report
Support for independence
People were encouraged to keep their skills, make choices and take positive risks. Some people travelled locally or abroad with suitable support.
“Staff understood the importance of independence.” from the report
Well-trained staff
Staff received training, supervision and competency checks. Inspectors found that staff had the knowledge needed to support people safely.
“Staff knew people well and had the appropriate knowledge and training to keep people safe.” from the report
Good partnership working
Staff worked with health and social care professionals and shared relevant information when people went to hospital or appointments.
“Staff worked closely with health care professionals to deliver person-centred care and treatment.” from the report
As-needed medicine guidance
seriousThere was no specific guidance explaining the triggers and signs that should lead to some psychoactive as-needed medicines being used. New guidance was created after the inspection, but it was still not specific enough.
“This remains an area for improvement.” from the report
Medicine records
seriousWhen some psychoactive as-needed medicines were given, records did not explain why they were needed or what other steps had been tried first.
“In addition, when people were given PRN medicines, it was signed on the medicine administration record (MAR) chart, yet an explanation for why the PRN was given was not recorded.” from the report
End-of-life wishes
needs fixingStaff had discussed funeral arrangements and wills with some people, but were not recording people's end-of-life wishes. The deputy manager accepted this needed improvement.
“Staff at Maltreath were not recording peoples end of life wishes.” from the report
- 01What written guidance is now in place for each person's as-needed psychoactive medicine?
- 02How do staff record the reason for giving an as-needed psychoactive medicine and the other steps tried first?
- 03How will you discuss and record my relative's end-of-life wishes?
- 04How do you check that staff understand each person's triggers, signs and preferred ways of calming?
- 05What action has been completed following the fire inspection that identified improvements were needed?
This was an unannounced comprehensive inspection covering all five CQC questions and both the accommodation and care provided. This explanation was written from the published report of 14 December 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 Maltreath Residential Care Home
4 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Maltreath Residential Care Home →
- December 2018Goodstayed GoodSafe: Requires improvementWell-led: Good
Read what inspectors found at Maltreath Residential Care Home →
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 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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