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Inspection carried out on 7 June 2019

During a routine inspection

About the service

Maple House provides care for up to five people who have a learning disability or autism.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was an adapted domestic style property. It was registered for the support of up to five people. Five people were using the service. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found:

Everyone we spoke with praised the management and staff for the quality of the service provided.

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

People were safe from abuse and avoidable harm. There were effective safeguarding procedures in place and staff followed them. Staff knew how and who to report any concerns to. There were enough staff to support people safely. There were systems in place for any absence of staff and managers, so people continued to receive their support as planned.

Staff were recruited safely and had the right skills and experience to meet people’s needs. The environment was clean, well maintained and a safe place for people to live. Evacuation procedures were robust in the event of an emergency.

Staff followed infection prevention and control procedures to reduce risk of infection and people received their medicines as required.

People’s needs, and choices were assessed before they used the service. Risks to people’s health and well-being were managed. Staff received training and updates on best practice guidelines that were appropriate to people they supported.

People were treated to kind and compassionate care. Staff protected people’s dignity and confidentiality discreetly. Staff were sensitive to people’s individual needs and they understood how best to support people. Relationships between people and staff were positive. Changes to people’s health were reported and monitored, and staff supported people to their appointments.

Support was person centred and delivered the way people preferred and met their individual needs. Staff understood people’s needs with regards to the protected characteristics of the Equality Act 2010. Information was available to people in accessible formats and staff knew people’s communication needs and understood how best to engage people.

People were occupied with activities, hobbies, and interests of their choosing. The atmosphere in the home was warm and friendly and people looked happy in their surroundings. The service met hosts from community venues to ensure people’s visits could be catered for safely and people’s diets and mobility needs were met.

People knew how to make a complaint and would feel confident doing so. People had opportunity to meet with the manager to discuss any concerns. Visitors were warmly welcomed at times suitable to them.

The service was managed well and there was an effective quality assurance processes in place. Action plans were developed following any shortfalls in the service and the registered manager worked closely with health and social care services.

The service applied the principles and values of Registering the Right S

Inspection carried out on 1 September 2016

During a routine inspection

This was an unannounced comprehensive inspection that took place on 1 September 2016.

Maple House is a care home registered to provide accommodation for up to five people who have a learning disability or who are on the autistic spectrum. The home is located on two floors. Each person had their own individual room. The home had a communal lounge, kitchen and dining room where people could spend time together. The home had a large garden, a sensory room and a spa pool. At the time of inspection there were five people using the service.

The service had a registered manager. 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. The registered manager was on leave. There was an interim manager in place.

People were protected from the risk of harm at the service because staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The provider dealt with accidents and incidents appropriately and reviewed these to try and prevent reoccurrences.

Risks to people’s well-being had been assessed. For example, where people displayed behaviour that may be deemed as challenging, staff had training and guidance available to them. We found there were enough staff to support people safely during our visit. Staff had been checked for their suitability before starting work.

People’s equipment was regularly checked and there were plans to keep people safe during significant events such as a fire. The building was well maintained and kept in a safe condition. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

People’s medicines were handled safely and were given to them in accordance with their prescriptions. People’s GPs and other healthcare professionals were contacted for advice whenever necessary.

Staff received appropriate support through an induction and regular supervision. There was an on-going training programme to provide and update staff on safe ways of working.

People chose their own food and drink and were supported to maintain a balanced diet. They had access to healthcare services when required to promote their well-being.

People were supported in line with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We found that appropriate assessments of capacity had been completed and DoLS applications had been made. Staff told us that they sought people’s consent before delivering their support.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected including staff discussing people in a professional and discreet manner. Staff knew people’s communication preferences. They had been trained and used one person’s preferred communication very effectively.

People were supported to be as independent as they could be. Skills that people had were developed and maintained. Staff knew people’s preferences and had involved people in planning their own support.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives.

People and their relatives had contributed to the planning and review of their support. People had support plans that were person centred and staff knew how to support people based on their preferences and how they wanted to be supported. People took part in activities and hobbies that they enjoyed.

People, their relatives and staff felt the service was well managed. The service was led by a registered manager and an interim manager who understood the requirements under the Care Quality Commission (Registration) Regulatio

Inspection carried out on 21st July 2015

During a routine inspection

The Inspection took place on 21 July 2015 and was unannounced.

At our last inspection on 2 July 2013 the service was meeting the regulations.

Maple House provides accommodation for up to five people who are aged over 18 and who have learning disabilities or Autistic Spectrum Disorder. The home has five single bedrooms, a communal lounge, dining room, kitchen and conservatory. The home has a large garden which has a sensory room, a spa tub and an allotment. There were five people living at the service at the time of our inspection.

The service had a registered manager. 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’s care plans were individualised and included details about people’s likes, dislikes and preferences in the way that staff supported them with their care. Risks relating to people’s care were assessed and control measures had been put in place to ensure that the risks were reduced. Staff provided care and support in line with people’s care plans.

Staff were kind, considerate and caring and knew the needs of the people that used the service well. There was detailed information about people’s behaviours that challenged others and guidance for staff on their response to ensure that this was consistent between members of the staff team.

There were policies and procedures in place to support the safe management of medicines. Medicines were being stored above the recommended temperature.

There were enough staff to meet people’s needs. There was a recruitment process in place that protected people from being supported by staff who were unsuited to the job. Staff received a thorough induction and time to get to know the people they were going be supporting before providing direct care and support.

People were supported to follow their hobbies and interests within the service and at externally held events.

Staff had an understanding of the Mental Capacity Act 2005 and the requirements of it. Decision specific mental capacity assessments had not been carried out where there had been a concern identified about a person’s capacity.

People felt able to raise any concerns with the registered manager. Where complaints had been raised they had been investigated, responded to and action taken to prevent them from occurring again.

Statutory notifications had not been completed and sent to CQC as required.

Inspection carried out on 3 July 2013

During a routine inspection

There were five people using the service at the time of our inspection. We were not able to speak to any of the people using the service due to their condition. We did, however, speak with five members of staff working at the home, including the home's manager and the relatives of three people who used the service and who regularly visited the home.

The relatives we spoke with all spoke highly of the care delivered by the service. They told us that the home provided a safe, clean and stimulating environment and that they were generally very happy with the care being delivered. One relative expressed concern about their son's weight but said that they had felt comfortable raising this with the manager at the home. One relative told us: "We are very lucky to have found the home. They have a genuine interest in X."

Staff we spoke with were knowledgable about the people they were caring for. Three of the staff members we spoke with were complimentary about the manager in post at the home. One staff member said: "I think a lot has improved thanks to the new manager. I can't complain really." They went on to comment that: "Training has greatly improved." We saw evidence that staff training had been carried out since our last visit and found that staff were being supported in their roles.

We found that people had a choice of freshly made meals each day and that care and support was being planned and delivered to ensure the safety and well-being of people using the service.

Inspection carried out on 3 January 2013

During a routine inspection

As part of our inspection on this service we spoke with six people working at the service, including the provider and the deputy manager. We also spoke with the relatives of two people who were living at the home. We were not able to speak to the people using the service due to their limited verbal communication skills.

The staff working at the service told us that they enjoyed their jobs. They described a supportive environment and told us that a key worker system was in operation, which they felt worked well for the people using the service. One staff member told us: "I like it. I think it's good. It's not at all institutionalised." Some of the staff we spoke with felt that, at times, they would benefit from having an additional member of staff.

The relatives we spoke with were very happy with the home environment the service offered and felt very comfortable with their relative living there. One relative said: "We feel very lucky to have found a place like Maple House." Both of the relatives we spoke with were complimentary about the service and the staff who worked there.

We reviewed care plans as part of the inspection and found these to be adequate. However, the risk assessments we looked at were not up-to-date and there was a lack of training in the area of physical intervention.

The home was clean and people's rooms were decorated as they chose. There were lots of activities on offer for people and a well equipped garden area for people to use.

Inspection carried out on 22 February 2012

During an inspection in response to concerns

Some of the people who lived at the home had limited communication; we were unable to ascertain what a number people felt about their experiences.

Staff spoke to us and told us how the recruitment process was operated when they were employed. Staff said they had to supply three references, and undergo two interviews before they were offered a post in the home.

We looked at the comments on the staff quality assurance (QA) exercise. People were asked to comment on a number of questions, and replied the following.

On what benefits there was working with Kings Residential Homes� people said �Working with the residents�; To gain more qualifications and experience�; �I have gained an NVQ 2 & 3 (training qualifications) and met a great group of people, as well as watch the residents grow�.

Reports under our old system of regulation (including those from before CQC was created)