Archived: Malvern Nursing Home

Updated 29 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 November 2018 and was unannounced. The inspection team consisted of one adult social care inspector, a mental health hospitals inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience of mental health care.

Before the inspection we reviewed information available to us about this service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law.

We also spoke with the local authority commissioning and safeguarding teams to gain their feedback about the service.

During the inspection we spoke with six people who used the service, three care workers, one nurse, the registered manager and provider. We reviewed three care plans, medicine records, and other records relating to the management of the service such as training records, audits and checks.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed the mealtime experience, activities and how staff interacted with people throughout the day.

Updated 29 November 2018

This inspection took place on 15 November 2018 and was unannounced.

Malvern Nursing Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can accommodate up to 28 adults with complex mental health needs. The service is in a residential area of Bradford approximately two miles from the city centre. At the time of the inspection there were 15 people using the service.

The last inspection took place on 21 November 2017 and was rated as ‘requires improvement’ as we needed to see the improvements could be sustained over time. No breaches of regulation were identified. On this inspection we found improvements had been sustained and developed further.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

People were safeguarded from abuse and improper treatment. Well understood policies were in place to protect people from harm. Risks to people’s health and safety were well managed. Risk assessment documents were in place to guide staff. Staff we spoke with knew people well and the risks they were exposed to.

People had access to a range of professionals to ensure their healthcare needs were met. Medicines were safely managed and given as prescribed.

Improvements to the premises were on-going. People’s bedrooms were personalised and comfortable. The home was clean and odour free.

Staff were recruited safely and there were enough staff to provide people with the care and support they needed. Staff received a range of training and developmental opportunities and told us they felt well supported.

The service had a good understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards and acted within the legal framework. People were involved in decision making to the maximum extent possible.

People’s nutritional needs were met by the service. People had access to a suitable range of home cooked food and plenty of drinks.

Staff treated people with kindness and compassion and knew them very well. Activities were provided which were meaningful to people and group and individual trips out were organised.

People’s care needs were met by the service. Each person had a range of appropriate care plans in place and we saw evidence needs were being met. People’s likes and preferences were sought to ensure care was person-centred.

People who used the service and staff praised the registered manager, said they were approachable and wanted the ‘best’ for people who used the service. They all felt able to raise issues or make comments which were taken on board and used to improve the service.

We found a friendly and inclusive atmosphere in the home with all staff working well together and in the best interests of people using the service. Clear, caring values were in place and staff consistently worked to them.

The registered manager had good oversight of the home. There was a strong emphasis on continuous improvement of the service. People’s views and opinions were a key part of this.