Malden House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider carried out an analysis of any safety events to look for ways of preventing harm to people. The provider shared some examples of how they put learning into practice. For example, staff had not correctly assisted a person during a manoeuvre. This led to staff having additional training in moving and handling. Everyone we spoke with told us they would know how to make a complaint if they needed to and it would be addressed without delay.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider had a clear process in place for referrals and admissions. Prior to moving into the home, a pre assessment of needs was carried out. This was to ensure people’s needs could be met by the home. The provider worked well with other partners including hospital discharge teams. This meant people could move between services easily and smoothly. If people came to the home for respite a full history of their needs was obtained. This meant people could be assured their care needs would be met during their temporary stay.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. There was a clear process for safeguarding concerns to be raised, investigated and escalated if needed. Staff were clear on how to protect people from harm.

Relatives told us people were safe in the home, 1 relative said, “Yes, [person] is very safe there, all their needs are meet, any problems are always dealt with, and [person] can speak up. [Person] has been there about 2 years now, and I feel they are very safe there. They had a lot of falls in hospital but is still a very independent person and they encourage that at the home. [Person] is looked after so well. Yes, they are very safe there, a very caring enjoyment to live. What more could you want.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the service was working within the principles of the MCA. The provider had the correct authorisations in place and used a best interest decision making tool to support people who may lack capacity.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care records reviewed showed people were involved in their care plans and where risks of harm were identified these were mitigated as much as possible. For example, if a person was at risk of falls, control measures such as a sensory mat were in place. Staff were able to explain how to manage risks to protect people from harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. During our visit we observed equipment used to support people. Staff used the equipment correctly. Staff told us how important it was to check the equipment before using it so people could be safe. The home was free from hazards and well maintained in all areas.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. During our visit we observed staffing levels and found there were enough staff on duty to meet people’s needs. Staff records showed that staff were recruited safely. Background checks were carried out including criminal record checks. Staff had sufficient training to carry out their role effectively. For example, we observed staff using correct techniques when supporting people to move around the home.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. During our visit we observed good infection, prevention and control practices. For example, staff used personal protective equipment when offering support to people such as gloves and aprons. Staff were knowledgeable about how to protect people from the spread of infections. The home was clean and well maintained. Infection prevention and control policies were in place for staff if required.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. During our visit we observed staff supporting people to take medicines. Staff were patient, asked people if they were ready before administering their medicine. Records of medicines were accurate and up to date. Staff had training to ensure they were effective in their role. Staff were able to explain the medicine process very clearly including what to do if there was an error. Medicine procedures were in place to guide staff if needed.