Maidstone Care Centre

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 remained Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in continued breach of legal regulation in relation to people’s safe care and treatment for the ways people’s medicines were managed.

This service scored 62 (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 identify and embed good practice.

The service had overall improved its practice in most areas of care delivery. People, relatives and staff were all positive about the learning culture of the service. Feedback was that the management took action when required to improve the service. A relative commented, “Slowly, but surely, it is improving here.”

Accidents and incidents continued to be reported and monitored by staff and the management team. The provider took appropriate action following accidents and incidents to mitigate future risks for people. There was now an embedded process to ensure accidents and incidents were reviewed to identify any patterns and trends. Where patterns or trends had been identified in relation to accidents and incidents, learning was shared across the staff team and action had been taken to implement learning and improvement. For example, there had been a reduction in accidents such as falls at the service as a result of the work completed.

The provider tried to work with healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. However, this had not always been successful. The management team for the service told us they had experienced poor systems from a healthcare partner and this had impacted on their ability to always meet people’s needs fully and safely in relation to their prescribed medicines. The provider had already identified this and taken action to address it, however, the resolution had not been timely.

The provider worked with people and made sure there was continuity of care, including when people moved between different services. People told us, “I feel safe here.”

A relative told us, “[We] visited before [relative] moved in. The care plan was discussed with myself.” A staff member confirmed, “Preadmission [assessment] is always done by managers, and they check everything. They share the information with us.” The provider aimed to put all mandatory risk assessments and care plans in place within 72 hours. We saw evidence that this was chased up with staff if it had not been completed.

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. The provider shared concerns quickly and appropriately.

People told us they felt safe living at the service. Relatives confirmed they felt people were safe. A relative said, “[Relative] is safe here.” We observed people were supported safely by staff.

People, relatives and staff felt able to raise concerns and that they would be acted on. A relative said, “We have raised safeguarding issues which have been dealt with.”

Staff told us they completed safeguarding training and records confirmed this. Staff knew the process to follow to raise safeguarding concerns. A staff member said, “Report it to the [person] in charge on the day. If they don't [act] you follow the hierarchy and take it upwards.” Staff were also aware of how to escalate concerns outside of the service when necessary. Safeguarding was discussed with staff and reviewed within the provider’s governance processes to ensure safe and effective oversight.

Staff had made Deprivation of Liberty (DoLS) applications to the local authority to deprive some people of their liberty. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. There was a tracker in place to monitor when these had been approved or were due for renewal.

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.

Most people and relatives told us they had been involved in their risk assessments and felt staff supported them safely. A person said, “I had a risk assessment. There is always someone with me when I move around.”

People’s risks were now fully assessed and there was now detailed guidance in place to support staff to monitor and manage people’s risks safely and effectively. For example, where people had health conditions such as Parkinson’s disease, diabetes or high blood pressure these risks had been assessed, including how the person’s condition affected them as an individual and specific guidance on how staff should monitor and support the person to ensure their condition did not deteriorate and what action to take if it did.

When people could display behaviour that challenged or people experienced distress or anxiety, there was guidance for staff about how to support the person. When triggers for people were identified, staff changed their practice to minimise impact for the person.

People and most relatives felt risks were well managed. A person told us, “My diabetes is controlled by diet. The staff support me with my diet.” A relative told us, “[Person’s name] is hoisted. It seems to be a safe procedure.” We observed staff supported people safely, in line with their risk assessments and care plans.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had undertaken relevant health and safety checks such as electrical installation and gas safety; legionella and water temperature checks. Equipment checks were carried out to ensure these were in safe and working order for people. People had personal emergency evacuation plans as required and the provider had assessed fire risk and trained staff in fire safety.

People and relatives were happy with the home environment. A person told us, “The building seems to be well maintained.” A relative said, “I think the building is in good repair.” A relative gave an example of how the building was maintained safely. They said, “[Person’s name’s] toilet seat was loose, and it was fixed quickly."

The provider made sure there were enough qualified, skilled and experienced staff, whom they supported with supervision and development. However, we received mixed feedback from people about how well staffed the service was to provide care that met people’s individual needs. Some people told us, “There are enough staff. I press my buzzer [when staff are needed].”, “When I need the staff they come in a reasonable time.” And “In [the lounge area], they always try to have [staff] around.”

Other people told us, “There are just about enough staff. I may have to wait sometimes when they are busy, to go to the toilet.” And “I have a buzzer in my room to call the staff. It depends how busy they are as to how quickly they come.”

Some relatives felt there were enough staff while others disagreed. Comments included; “I have noticed that as soon as a call bell goes off, someone comes. There seem to be enough staff.”, “I feel that there aren’t enough staff on duty…I can often hear the cries from the residents and see the carers running around.” And “There are often people calling out for a carer. If we are in the lounge, someone might ask for the toilet, call out, but the staff don’t respond straight away.”

However, the provider carried out regular assessments to ensure there were enough staff to meet people’s needs. The home was staffed to their required staffing level during the inspection. We observed people’s needs were met in a timely manner and staff did not appear to be rushing. Staff told us they felt there were enough staff to meet people’s needs. A staff member said, “Staffing levels -tremendously improved more than before. The staffing is good now. I can't remember when we used an agency staff last. Staffing is good.”

Staff felt they had received the training they needed to carry out their roles and meet people’s needs. For example, a staff member told us, “I have done dementia training. It's an external training and I find it very insightful. It gives me understanding of the issues people with dementia face. It makes me more understanding, kind and sympathetic towards them.” People and relatives felt staff had the skills needed to support them. A person told us, “The medical nurses are very good.” However, we were not assured in relation to staff’s application of their knowledge, experience and skills in relation to medicine’s management due to issues we found in this area.

Recruitment practices within the service were now safe. The provider completed pre-employment checks as required, they had obtained recruitment references, monitored to ensure staff provided full employment history and carried out Disclosure and Barring Service checks and Right to Work checks.

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.

The home appeared clean during our visit and we saw housekeeping staff maintained a clean home environment for people. People told us, “My room is clean.” And “The cleaner comes in every day.”

Staff told us they received infection control training and understood how to mitigate the risk of infection. A staff member said, “We have personal protective equipment and I check that staff are using it and they do.”We observed staff followed good infection control procedures such as supporting people with hand hygiene before meals and ensured food was served at safe temperatures.

Staff monitored people for any signs of infection, where there were concerns, these were escalated to ensure people received any required treatment.

The registered manager and provider maintained oversight of infection prevention and control practice within the service through regular audits to ensure compliance and identify any areas for improvement.

The provider continued to not always make sure that medicines and treatments were safe and met people’s needs and capacities.

Although staff told us they received regular training to administer medicines and competency assessments; we found medicines had not always been well managed.

Between 01 August 2025 and 15 October 2025, we found 25 people had missed some of their prescribed medicines for short periods of time. In a care setting, the provider is responsible for ensuring people have access to their medicines as prescribed to ensure people’s needs are met and to try to prevent deterioration in their health or well-being. Although some people had alternative options available and offered, this was not the case for all people and all medicines. People had not been effectively protected from this potential risk at this time although we found no evidence that people experienced harm. Prior to the inspection, staff had taken some actions to try to get the stock required however this had not always been effective or robust. The provider told us they felt assured that from November 2025 their stock supply would not be an issue, and they strengthened their systems and processes to prevent this from happening again. We will check this at our next inspection.

We received mixed feedback from people about medicine management. Some people and relatives felt medicines were not managed well. Comments included, “[Some staff], I do have complaints, [they] get my tablets wrong. I looked and said it is not right, [staff] went away and checked and said I was right.” And “Sometimes we come in and find [relative’s] tablets are stuck to the blanket. [Relative] also tucks them away in [their] cheek. The staff know that, but we still find that [relative] hasn’t swallowed them.” Other people and relatives felt medicines were managed well. Comments included; “I take lots of medicines. I have painkillers early am, then my regular meds at 9 am. I have more painkillers at tea-time.” And “I get my tablets when I need them. The nurse stays until I have swallowed them.”

Staff had not always disposed of medicines that were past their use by date. Use by dates are important because using medicines beyond this date can affect the medicines’ effectiveness and some medicines can become toxic. Staff had administered medicine past the use by date, on a few occasions, to 1 person. There was no evidence the person experienced harm as a result of this. There were some other medicines past their use by date that had not been given. However, this had not been identified by the staff until we raised it. There was a potential risk some other people could have been given these medicines. We raised this with staff, and the medicines were disposed of and replaced where necessary.

Staff were still not always disposing of controlled drugs safely as single use destruction kits were still not being used in line with manufacturer’s instructions.