This inspection visit took place on 31 January 2018 and was announced. Malvern House is registered to provide care and accommodation for up to eight persons who have a learning disability, mental health needs or autistic spectrum disorder. The home is situated in Heysham close to a number of facilities and amenities. All accommodation at the home is provided on a single room basis and all of the bedrooms have en-suite facilities. At the time of our inspection visit there were three people who lived at the home.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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.

At the last inspection on 26 January and 02 February 2017 the service was rated Requires Improvement. During the inspection we found improvements had been made and all breaches had been met from our inspection on 19 and 28 April 2016. However further work was required to embed the changes made to care records and for the registered provider to seek further clarification on the principles of the Mental Capacity Act 2005. We made recommendations about this.

At this inspection carried out on 31 January 2018 we have rated the service Good.

We spoke with one person who lived at the home and two people who were staying there on respite care. They all said they were happy, felt safe in the care of staff and were treated with kindness. One person said, “It’s been a good experience staying here. The staff have been brilliant with me.”

The service had sufficient staffing levels in place to provide support people required. We saw staff showed concern for people’s wellbeing and responded quickly when they required their help.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

Medication procedures observed protected people from unsafe management of their medicines. People received their medicines as prescribed and when needed and appropriate records had been completed.

We saw there was an emphasis on promoting dignity, respect and independence for people who lived at the home. People told us staff treated them as individuals and delivered person centred care. Care plans seen confirmed the service promoted people’s independence and involved them in decision making about their care.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff knew people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified care and support people required. We found they were informative about care people had received.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between

This inspection visit took place on 26 January and 02 February 2017. The first day was unannounced and the second day was announced so that we could meet with the manager and the registered provider.

At the last inspection on 19 and 28 April 2016 we asked the provider to take action to make improvements because we found breaches of legal requirements. This was in relation to risk management, care planning and management and governance of the home. We also found the service had not followed the principles of the Mental Capacity Act 2005 ensuring people’s rights were protected.

During our inspection visit on 26 January and 02 February 2017 we found improvements had been made and all breaches were met. However further work was required to embed the changes made to the care records and we have made recommendations about this.

Malvern House is registered to provide care and accommodation for up to eight persons who have a learning disability, mental health needs or autistic spectrum disorder. The home is situated in Heysham close to a number of facilities and amenities. All accommodation at the home is provided on a single room basis and all of the bedrooms have en-suite facilities. At the time of our inspection visit there were four people who lived at the home.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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. At our inspection on 26 January and 02 February 2017 the provider informed us that they had appointed a manager for the service and the manager was in the process of applying to become the registered manager.

We spoke with three of the four people who lived at the home. They told us they felt safe and liked the staff who supported them. Comments received included, “I am leaving soon but have enjoyed my time here. They have done a lot for me and I appreciate that.” And, “The new manager is very nice and helpful.”

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient towards the people in their care.

The three people we spoke with told us they were happy with the variety and choice of meals available to them. We saw snacks and drinks were provided between meals. One person told us staff tried very hard to encourage them to eat a healthy diet.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Staff spoken with and records seen confirmed training had been provided to enable them to support people in their care. They were knowledgeable about the support needs of people and how they wished their care to be delivered.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People who lived at the home told us they felt safe and staff were available when they needed them.

The manager and registered provider had completed training to help them understand the principles of the Mental Capacity Act 2005. People ’s capacity had been assessed however this was not required for each decision about their care and treatment. We have made a recommendation that the registered provider seeks further clarification on the principles of the Mental Capacity Act 2005.

There had been no new staff appointed to work at the home since we last completed a comprehensive inspection of the service in September 2015. We did not i

We carried out an unannounced comprehensive inspection of this service in September 2015. At this inspection breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Malvern House on our website at www.cqc.org.uk.

This focussed inspection took place across two dates, 19 April and 28 April 2016. The first day of the inspection was unannounced. This means we did not give the registered provider prior knowledge of our inspection. The second day was announced. We also revisited the registered provider on the 16 May 2016 to give feedback of our inspection findings. We did this by prior arrangement.

Malvern House is registered to provide care and accommodation for up to 8 persons who have a learning disability, mental health needs or autistic spectrum disorder. The home is situated in Heysham close to a number of facilities and amenities. All accommodation at the home is provided on a single room basis and all of the bedrooms have en-suite facilities.

There was an individual registered provider in place. They became legally responsible for the home in June 2015. The registered provider manages the day to day running of the home. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the comprehensive inspection of Malvern House in September 2015 the service was rated as ‘requires improvement’ overall, with ‘requires improvement’ ratings in two of the key questions ‘is the service safe?’ and 'is the service well – led?’ We identified a breach of Regulation 12, (Safe care and treatment) as risks to a person who lived at the home were not managed safely. We also identified a breach of Regulation 13, (Safeguarding service users from abuse and improper treatment) as referrals to safeguarding authorities were not always made. In addition we identified a breach of Regulation 17, (Good Governance) as there were ineffective systems in place to identify, monitor and assess the risks relating to the health, safety and welfare of people who used the service. We further identified a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 as notifications to the Care Quality Commission were not always made.

We carried out this focussed inspection in April 2016 to check improvements had been made.

During the focussed inspection carried out in April 2016, we found risk assessments were not reviewed to ensure people received care and support which met their needs. In addition we found risks were not always suitably assessed and managed. This was a continued breach of Regulation 12, (Safe Care and Treatment).

We noted there were ineffective quality monitoring systems in place as areas for improvement had not been identified by the registered provider. This was a continued breach of Regulation 17, (Good Governance.)

We viewed care records to ascertain the care and support people received. We found information was sometimes difficult to find and there were gaps in some daily entries. In addition we noted care and support needs had not been fully documented to ensure staff knew people’s care and support needs and the reasons for these. We further found there was no documented evidence of agreements made with people regarding the purchasing of essential items. This was a breach of Regulation 17, (Good Governance.)

We found best practice guidance was not implemented in relation to supporting people who are living with a learning disability. We have made a rec

This inspection took place across two dates, 21 September and 25 September 2015. The first day of the inspection was unannounced. This means we did not give the provider prior knowledge of our inspection. The second day was announced.

Malvern House is managed by an individual registered provider who manages the day-to-day running of the home. They became legally responsible for the home in June 2015. This is the first inspection since the provider became responsible for Malvern House.

Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Malvern House is registered to provide care and accommodation for up to 8 persons who have a learning disability, mental health needs or autistic spectrum disorder. The home is situated in Heysham close to a number of facilities and amenities. All accommodation at the home is provided on a single room basis and all of the bedrooms have en-suite facilities.

During the inspection we saw people were treated with respect and people told us they were happy living at Malvern House.

We saw people were referred to other health professionals if their health needs changed and we saw evidence which showed people were asked for their views regarding the running of the home.

We found people were supported to eat a healthy diet and people told us they liked the food. We were also told alternatives were provided if requested.

There were no authorisations to deprive people of their liberty in place at the time of the inspection. We discussed this with the registered provider. Following the inspection we received written confirmation that a Deprivation of Liberty Safeguards (DoLS) authorisation had been submitted to the appropriate authority for consideration for one person.

During the inspection we observed peoples’ needs being met promptly. People told us they were happy with the number of staff available to support them. The registered provider told us they arranged staffing to meet peoples’ needs and they were currently recruiting a further member of staff.

Recruitment checks were in place to help ensure suitable staff were employed by the home. Staff received training and supervision to enable them to support peoples needs.

During the inspection we identified breaches of Regulation 12 and 13 of the Health and Social Care Act 2008. We found evidence that risks to a person who lived at the home were not managed safely and referrals to safeguarding authorities were not always made. We also identified a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. We found required notifications to the Care Quality Commission were not always made.

You can see what action we told the registered provider to take at the back of the full version of the report.