Maurice House

Updated 7 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 17 and 19 October 2017 and was unannounced. The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone in a care home setting.

The provider completed a Provider Information Return (PIR) before the inspection. This is a form that asks the provider to give key information about the service, what it does well and improvements they plan to make. We reviewed the information in the PIR along with other information we held about the service. We looked at previous inspection reports and notifications received by the Care Quality Commission. Notifications are information we receive from the service when a significant event happens, like a death or a serious injury.

We looked around all areas of the grounds and service. We met and spoke with 25 people living at the service and nine relatives. We also spoke with a community nurse. We spoke with nine members of the care team, the head of residential care, the head of dementia care, the deputy manager and the registered manager.

We observed how staff spoke and engaged with people. We looked at how people were supported with their daily routines and activities and assessed if people’s needs were being met. We reviewed six care plans and associated risk assessments. We looked at a range of other records including three staff files, safety checks and records about how the quality of service was monitored and managed.

We last inspected Maurice House in November 2015 when no concerns were identified.

Updated 7 December 2017

This inspection took place on 17 and 19 October 2017 and was unannounced.

Maurice House provides care and support for up to 77 people. Maurice House has 47 bedrooms, large and small communal areas, a dedicated activities room and a well maintained courtyard with step-free access to a large garden with several seating areas. Maurice Lodge is a purpose built dementia care unit set in the grounds of Maurice House in Broadstairs. Maurice Lodge has 30 bedrooms and three themed units; Farm, Beach and Woodland. Each unit has its own dining area, conservatory and enclosed garden. A central ‘hub’ was the hive of activity where people chose to spend much of their time together. Like each of The Royal British Legion services Maurice House is exclusive to ex-Service people and their dependents. At the time of the inspection there were 76 people living at the service, some of whom were living with dementia.

A registered manager was 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. The registered manager was present on the day of the inspection and was supported by a deputy manager.

At the last inspection in November 2015 the service was rated Good and outstanding in the caring domain.

At this inspection we found the service remained Good and good in the caring domain.

Why the service is rated Good

People told us they felt safe living at Maurice House and Maurice Lodge. Risks to people were assessed, managed and reviewed and action was taken by staff to keep people as safe as possible. People were protected from the risks of abuse, discrimination and harm and staff were confident to raise any concerns.

The registered manager followed safe recruitment processes to make sure staff employed were of good character and safe to work with people. There were enough staff on each shift and this was monitored and amended when people’s needs changed. People received effective care from staff who were knowledgeable and trained to carry out their roles.

People’s medicines were managed safely. Changes in people’s needs were identified quickly and staff contacted health care professionals for additional support and guidance when needed. People enjoyed a healthy and balanced diet.

People were 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 support this practice. Staff understood the importance of giving people choices and gaining people’s consent.

Staff understood the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called DoLS. Applications had been made in line with guidance.

People were treated with kindness, compassion and respect and their dignity was promoted and maintained by staff. There was a strong, visible culture which centred on people being empowered to live their lives as fully as possible.

People were given the information they needed, when they needed it and in a format that they could understand. Signs around the service were mounted low enough to make sure people could see them. ‘Hearing loops’, large print information and magnifiers were available for people with sensory impairments.

People’s choices for their end of life care were discussed, recorded and reviewed to make sure their preferences and wishes were respected.

People had plenty to do during the day. They were empowered to follow their interests. People were supported to remain as independent as possible and to maintain relationships with their families and friends.

People, relatives, stakeholders and staff were actively encouraged to provide feedback on the quality of the service. Complaints were investigated in line with the provider’s policy and action was taken to address any concerns. People felt they could speak to staff if they had a concern and that they would be listened to.

People, relatives, staff and health professionals told us they felt the service was well-led. Leadership was visible at all levels and people felt they were approachable. The registered manager promoted an open and transparent culture. Regular audits were completed and the registered manager had oversight of the quality of the service.

The provider had a range of policies and procedures in place that gave guidance to staff about how to carry out their role safely. The registered manager submitted notifications to CQC in an appropriate and timely manner and in line with guidance. The latest CQC report and rating was displayed in the service and the details were also on the provider's website.