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Inspection carried out on 9 November 2017

During a routine inspection

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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection site visit took place on 9 November 2017 and was unannounced. It included observations, speaking with people and staff and reviewing records. The inspection was carried out by one inspector and an expert by experience who had experience of a learning disability services. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care 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. As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law. We also contacted the local authorities who are responsible for funding some people’s care for information.

We spoke with six people who used the service, four care staff and the registered manager. We looked at two records about people’s care, minutes from staff and people’s meetings, complaint and compliments file, incident forms and quality audits that the registered manager and provider had competed.

Inspection carried out on 11 August 2016

During a routine inspection

This inspection took place on 11 August 2016 and was unannounced.

The provider of is registered to provide accommodation for personal care for a maximum of 13 people. There were seven people living at the home on the day of our visit.

At the time of our inspection there was manager in post who had recently been appointed and has since registered with us. This 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 told us that they were safe and with staff support they knew who to talk to about any concerns about their safety. Staff knew the steps to take to reduce the risk of harm or abuse for people. Staff were confident they would protect people and immediately report any concerns to management. People’s risks that related to their safe care and treatment had been looked at and reviewed so all staff knew what they needed to do to help minimise those risks.

People were supported by staff being available at the times they wanted support. We saw that staff responded to people as needed and told us they had time to support people as required. People had been asked about the level of help they needed with their medicines and staff provided people with support and recorded when they had received them.

Staff were confident about how to care for people and that their training and support provided them with the skills needed. All staff told us they felt supported by the management team to carry out their roles effectively. Staff listened and respected people’s decisions about their care and treatment. Staff showed they listened and responded to people’s choice to choose or refuse care.

People’s nutritional needs were met and they had choice in most meals they wanted. People saw other health professionals when needed to support and maintain their health and wellbeing.

People told us they liked living at the home and that staff were friendly and kind. People told us that staff made sure they remained independent and were encouraged to be involved in their care. They knew the staff well and felt they had developed positive relationships with them. Staff were considerate when talking about people and knew it was important to maintain a person’s privacy and dignity.

Improvements were needed to ensure communication with people was right for them. Activities available to people within their home needed to be reviewed and focus on people’s interests and skills. Staff had also been involved to support people when their needs changed and continue to provide care that met people’s needs. The manager was available, approachable and known by people who were confident to raise their concerns. Staff were also supportive to raise any concerns of behalf of people.

The recent change in the management structure will need to demonstrate that people continue to receive care that meets their needs. People knew the management team and felt involved in their home. The management team had kept their knowledge current and the provider ensured regular checks were completed to monitor the quality of the care that people received and looked at where improvements may be needed.

Inspection carried out on 6 August 2014

During a routine inspection

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection on 6 August 2014.  At the last inspection on 7 November 2013 there were no areas of concern. Maple Leaf Lodge provides accommodation and care for up to 12 people who have a learning disability. There were 10 people living at the home when we visited and 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 positive about the care they received and the staff at the home. Our observations and the records we looked at supported this view.

People told us that they felt safe and well cared for. Staff were able to tell us about how they kept people safe. During our inspection we observed that staff were available to meet people’s care and social needs.  We found that additional redecoration work was required in the communal areas of the home.

People told us and we saw that their privacy and dignity were respected. We saw that the care provided took into account people’s views and input from their relatives. Guidance and advice from other professionals such as social workers had also been included.

The provider acted in accordance with the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the care or treatment they receive. At the time of our inspection all people were currently being assessed for DoLS.

We found that people’s health care needs were assessed, and care was planned and delivered to meet those needs. People had access to other healthcare professionals such as a dietician and a chiropodist.

People were supported to eat and drink enough to keep them healthy. People had access to a range of snacks and drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

Staff were provided with both internal and external training how to care for people who lived at the home. They also felt supported in their role with regular supervision and leadership from the registered manager. Staff were confident that any concerns raised by them or on behalf of people who lived at the home were dealt with.

Inspection carried out on 7 November 2013

During a routine inspection

We inspected Maple Leaf Lodge and spoke with three of the 10 people who lived at the home. We spoke with three members of staff on duty and the registered manager. We were unable to hold conversations with all of the people who lived at the home due to their communication difficulties. We spent time and observed the care and support people received.

We read care records for three people and other supporting documents for the service. We saw that people were respected by staff. Staff asked people if they were happy with them giving care before they gave it.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that staff were aware of each person’s needs and how to give care and support to meet those needs. People told us that: “Staff are really good here, they look after me”. We saw that staff were kind and caring in their approach to people who lived in the home.

The registered manager showed us around the home. People told us: “The home is nice and we help to look after it”. “I like living here, and I feel safe”.

There was a complaints procedure in place at the home. We found staff knew how to support people to make a complaint if they needed to.

Inspection carried out on 26 February 2013

During a routine inspection

During our inspection we spent time with people who used the service and observed how care was provided for the people who lived at the home. We spoke with three people who lived at the home, the registered manager and two members of staff.

We saw that staff treated people with dignity and respect. We saw that staff were friendly and supportive to people and helped them to make everyday decisions.

We spoke with people who lived at Maple Leaf Lodge who told us that: “Maple Leaf Lodge is the best place to live”. We were told that staff were: “Very good and always help us when we need it”.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff were aware of each person’s needs. They knew how to give care and support to meet those needs that ensured people’s health and welfare was maintained. People confirmed that staff: “Give me the help I need”.

We saw that staff had a kind and caring approach towards people they supported. People told us they liked living at Maple Leaf Lodge and that they felt the staff were: “Very kind and helpful”.

Recruitment procedures made sure that only suitable staff were employed to safeguard people from the risk of harm.

A quality assurance system was in place. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

Inspection carried out on 23 January 2012

During an inspection to make sure that the improvements required had been made

We visited the service to see what improvements had been made since our last visit in August 2011. Following our last visit the provider sent us an action plan to show us how they were going to improve the service.

We did not speak to people about their care and treatment on this visit as we focussed on the changes that had been made to care planning and safeguarding. During our last visit people told us they were happy with the care and support they had received.

On this visit we observed that interactions between care workers and people that used the service appeared appropriate and individual. One person that lived at Maple Leaf Lodge told us they did not have concerns.

We looked in two people’s bedrooms. One person was happy to show us their room and they told us about their belongings and the things they liked in their room. One person was happy for us to look at their room but did not come with us. We saw many personal items, including DVDs and games in their room with their favourite posters on the wall.

Inspection carried out on 3 August 2011

During an inspection in response to concerns

The service had appointed a new manager in June 2011 who had identified areas that required improvement and had completed an action plan to address these.

We spoke to people who told us they were happy living there and they liked the staff. They told us they were given choices about how they spent their day and they could have trips outside the service. They also told us that they were able to spend time outside in the garden, and one person had developed a garden of their own.

We saw staff were attentive to people and assisted them with the activity or task they were doing. People were able to access the communal areas of the service, and a secure outside garden.

The service needed to be redecorated and the manager told us of their plan to improve this and develop a more ‘homely feel’. The manager had added pictures to the wall and planned to have the current photographs, which were hung high on the wall lowered so that they were easy for people to see and enjoy.