The inspection took place on 6 December 2016 and was unannounced. Maldon House provides care and accommodation for up to ten people with learning disabilities. On the day we visited nine people were living in the service.

The previous registered manager had left the service. A new manager had been appointed and was currently in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the CQC managed the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We met and spoke to all nine people during our visit. People were not all able to fully verbalise their views and used other methods of communication, for example pictures and electronic equipment. We therefore spent time observing people. One person when asked if they were happy at Maldon House responded; “Yes it’s nice.” A staff member said; “It’s a lovely place to work in.”

Surveys returned to the service recorded; “Many thanks for helping us get […] through the recent worrying times we have had. It’s really appreciated - you’re all fabulous.” Another said; “A big thank you for looking after […] for the past 10 years.”

People’s medicines were mostly managed safely. One person had their medicine crushed and administered through a tube in their stomach. We found this had not been authorised by their new GP. However after the inspection the manager contacted us to confirm this authorisation had taken place. Other peoples medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals, such as speech and language therapists.

People were engaged in different activities and enjoyed the company of the staff. People were busy; however there was a calm and relaxed atmosphere within the service.

People’s care records were very detailed and personalised to meet individual needs. Staff understood people’s needs and responded when needed. People were not able to be fully involved with their support plans, therefore family members or advocates supported staff to complete and review people’s support plans. People’s preferences were sought and respected.

People’s individual risks were documented, monitored and managed well to ensure they remained safe. People lived full and active lives and were supported to access local areas and a wide range of activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed whilst maintaining a healthy diet. People, when possible, were encouraged to help prepare meals and drinks.

Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by the manager. They knew how to make sure people who did not have the mental capacity to make decisions for themselves, had their legal rights protected and worked with others in their best interest.

Staff had completed safeguarding training and had a good knowledge of what constituted abuse and how to report any concerns. Staff described what action they would take to protect people against harm and were confident any incidents or allegations of abuse would be fully investigated.

Staff described the new manager as being very approachable and supportive. Staff talked positively about their roles.

The manager and registered provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to ac

The registered manager that appears on this report is known to have left this home, however an application to remove them from the register has not yet been received. This means their name will appear on all reports relating to this home until such time as an application to remove them is submitted and accepted. Another person is known to have been appointed to manage the home and an application for them to become the registered manager has been received.

People's needs were assessed and care and treatment was planned and delivered in accordance with their individual care plan. Two people who live at the home told us they were happy with the support they received. The relatives of another two people told us they had no concerns and were every happy with the care provided. It was clear from our observations that people’s independence was promoted and that staff supported people effectively. People’s health care needs had been monitored and that specialist advice and support had been sought when needed.

A relative told us “I have no concerns what so ever, I’m completely satisfied with the care here”. Another visitor told us told us “If we ever had the slightest concern we would say something”.

Recruitment procedures were robust. Staff told us they were happy working in the home and they had received the training they needed to meet diverse needs of the people who lived there.

The staff at the home worked in co-operation with others. We saw that each person’s care had been reviewed annually and that relevant health care and social care professionals had been involved in this process.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The equipment provided at the home promoted peoples comfort, safety and independence. It was safe to use and had been well maintained.

People living in the home used a diverse range of methods of communication and not everyone was able to give us their views. To help inform us we observed people throughout our visit.

People who could give us their views told us they were happy living in the home and felt safe. We noted that staff knew people well and had the skills they needed to effectively communicate with the people living there.

It was evident from the smiling, laughter and positive interactions we observed, that people were happy and relaxed with each other and with the staff team. We observed people moving freely throughout the home and gardens and were clearly comfortable with their surroundings.

We noted that people initiated their own activities and that staff supported them to do this. Staff showed patience, understanding and gave encouragement to people when supporting them. People were asked about their preferences in relation to food and drink and involved in discussions around planning activities and outings that day.

Feedback from a quality monitoring visit by the local authority in September 2011 was positive. The home had carried out survey in March 2012 with people who live in the home, their relatives and professionals involved in people’s care. The results indicated a high level of satisfaction with the standard of care provided.