Maldon House

Updated 30 December 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Maldon House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spent time with people living at the home and observed people and staff spending time together. We spoke with four members of staff which included the regional manager, manager, and two senior support staff. We reviewed a range of records relating to health and safety. We reviewed a range of medication records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed records relating to people’s care such as their support plans and mental capacity assessments. We reviewed records relating to staffing such as the training matrix and recruitment information. We spoke to one professional who regularly visits the service, five relatives of people who live at the home and four support staff.

Updated 30 December 2021

About the service

Maldon House is a care home providing accommodation and personal care for up to 10 people with a learning disability or autistic people. At the time of our inspection, 10 people were living at the home.

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

Quality assurance processes at the home did not always identify issues and where issues were identified, these were not always actioned in a timely way. Aspects of the environment needed improvement. Where we identified issues with the environment, these were immediately actioned by staff. People's relatives told us that whilst staff were very responsive to issues raised, these issues were not always resolved in the long term. This included concerns around cleanliness and people's laundry. We found that some documents required improvement, this included ensuring information was effectively recorded in people's support plans to ensure staff that were not familiar with people would be able to support them when they became upset.

Risks to people were safely monitored and managed and regularly reviewed. People were supported to meet their individual needs in a safe way by staff. There were enough staff to support people. Staff had been recruited safely. Medicines were managed safely, although some aspects of recording needed to be improved. Although the home was clean, aspects of the environment needed attention to ensure that safety was promoted through the layout and hygiene practices of the premises.

People's needs and choices were assessed and staff knew people well. Staff were trained in areas that were related to people's needs and received a full induction before working at the home. Staff supported people to lead healthy lives and where people's goals were to lose weights, staff took steps to encourage and support the person to achieve their goal. The design of the home had been adapted to meet people's individual needs. People's mental capacity and ability to make decisions was assessed by staff. Where people were not able to make their own decisions, staff made decisions in the person's best interest in partnership with the person's family.

Staff were kind and caring and treated people as individuals. Staff respected people's individual needs and choices and appreciated people's unique personalities. Staff spent time speaking to people and engaging their interests. Staff knew how to cheer people up if they became upset. People's privacy and dignity was respected by staff. Staff encouraged people to be independent and do as much for themselves as possible.

People's support was personalised to their needs and people were in control of how they spent their time at the home. People's support plans contained information on how to encourage people to achieve things for themselves. Staff knew each person's individual communication needs and we saw that staff understood people. People were supported with a range of activities throughout the COVID-19 pandemic. There was a complaints log for complaints and action plans were drawn up following complaints received on how to resolve them.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence. People’s opinions and choices were valued and respected by staff. Staff knew people well and understood how to support people safely. There were no identifying signs outside the home that indicated it was a care setting. Staff wore their own clothes which did not identify them as support workers. People were supported to go out regularly and attend events and activities that they enjoyed. People had their own personalised space and were involved in the decoration of rooms used by everyone.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. Staff respected people’s dignity and privacy and gave people space when they wanted it. People were supported to make their own choices. People received care and support that met their individual needs. We saw that people enjoyed spending time with staff and smiled and laughed with them. One person’s relative told us, “It's the best place for [person] and they're really happy there. You can tell on [person's] face, they love it. “

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The culture of the staff team was positive towards people and staff focused on what people could achieve. Staff were positive about the support provided by the management team and their peers. One person’s relative told us, “I can't fault the care that [person] is given at all, it's spot on.”

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

Why we inspected

This service was registered with us on 25 September 2020 and this is the first inspection. The last rating for the service under the previous provider was requires improvement (Published 21 January 2020).

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.