We carried out an inspection of The Maltings Care Home on 26 October 2016. The inspection was unannounced.

The Maltings Care Home is registered to provide accommodation and personal care for up to 43 older people, some of home may be living with dementia. Accommodation is provided on two levels in 43 single bedrooms. At the time of the inspection there were 43 people accommodated in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage 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.

During this inspection people said they felt safe and that staff treated them well. Safeguarding adults' procedures were in place and staff understood how to protect people from abuse. Risks associated with people's care were identified, assessed and recorded. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

Policies and procedures were in place to guide staff with the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely by trained staff.

Staff acted in a courteous, professional and safe manner when supporting people. There were sufficient staff numbers on duty to keep people safe and to meet people's needs. Safe staff recruitment procedures were in place which ensured only those staff deemed suitable to the role were in post.

Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the main principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation.

There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and respected their privacy.

Staff consulted people living in the home about their care needs and involved them in the care planning process. People were comfortable and relaxed with staff. Support plans and risk assessments provided guidance for staff on how to meet people's needs and were reviewed regularly. Staff encouraged people to remain as independent as possible and supported them to participate in a variety of daily activities.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care and oversight by a senior manager. Regular checks were undertaken on all aspects of care provision and actions were taken to continuously improve people's experience of care.

This inspection was carried out by a single inspector. Forty three people were using the service at the date of our inspection. As part of our inspection we spoke with four people who were receiving support, three relatives, the manager, the regional manager and six staff working at the service. We also observed people receiving support and looked at the support plans for six people. We used the evidence collected during our inspection to answer five questions.

Below is a summary of what we found.

Is the service safe?

People who we spoke with told us they felt safe and the staff were very helpful and met their needs. One person said, “We are well looked after. It is spotless here.” Assessments of any potential risks to people had been carried out and measures put in place to reduce the risks. This meant that people were protected from the risk of harm.

People were also protected from the risk of abuse as staff had received training and were clear about their responsibilities to recognise and report any concerns.

People we spoke with said they were confident to raise any concerns they had with the manager.

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

The provider had a system in place to demonstrate they had given consideration to whether each person using the service had the capacity to make decisions about their day to day care in accordance with the Mental Capacity Act (2005). The provider was in the process of improving this system. The provider had contacted the local authority and was taking action to ensure that people who used the service were only deprived of their liberty when this had been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards.

The Mental Capacity Act is a law which requires an assessment to be made to determine whether a person can make a specific decision at the time it needs to be made. It also requires that any decision made on someone’s behalf is recorded, including the reasons why it has been made, how the person’s wishes have affected the decision and how they were involved in the decision making process. The Deprivation of Liberty Safeguards are part of the Mental Capacity Act (2005) and give people protection who cannot make a decision for themselves and may be deprived of their liberty

Is the service effective?

People we spoke with told us, and our observations confirmed, that people were happy with the service they received. Staff spoke positively about working at The Maltings Care Home. It was clear from our observations, and from our conversations with staff and the manager, that staff knew people’s needs well. Staff followed the guidance contained within people’s care plans.

Staff worked closely with professional health staff to ensure that people’s needs were met by staff with the most appropriate, knowledge, skills and experience.

Staff were well trained. They received appropriate professional development.

Is the service caring?

One of the staff we spoke with said, “I enjoy working here.” We observed that people were listened to and staff spoke to people and responded to them in a respectful and kind way. Staff told us how they supported people and they spoke in a thoughtful and sensitive way about each person’s needs.

We spoke with four people who used the service. Each person spoke positively about the staff and said that the staff were kind and caring. One person said, “The staff look after us well here.” One person’s relative said, "I am very satisfied with the care my family member receives.”

Is the service responsive?

People’s needs and care plans were regularly reviewed by the staff and management at the home. Referrals were made to health professionals to ensure that people received appropriate support by people with the most appropriate knowledge and skills.

Support plans included information on people’s likes and dislikes and their preferences, to ensure care and support was delivered taking into account their personal preferences. The staff we spoke with told us they were trained to do their job and knew how to meet the needs of people using the service.

People participated in a range of activities of their choice and were encouraged to participate in activities within the local community.

One member of staff said, "We are a team. We support each other and the atmosphere is really good.”

Is the service well led?

Staff told us they received regular supervision and appraisals. They told us they received good support from the management team.

The relatives we spoke with told us they felt the service was well-managed. They said they were confident to raise any concerns or complaints they had with the manager. One relative said, "The manager is very approachable. They listen to our concerns.” There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

The provider had effective quality assurance and audit systems in place to monitor all aspects of the service and ensure improvements were made where necessary.

People who used the service and staff working at the service, all said that they felt the manager listened to them and made improvements to the service based on their feedback.

As part of this inspection we spoke with 12 people and two relatives throughout the day. All these people were able to answer our questions and give their views on the service provided. We were given positive comments throughout. One example was, "If I cannot live at home I cannot think of a better place to be as I have all the care and support I need." Another comment was, "I decided to come here after spending time previously as a visitor to the home. I am so glad I did as I have not been disappointed." One person said, "We are always asked our views and if we are happy with the care provided. I would soon say if I was not happy."

The care plans we looked at gave us a picture of people’s needs. Risks associated with the care needs had been assessed and acted upon showing the care was appropriate and safe for the individual people concerned.

The people who lived in The Maltings were offered a suitable choice of meals throughout the day. Fluid intake was monitored and people who required assistance to ensure they had suitable quantities of food had their meal intake recorded.

The staff at the home welcomed and received support with guidance and training from other professionals, that ensured people had the correct support for their needs. The manager also supported this interaction showing the staff team were responsive to all needs of individual people.

We found a robust system in place for the recruitment of new staff. Recruitment procedures and records were completed correctly to ensure people were cared for by suitable staff.

The home had received complaints. They had been recorded, acted upon and the problem resolved. We had received a notification from the manager about the problems in the building that led to most of the complaints. The manager had acted appropriately.

Throughout our unannounced visit on 9 May 2012 we received nothing but positive comments from people who use the service, visitors and staff.

Seven people who live in The Maltings were spoken with. They described how ‘kind and considerate’ the staff team were. They told us how they were offered choices and how well they were supported with all their various needs.

They told us the food was excellent and there was always a variety of choices to meet all tastes. We were told that “Nothing was too much trouble” and “I will not hear anything bad said about this home”.

People spoke about how difficult it had been to make the decision to move into this home. We were told after the initial settling in period they felt better and were now content. They said they felt safe and that the staff knew how to support them in a confident manner.

People told us about the various ways the home kept them occupied and how they are encouraged to be involved.