CQC report explained · a residential care home
What the CQC found at Malvern View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by safeguarding systems, personalised risk assessments and suitable staffing. Inspectors found discrepancies between some medicines records and the medicines in stock, but were assured this was a recording issue and that medicines had been given safely.
- Effective?
- Good
- Care plans reflected people's health, social and emotional needs. Staff training had improved, people received suitable food and health support, and staff followed the principles of choice and best-interest decisions.
- Caring?
- Good
- Staff had positive relationships with people and treated them with kindness, dignity and respect. People were involved in decisions and supported to communicate their choices and maintain independence.
- Responsive?
- Good
- Care plans were detailed and reflected people's preferences, communication needs and possible triggers. People were supported to take part in activities and go into the local community, although some daily care records were incomplete.
- Well-led?
- Requires improvement
- Management stability and oversight had improved, but managers had not identified some incomplete care records, missing medicines entries and gaps in staff training. Further improvement was needed in checking the quality and completeness of records.
What inspectors found, April 2020
Rated Good overall; inspectors found safe, caring support, but the home needed to improve its management checks and records.
Inspectors visited on 12 and 13 March 2020. They spoke with people, relatives, staff and a healthcare professional. They observed care and checked care plans, medicines records and management documents.
The home was rated Good for Safe, Effective, Caring and Responsive. People were supported by staff who knew their needs, had suitable care plans, received health support and were offered activities suited to their interests.
The home was rated Requires Improvement for Well-led. Some daily care records and medicines records were incomplete or did not match stock levels. The provider acted straight away and arranged further checks and training.
The overall rating was Good. The previous rating was Requires Improvement, and the earlier breach had been resolved. The home was no longer in breach of regulations, although further improvement was still needed in management oversight.
Safe staffing
There were enough staff to meet people's individual needs. Regular agency staff were used where needed, and the home tried to maintain consistency for people who needed it.
“There were enough staff to meet people's individual needs.” from the report
Personalised care
Care plans gave staff detailed information about people's needs, preferences and how they communicated. Staff used this information to provide person-centred support.
“People's care records were person centred and provided staff with detailed information on who they are and how they would like their needs met.” from the report
Kind relationships
Inspectors saw staff treating people with empathy and respect. Relatives and people gave positive feedback about the staff team.
“We saw that people were relaxed around the staff supporting them and saw that staff were caring and empathetic in the way they interacted with people.” from the report
Activities and choice
People were supported to take part in activities inside the home and in the community. These activities reflected their interests and choices.
“People were provided with a range of opportunities to engage in activities both inside the home and local community, which were tailored to meet people's individual needs and interests.” from the report
Medicines records
needs fixingSome medicines records did not match the amount of medicines in stock. Inspectors were assured that people had received their medicines safely, but the recording and checking system needed improvement.
“However, we did find some discrepancies between what the medicines records told us had been given to people and the amount of medicines in stock.” from the report
Incomplete daily records
needs fixingSome daily care records were incomplete. This meant the home's records did not always give a full picture of how people had been from day to day.
“However, some of the daily care records which provided staff and the registered manager with information about how people were on a day to day basis were incomplete.” from the report
Training oversight
needs fixingManagement checks had not always identified whether staff training was up to date. A delay in behaviour management training meant one staff member could not work alone with certain people.
“The provider and registered manager had not maintained effective oversight of some staff training and this had meant that staff could not be utilised fully in working with some people at the home.” from the report
- 01How are medicines records checked against medicines in stock now?
- 02How do managers make sure daily care records are completed every day?
- 03What checks confirm that all staff have completed the training needed to support each person?
- 04What action has been taken since the inspection to strengthen management oversight?
- 05How are people's choices, communication needs and community activities kept up to date in their care plans?
This was a planned inspection covering all five key questions, including the care provided and the premises, and it followed the previous Requires Improvement rating. This explanation was written from the published report of 4 April 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, April 2019
Rated Requires Improvement; inspectors found kind, responsive care but gaps in safety checks, staff guidance, medicines records and management oversight.
Inspectors visited the home without notice on 6 February 2019. They spoke with people, a relative, staff and managers. They reviewed care records, medicines records, staff files, training information, incident records and quality audits.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good. Inspectors found people were usually treated kindly and supported to make choices, enjoy activities and keep in touch with relatives.
However, safety and management systems were not reliable enough. Medicines records were incomplete, some risks lacked clear staff guidance, staff had not received training in specific mental health conditions, and personal information was left on display. The home had one breach of the regulations about good governance.
Kind and respectful care
People were treated with kindness and staff understood how to protect dignity during personal care. Relatives said they were welcome to visit.
“We observed people were treated with kindness and they were positive about the staff's caring attitude.” from the report
Choice and independence
People were supported to make daily choices and remain as independent as possible. Staff used people's preferred ways of communicating.
“People were supported in an individualised way that encouraged to remain as independent as possible.” from the report
Activities and contact
People were offered activities and trips, and were supported to keep in touch with family and friends.
“We saw people were offered a range of interesting activities and past times.” from the report
Health support
The home worked with health and social care professionals, including the community learning disabilities team, to support people's health needs.
“There was effective joint working with other health and social care professionals.” from the report
Medicines records
seriousSix medicines administration signatures were missing. Reviews for some as-required medicine protocols were overdue and there was no evidence that the reviews had happened.
“we found six missing signatures on people's Medication Admission Records [MAR] charts” from the report
Incomplete risk guidance
seriousSome risks had not been assessed, including how to support people whose behaviour could challenge. One-to-one support was not always recorded.
“some areas of risk had not been assessed and guidance for staff how to support people whose behaviour could challenge.” from the report
Staff training
needs fixingStaff had not received training in specific mental health conditions, despite supporting people with these needs. Further training was being arranged.
“Staff told us, they had not received any training in specific mental health conditions, despite supporting people with these needs.” from the report
Privacy
seriousPersonal care information was visible in a communal area. This included a shift handover sheet and a person's food and fluid intake chart.
“People's right to confidentiality was not always respected.” from the report
Weak quality checks
seriousAudits did not identify or reduce several risks. The lack of reliable oversight contributed to the breach of good governance regulations.
“There was a lack of systems and processes in place to effectively monitor and improve the quality and safety of support provided.” from the report
- 01What has been done to make sure every medicine administration is recorded and as-required medicines are reviewed on time?
- 02Where are the current risk assessments and staff instructions for people whose behaviour may challenge?
- 03What training have staff now completed in the mental health conditions affecting people at the home?
- 04How do you now keep care records, handover information and food and fluid charts private?
- 05What action was included in the report sent to CQC after the Regulation 17 breach, and has CQC confirmed that it was completed?
This was an unannounced inspection covering all five key questions, with the overall rating compared with the previous inspection. This explanation was written from the published report of 10 April 2019 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 Malvern View
4 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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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At least 100 live-in carers within about an hour of Worcestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.