Maple House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice, including in response to any incidents. A staff member told us, “I have received training and support on how to complete incident records properly. Managers provide feedback and de-briefs when needed, which helps me improve my practice.” For example, we saw 1 person became anxious when their weekend plans changed, so the service put in place social stories to explain to the person in good time about any changes to their routine. Social stories are used to explain to people, often autistic people, what will be happening next, so they can prepare for changes and reduce anxiety. This led to positive outcomes for the person.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Since the last inspection, the service had introduced new electronic care plans which set out people’s needs clearly. People had a hospital passport which set out important information for healthcare professionals should they have to go to hospital for care and treatment. The service also ensured safe transitions when people visited their relatives, in relation to key areas such as medicines and supporting wellbeing. For example, 1 relative said, “Staff are strict with the transfer of medication during home visits.” Another relative said, “[Person] is so happy to go back [to Maple House] after visits, which is a positive for me.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We received feedback people felt safe living at Maple House. The service shared concerns quickly and appropriately, and staff were confident leaders would take action if required. A staff member told us, “Even if something looks very small, [manager] takes it very seriously.” Staff received safeguarding training. A staff member told us, “I know how to identify and report a safeguarding concern.As a support worker, I understand it's my duty to be vigilant for any signs of abuse, neglect, or exploitation and to follow the correct reporting procedures.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were completed in a range of areas including on how to reduce the risk of choking, road safety, health needs, and how to support people when expressing anxiety or distress. We saw records contained sufficient detail to guide staff on how to keep people safe and followed the recommendations of external professionals. For example, 1 relative told us, “The SALT (Speech and Language Therapy) team visited for [person] due to a choking incident, and I was immediately notified.” The manager was also in the process of updating plans for all people living at Maple House, with how best to support them when communicating their needs, emotions or distress.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff completed environmental safety checks, including in relation to fire safety and legionella. Records showed staff took part in fire drills, so they were prepared in the event of an emergency, including at night. People had personal emergency evacuation plans (PEEPs) in place, to guide staff on how to support them to evacuate safely if required. This included important information about people, such as the impact of any medicines and how to support them if distressed by the situation. Staff received training including on fire safety, health and safety, and basic life support.

The provider made sure there were enough qualified, skilled and experienced staff. They made sure staff received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. We found minor improvements were needed in recruitment records to ensure a full employment history was recorded. The manager told us they would act on this feedback straight away. However, specialist training was made available to staff, including on how to support people with a learning disability and or autistic people, and to administer emergency medication for seizures. The service had also introduced new ‘Staff Champion’ roles, where staff had enhanced training and responsibility for areas such as nutrition, positive behaviour support (PBS), meeting sensory needs and safeguarding.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff received training in infection prevention and control, as well as in good food hygiene practice. A staff member told us, “My role also includes keeping the house clean and tidy, doing laundry and ironing, and preparing the environment for the next day.” Observations showed the environment was clean, tidy and well-maintained. A relative said, “When I visit [person], the room is clean and tidy.” Regular checks and audits were in place to confirm good infection control practice.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received their medicines safely and as prescribed. Medicines profiles were in place for each person and were person-centred, including preferences for administration, capacity assessments, and best interest decisions where applicable. Records for medicines administered were completed on an electronic system. Medicines were counted at each administration, and spot checks confirmed that stock balances were accurate. PRN (as required) protocols were in place for oral and topical medicines, including guidance on application sites. Where PRN medicines were prescribed for anxiety, these were rarely used. Staff had a clear understanding of alternative strategies and had worked with prescribers to review and de-prescribe medicines where appropriate. Fire risk assessments were in place for paraffin-based skin products. Seizure management plans were in place and contained detailed information from external specialists. Medicines reviews were completed with GP involvement and included physical health and side effect monitoring. Medicines were ordered on a four-week cycle, with systems in place to ensure timely reordering and prevent missed doses. Temperature monitoring was completed daily in storage areas, and staff followed clear processes to manage excursions. Controlled drugs (CDs) were stored securely. There was a process in place to ensure information about a person’s prescribed medicines was available when moving between services. This included hospital packs and access to GP and discharge records.