Archived: Maple Lodge Care Home

There was a registered manager in place. 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.

Maple Lodge provided good care and support for the people that lived there. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. There were good systems in place to make sure that people were supported to take medicines safely and as prescribed. Risks to people had been assessed and plans put in place to keep risks to a minimum.

There were enough staff on duty to make sure people's needs were met. Staff recruitment processes included carrying out appropriate checks to reduce the risk of employing unsuitable people. Staff told us they enjoyed working at the service and that there was good team work. Staff were supported through training and team meetings to help them carry out their roles effectively.

People received their medicines at the times they needed them. The systems in place meant medicines were administered and recorded properly and this was audited regularly by the service and the dispensing pharmacist. Staff were assessed for competency prior to administering medication and this was re-assessed regularly.

Staff received appropriate training, supervision and support. Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to ensure that people’s rights were protected where they were unable to make decisions.

People had their nutritional needs met. There was a variety of choices available on the menus, snacks were freely available throughout the home and people were supported to have sufficient food and drinks to meet their dietary needs. People who required special diets were catered for.

People knew how to make a complaint if they were unhappy and all the people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything.

People told us that they were well cared for and happy with the support they received. We found staff approached people in a caring manner and people’s privacy and dignity was respected.

People looked well cared for and appeared at ease with staff. The home had a relaxed and comfortable atmosphere.

People were involved in the decisions about their care and their care plans provided information on how to assist and support them in meeting their needs. People's needs were regularly reviewed and, where necessary, appropriate changes were made to the support people received. People were supported to maintain their health and had access to health services if needed.

The registered provider actively sought the views of people using and visiting the service. They were asked to complete an annual survey and provided information using an electronic feedback iPad located in the entrance hall to the home. This enabled the provider to address any shortfalls and improve the service.

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result we could see that the quality of the service was continuously improving.

On the day of the inspection there were 43 people living at Maple Lodge. We talked with seven people about their experience of living in the home, spoke with four relatives, talked with seven staff and looked at records. As some people were unable to communicate due to frailty or dementia, we spent time in communal areas of the home observing interactions with staff to see how they were supported and how care was provided. Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff and people we spoke with told us that they felt safe. Staff had received training in safeguarding and understood how to safeguard the people they supported. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents. This reduced the risk to people and helped the service to continually improve.

People were cared for in a service that was safe, clean and hygienic. Risk assessments were in place in individual support plans in relation to activities of daily living. Details of training undertaken by staff demonstrated that they had the required skills and experience needed to support the people who lived in the service. Medicines were administered safely by trained staff and within the policies and procedures of the home.

Is the service effective?

People told us that they were happy with the care they received. From observing the interactions between staff and people who lived in the service it was clear that people's care and support needs were well understood. Staff had received training to meet the needs of the people living in the home and their individual requirements were assessed with them. Where people were frail or had difficulty communicating, some family members were involved. Two relatives we spoke with were able to describe specific benefits to the health and wellbeing of their relatives living at Maple Lodge and the impact that this had on their daily life. One person we talked with told us, "I love it here, I can talk with the staff, they're brilliant."

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. Where shortfalls or concerns were raised, these were addressed. People we talked with told us that they found the staff kind and caring and if they had any concerns they could talk with the manager. People's preferences and needs had been recorded and care and support had been provided in accordance with their wishes. One relative told us, "Nothing's a bother; the staff go above their duties."

Is the service responsive?

Some people were involved in a range of activities inside and outside the service supported by an activities coordinator. The home supported people to take part in activities which included visits to local places of interest. People told us that they knew how to make a complaint if they were unhappy and two people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything. One relative expressed concern that staff always appeared to be busy when they were there and they told us they were concerned that their relative had to wait for support. We observed during our discussion that staff came into the room on three different occasions to bring tea, ask for menu choices and to check to see whether the person was alright as their alarm had been mistakenly activated. The manager told us that they were in the process of recruiting additional staff to ensure that staffing levels were maintained.

Is the service well-led?

The service worked well with other agencies and services to ensure that people received their care in a joined up way. The service had in place a quality assurance system which included planned audits. Records seen by us showed that safeguarding and whistle blowing incidents were taken seriously and the manager acted appropriately to address any issues raised. Any identified shortfalls were addressed promptly and there was a plan in place for ongoing refurbishment and improvement of the building. As a result the service was constantly improving. When we spoke with two relatives and staff, they told us that they believed the service was well run and was a positive place for people to live. Staff told us that they felt well supported by the manager. We saw that relatives were invited to annual reviews and one relative said, "The current manager is very good."

We found that where people lacked capacity their rights were respected and the provider acted in accordance with legal requirements.

People had care plans and risk assessments in place which helped staff to understand and meet people's needs. We observed staff and people who used the service had positive relationships and staff had the knowledge and experience to meet people's needs. We received comments from people including; 'It's [the home is] absolutely wonderful.' And, 'I have everything I need; the staff are very helpful and listen to what I want.'

We found people were provided with a choice of suitable nutritious food and drink. People commented, 'The food's excellent.' And, 'The food is very good.'

There were sufficient staff available; we saw people being assisted promptly and we saw that staff had time to spend socialising and engaging with people. People commented, 'Staff are busy but there are always enough around and I never have to wait long.' And, 'The staff are super.'

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

Records were maintained, up to date and kept securely.

People were not always given enough support during meal times. During the inspection we observed that food was left in front of people out of reach and cold. These people had been assessed as being prone to losing weight. This means that people were not given enough support to eat their meal and their assessed nutritional needs were not being met fully.

We also identified other poor care practices that were taking place. Some people were being put at risk of pressure damage to their skin. The staff we spoke with gave differing accounts of what care was provided to the same person. This means that some people were receiving inconsistent care and not having their assessed care needs met on some occasions.

When we spoke with the area manager about our findings during the inspection they acted very promptly and took immediate action to put some things right straight away so that people were kept safe.