CQC report explained · a residential care home
What the CQC found at The Maltings
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safeguarding, staffing, recruitment and medicines systems were safe. They noted that behaviour guidance needed more detail to make sure people were not isolated when distressed.
- Effective?
- Good
- Staff were trained and supervised, and people received support with food, health appointments and day-to-day decisions. Some best-interest records needed updating to clearly show when Deprivation of Liberty Safeguards applications had been made.
- Caring?
- Good
- Inspectors saw kind and respectful interactions. Staff understood people's preferences and a relative gave positive feedback about the care.
- Responsive?
- Requires improvement
- Some care plans were task focused, out of date or not sufficiently personalised. Activities were mainly in-house, communication records did not always use suitable formats, and people's advance wishes had not yet been sought.
- Well-led?
- Good
- The home had effective quality checks and an action plan. The registered manager had identified the same areas for improvement found by inspectors and monitored progress.
What inspectors found, April 2020
Rated Good overall; inspectors found kind, safe care, but the home needs to improve personalised support plans and activities.
This was an unannounced inspection on 20 February 2020. One inspector observed care, spoke with staff, the registered manager and a relative, and reviewed care, medicines, recruitment and management records. People living at the home could not tell the inspector about their experiences.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, access to healthcare and kind interactions between staff and people.
Responsive was rated Requires Improvement. Some support plans were out of date, task focused or not personalised enough. Activity plans were mainly for things inside the home, and some communication records did not include formats such as pictures or audio. The overall rating stayed Good, but this means some people's needs were not always met.
Kind, respectful care
Staff used gentle, individual approaches and inspectors saw good engagement between staff and people. A relative also praised the care and support.
“We saw examples of good engagement between people and staff.” from the report
Management oversight
Quality checks were in place and the registered manager had an action plan covering the improvements identified.
“Quality assurance systems were in place and effective. The areas identified at the inspection were already set for action by the registered manager.” from the report
Out-of-date and impersonal plans
needs fixingSome support plans were not person centred, and some reviews had not been updated since 2017. This could make it harder for staff to follow current, individual guidance.
“Support plans were not always person centred and for some people the reviews had not been updated since 2017.” from the report
Behaviour guidance and possible isolation
needs fixingBehaviour plans did not give enough detail about how to support people when distressed. One plan did not tell staff to explain when the person could leave their bedroom.
“There was potential for the person to be isolated as the guidance did not included that staff were to inform the person when they were able to leave their bedroom.” from the report
Limited activity planning
minorWeekly plans showed that activities were mainly in-house, with visits to coffee shops once a week. The activity programme was due to be developed further.
“However, the weekly planners showed people's activities were mainly in-house and there were once weekly visits to coffee shops.” from the report
Advance wishes not yet recorded
needs fixingThe home had not yet sought people's advance wishes about end-of-life care. The registered manager said staff were working to gather this information.
“The registered manager had identified through audits that people's advanced wishes were not sought.” from the report
- 01Which support plans had not been updated since 2017, and what has been changed in each one since the inspection?
- 02How will behaviour plans make sure a person is not isolated and is told when they can leave their bedroom?
- 03What community activities are now available, and how often can each person take part?
- 04How are communication records being changed to include suitable formats such as pictures or audio?
- 05How are people's advance wishes being discussed and recorded?
This was an unannounced planned inspection covering all five key questions, including both the premises and the care provided. This explanation was written from the published report of 3 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, August 2017
The Maltings was rated Good overall; Safe, Effective, Caring and Well-led were Good, but Responsive Requires Improvement.
Inspectors made an unannounced visit on 26 July 2017. They spoke with the manager and three staff, reviewed care plans and other records, looked around the home, and observed care. They also used an observation method for people who could not explain their experiences.
People were treated kindly and there were enough staff. Staff understood safeguarding, mental capacity, health needs and risks. People had access to healthcare, activities and support that reflected their preferences.
The main weakness was care planning. Plans were reviewed yearly but were not always updated when people's needs changed. There were also medicine concerns, including a lack of advice from a pharmacist about medicines being chewed or given with food.
The overall rating was Good. However, the Responsive question was rated Requires Improvement, so the home met the required standard in most areas but needed to improve how it kept care plans up to date.
Kind and respectful care
Inspectors saw staff treating people with kindness and compassion. Staff used activities and calm spaces to help people who were distressed.
“People were treated with kindness and compassion.” from the report
Enough staff
Rotas showed two staff were on duty during the day and at night. Inspectors saw staff were available to support people.
“There were sufficient staff to support people and we observed that staff were visible and available to people.” from the report
Skilled staff and healthcare
Staff had relevant training and understood people's health needs. People had access to healthcare professionals and specialist guidance.
“Staff had the knowledge and skills to carry out their roles and systems were in place to support staff with the responsibilities of their role.” from the report
Improved management systems
The home had improved its quality checks and records since the previous inspection. Actions were recorded, allocated and monitored.
“At this inspection we found there had been improvements with quality assurance systems.” from the report
Care plans did not always keep pace with changing needs
needs fixingCare plans were reviewed annually but were not consistently checked between reviews. One person's changing eyesight and need for help moving around the home had not been fully reflected.
“Care plans were not always updated when people's needs changed.” from the report
Pharmacist advice was missing
needs fixingSome people chewed medicines or took them with food. The pharmacist had not been asked to confirm that this did not affect the medicines.
“However the pharmacist had not been consulted to determine that the integrity of the medicines was not compromised by the medicine being taken with food and by chewing the medicines.” from the report
DoLS applications did not include some monitoring systems
needs fixingApplications had been made for people subject to continuous supervision, but they did not cover sensors and monitors used for people with epilepsy. The applications were still outstanding.
“While DoLS applications were made we noted they did not cover monitoring systems for people at with epilepsy.” from the report
Quality checks missed care planning problems
needs fixingAlthough audits and action plans were in place, the provider and manager had not identified the care plan concerns found by inspectors.
“The provider and registered manager had not identified the concerns around care plans that we highlighted during the course of this inspection.” from the report
- 01How do you check and update care plans between annual reviews when someone's needs change?
- 02What advice did you obtain from the pharmacist about medicines being chewed or given with food?
- 03Have the outstanding DoLS applications been authorised, and do they include the sensors and monitoring systems used?
- 04How do you make sure changing eyesight, mobility or other health needs are recorded promptly in care plans?
- 05What activities are available now, and how are they matched to each person's preferences?
This was an unannounced inspection of the overall service, covering all five CQC questions; inspectors reviewed records and observed care, including through SOFI because people could not explain their experiences verbally. This explanation was written from the published report of 30 August 2017 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 The Maltings
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
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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