The Mallards

The Mallards is a residential care home providing personal care and accommodation for up to 23 people aged 65 and over. At the time of the inspection 20 people were using the service.

Accommodation is provided over the ground and first floors with various lounges a dining room and an accessible garden.

People’s experience of using this service and what we found

People received safe care and were protected against avoidable harm, neglect, and discrimination. Risks to people’s safety were assessed and strategies were put in place to reduce any risks. There were sufficient numbers of staff who had been safely recruited to meet people’s needs.

Staff received training in relation to the safe administration of medicines and their competencies were checked to ensure safe practice. Infection control measures were robustly followed, and staff had access to sufficient PPE.

People’s care needs were assessed before they went to live at the service, to ensure their needs could be fully met. Staff received an induction when they first commenced work at the service and ongoing training that enabled them to have the skills and knowledge to provide effective care.

People were supported to eat and drink enough, and people told us they enjoyed the meals provided. Staff supported people to live healthier lives and access healthcare services.

The premises was homely and adapted to meet the needs of people using the service.

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; the policies and systems in the service supported this practice.

Staff provided care and support in a very caring and meaningful way. They knew people well and had built up kind and compassionate relationships with them. People and relatives, where appropriate, were involved in the planning of their care and support. People’s privacy and dignity was maintained at all times.

An activities programme was in place, and care plans were personalised to each individual detailing their likes, dislikes, and personal preferences. A complaints system was in place and was used effectively.

The service was well managed. People, relatives, and staff were very positive about the leadership of the service and praised the management team. There were systems in place to monitor the quality of the service; actions were taken, and improvements were made when required. Staff felt well supported and said the registered manager was open and approachable. The service worked in partnership with outside agencies.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (published 24 September 2019)

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Mallards on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Mallards is a residential care home providing personal care and accommodation to 23 people aged 65 and over at the time of the inspection. The service can support up to 23 people.

People’s experience of using this service and what we found

We found shortfalls with the hygiene and how the risk of infection was managed at the home. There were also issues with the maintenance and upkeep of the home, which could also contribute to poor infection control. We also identified shortfalls in some staff practice in this area. Some people’s equipment and certain rooms such as bathrooms were not clean which put people at potential risk of harm. The provider acted on these issues. They sent us an action plan with scheduled work. Some of this started during and just after the inspection.

Some staff were knowledgeable about what constituted abuse and harm and they knew what to do about it. Other staff did not have a good understanding or knowledge in this area. People had risk assessments in place, but these did not always guide staff practice to further promote people’s safety.

Staff told us, and we observed that, there was not enough staff to meet people’s social needs and spend time with people. People received their medicines as prescribed, but we found poor practices with ensuring people’s creams were in date and safe to use.

People told us that they felt safe living at the home. People’s relatives said they had no concerns about their relative’s care.

We saw that people did not have a positive dining experience. There was no real atmosphere within the dining room and lounges at this time. Staff did not always respond to people’s request for more food or if they needed support. We observed poor staff practice when some people were being supported to eat their meals. People had limited choice and control over what they ate and drank. Pureed food was not presented in a way to make it look appealing.

We identified shortfalls in staff practice in relation to helping people to move in a safe way which promoted people’s dignity.

Staff received training, supervisions, and felt supported by the registered manager.

People were not always supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

There were improvements needed in terms of the service promoting people’s dignity and respect. In terms of how people’s rooms and personal equipment was looked after, the hygiene and up keep of the home reflected poorly on how people were valued.

People who could communicate with us and people’s relatives felt staff and the registered manager were kind and caring.

There was not enough staff to spend real time with people such as complete an activity together, go out, or promote people’s interests. Staff were too busy with tasks, to perform this part of their work, despite being willing to do so. Events and activities had taken place.

Relatives and staff spoke positively of the registered manager. They felt the registered manager was involved and committed to the service. The staff presented in an open way during the inspection.

The provider and the registered managers quality monitoring systems were not always effective. They had not identified the shortfalls which we had seen. When we spoke to the management team about our findings they produced an action plan responding to most of these issues. They disagreed that there was an issue with staffing levels and time spent with people. They based this view on the fact they had receive a positive report from the local authority.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was rated as Good (published 14 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have identified breaches in relation to the governance of the service, the safety in terms of hygiene and people’s experiences in relation to person centred care.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection, the service was rated Good.

The inspection was undertaken as part of our routine re-inspection programme, to review the rating from the first comprehensive inspection completed on 11 November 2014. At this inspection we found the service remained Good.

People told us that the service was extremely caring and that staff consistently went the extra mile in ensuring they received support that was kind, courteous and always considerate. People and their relatives were forthright in their praise for the gentle and empathetic care provided at the service. They told us that people’s individual needs were considered to be supremely important by staff and that each member of staff supported people in a dignified and gracious manner. People said that without fail, staff went above and beyond to ensure that they received care that was right for them.

Staff had nurtured meaningful and trusting relationships with people which had a significant impact upon their health and well-being. People were exceptionally happy and we observed that they spent large parts of the day with big smiles on their faces, laughing and engaging with staff and each other in a really sincere and positive manner. People were valued for their contribution towards the service and their involvement was never forgotten, even when they had left.

People were inspired and empowered to be as independent as possible and made to feel as though their contribution was extremely important. Staff enabled people to take on small, but valuable roles and people were supported by exceedingly dedicated staff that were very knowledgeable about how to meet their needs. Staff instinctively knew how people preferred to be supported, and were skilled in communicating with them and facilitating them to make as many decisions for themselves as possible. People were fervent in their belief about the positive impact that staff had made to their lives and how much their support had changed their lives for the better. People told us they could always rely upon staff to be there for them and provide support, affirmation and a friendly, caring face at all times. People and their relatives were placed firmly at the heart of the service, with all aspects of care being focused on them.

People felt safe in the service. Staff knew about abuse and how to report it and other incidents or accidents which took place. Risks to people were regularly assessed and updated to ensure they had as much independence as possible. Staff were recruited using a robust process and numbers of staff were appropriate to meet people’s needs. There were safe systems in place for the administration, disposal, storage and recording of medicines.

Staff received an appropriate induction and regular refresher training to make it possible for them to perform their roles appropriately. People were supported to have choice and control and staff cared for them in the least restrictive way possible; the policies and systems in the service support this practice. Where appropriate people living at the service had their freedom lawfully restricted under a Deprivation of Liberty Safeguard (DoLS) authorisation. People enjoyed a choice of dietary intake and were able to access healthcare professionals, such as their GP and dentist to maintain their health and well- being.

People received person-centred care, based on their likes, dislikes and individual preferences and care staff were guided in the delivery of care through robust care records. People’s hobbies and interests had been identified and were supported by staff in a way which involved people to prevent them from becoming socially isolated. The registered manager attended to complaints and concerns in accordance with the formal complaints policy.

The service had a clear ethos and a positive culture. Staff members were motivated to perform their roles and meet people's needs. The registered manager was known to people, relatives and staff members and was approachable to all. They, and the provider, carried out regular quality assurance processes to help the service develop and improve.

We spent time observing people and saw they were engaged in activities of their choice and at a level appropriate to them. We observed staff engaging positively with people and supporting them to read the newspaper or watch television. We found staff were respectful in their approach to people and treated them with dignity and respect, calling them by their preferred name. People appeared relaxed in the presence of staff and there was a friendly atmosphere in the home.

We saw from care records that the provider ensured that people were referred to appropriate professionals and attended relevant appointments to ensure their general health and well-being. On the day of our inspection, we observed a doctor visiting someone and were aware of staff talking to the dietician about another person.

We found that equipment used within the home was fit for use and well-maintained. Staff had access to on call maintenance for repairs should this be required.

We reviewed training records and spoke with three staff and the registered manager about their experiences of staff training. We found that staff training was up to date which ensured that staff had the appropriate skills and knowledge to provide care for the people they supported.

Everyone we spoke with told us they enjoyed the home and atmosphere, and one person said 'you wont' find anything wrong here, it's lovely'. Another person said 'I am looked after well and the staff are really caring'.

We observed a relaxed, friendly environment with positive engagement and involvement between staff and residents. People were spoken to respectfully at all times and involved in decisions related to their care and support.

We saw that relatives and visitors were made to feel welcome on arrival and one person said 'I feel part of the family'.