Maldon 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. People had smooth transitions into the home and between services. People and their relatives were involved in decision making and their care planning. There were processes in place to ensure that people were kept safe, and staff had appropriate and specialised training to ensure they could meet the needs of the people living at the home. People and their relatives were involved in all care planning and people were encouraged to take positive risks.

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 manager told us how they practiced lessons learnt in team meetings, identifying areas of training required. There were effective systems in place for reporting incidents and accidents and staff told us about the ease of reporting by scanning a QR code to access forms. After certain incidents staff members discussed with people what had happened including their emotions and behaviours if appropriate and helped to identify what could be done differently.

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 manager told us how they completed preadmission and compatibility assessments. Staff told us how people moving into the home were invited to visit a few times, meet people and stay for tea to see if they liked the home before moving in. Staff supported people to attend community health appointments and people had Health Action Plans that went with them to appointments. One relative told us, “They did come around to see them and they had visited there a couple of times for tea."

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 manager shared concerns quickly and appropriately. Staff had received appropriate safeguarding training and demonstrated awareness of how to safeguard people and the types of abuse they might face. Staff were observed throughout our visit responding to people’s needs with patience and care. One person became upset, and staff supported them and reassured them. People all had missing person plans and these detailed about how to communicate and support this person to keep them safe.

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. The management team and staff knew people well and how best to support them. Staff knew what risks people might face and how they managed those risks, for example, if they were distressed or angry. They told us how they would support the person, and others, to help resolve the situation. They were aware of what may trigger distress and how to prevent it. Care plans contained clear guidance for staff to follow. Staff told us how they supported people who experienced seizures. They told us how seizures affected each person and actions they would take to keep the person safe.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The home had a good oversight of any maintenance work and carried this out promptly, on our first visit we highlighted that window restrictors needed upgrading and by our second visit this job had been completed. The fire brigade had recently been out to carry out routine safety checks and the home had regular fire drills and staff received appropriate fire training. There was a system to ensure the home and equipment was maintained and serviced. This included regular servicing contracts. The manager told us of the improvements being implemented at the home so that people living at the home would be able to access the garden and have more communal areas inside to be able to enjoy. People’s rooms were in the process of being personalised. People, their relatives and staff worked together to create a personalised space that individuals could enjoy. One relative told us, "Since [the manager] has become manager there has been a lot of change in a positive way. They had the conservatory done, kitchen done, the lift has been upgraded. I feel it is much better maintained more recently than the last couple of years."

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. Staff were observed throughout the day, they had a good level of knowledge and understanding of people’s needs to be able support them safely. When staff took people out there were enough staff to support people at the home. We gathered mixed feedback regarding staffing levels, for example some relatives felt staffing levels could be higher. On our visits we saw there were enough staff, they were attentive and visible. Staff rotas were viewed, and the staffing levels that reflected the needs of people were in place. Several people had allocated 1:1 hours this was seen to be provided. One relative told us, "Every time we turn up to visit there seems to be a fair few of them." Another relative told us, "I think there are enough staff. It always looks as though there are." Safe recruitment procedures were in place and the home had nearly recruited enough staff to be fully staffed. Some agency staff were still being used however the home used the same agency and staff to ensure good continuity of staff for people so they knew people's needs and how they like to be supported.

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. Infection prevention policies in place and staff had specific training for this. The home was clean and well maintained. Infection prevention control was used in line with the IPC guidance and there was enough Personal Protective Equipment (PPE) for staff to use. We were told about a recent incident at the home which had been addressed by the relevant external contractor to prevent risks to people.

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. A medication round was observed, staff were confident and had a good understanding and knowledge of what medicines people took and what they were for. Staff knew who was anxious about taking medication and they were observed offering reassurance, being mindful and patient. Staff had appropriate training and knew how to deliver emergency medication when required. The Medicines Optimisation in Care Homes team (MOCH) were working with the home to start introducing holistic medicines with the MOCH teams guidance.