Maria Residential Home

Maria Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Maria residential home accommodates up to eight people in one adapted building. At the time of our inspection seven people were living there.

People’s experience of using this service:

Maria Residential Home is a family run organisation. At the time of our visit the service was going through a transition. The current registered manager was retiring, and the role was being handed over to one of the proprietor’s sons. Another son was taking over the role of nominated individual.

People’s views of the services included comments such as “It’s a lovely place, I would recommend it to anyone” and “Long may they (care staff) continue to give the care and consideration they do,” 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 supported this practice.

However, we found a few areas that required improvements. These included adherence to the fire regulations, for example, not propping fire doors open and taking preventative measures to reduce the spread of potential fires. Other areas included the maintenance of records to ensure they were up to date and accurate.

Food was not always labelled in the fridge after opening. These all placed people at risk of harm. On the second day of our inspection we found most of the areas had been rectified. Plans were in place to address the remaining areas which could not be addressed immediately.

People told us they felt safe living in the home. Checks had been completed on essential safety apparatus such as safe water systems and hoists. Services such as gas and electricity had been maintained. People told us they were happy living in the service and had built up strong positive relationships with the staff. People were respected and treated in a dignified and caring way by staff.

People’s nutritional and dietary needs were assessed, documented and care was provided in line with their needs. External professional provided professional advice when needed.

People were treated equally by the staff. Training was provided to staff the area of equality and diversity.

Staff were trained and knew how to protect people from the risk of abuse. Where concerns had been raised these had been dealt with appropriately.

Activities were available to people. They told us they enjoyed them. This protected them from the risk of loneliness.

People received medicines from trained staff, however, we have made a recommendation about medicine administration. This is to ensure the service is up to date with current best practice.

We have also made a recommendation regarding the code of practice for the Mental Capacity Act 2005. This is to ensure records related to mental capacity assessments and the best interest process are produced.

Complaints were dealt with effectively and efficiently.

Staff told us they felt supported by senior staff. The staff in the service were caring. They told us they worked well as a team. They respected each other and supported each other. They received support from the provider and the registered manager. They also received support through regular training, supervision and team meetings.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Rating at last inspection:

The last inspection the service was rated Good. (Published 10 November 2016)

Why we inspected: The inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Maria Residential Home is a family run care home registered to provide care and accommodation for up to eight older people with dementia. At the time of the inspection there were seven people living at the home. The home does not provide nursing care.

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 l Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 24 April 2015 the provider was in breach of four regulations. We asked the provider to take action and make improvements in relation to the management of medicines, notifying the Care Quality Commission of significant events or incidents, improve the quality assurance processes and to ensure fire risk assessments were in place and regular fire alarm tests were undertaken to protect people from potential harm. The provider sent us an action plan outlining the actions they were going to take. At this inspection we found improvements had been made and the provider had completed these actions.

People and their families told us they felt safe at Maria Residential Home. Staff understood their responsibilities in relation to safeguarding people. Staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the authorities where concerns were identified. People received their medicine as prescribed.

People benefitted from caring relationships with the staff. People and their relatives were involved in their care and people’s independence was actively promoted. Relatives and staff told us people’s dignity was promoted.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff sought people’s consent and involved them in their care where possible.

There were sufficient staff to meet people’s needs. Staff rotas confirmed planned staffing levels were maintained. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable to undertake their care role.

People and their families told us people had enough to eat and drink. People were given a choice of meals and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

Relatives told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the Registered Manager and all of the team at the home. Staff supervision and other meetings were scheduled as were annual appraisals. People, their relatives and staff told us all of the management team were approachable and there was a good level of communication within the service.

Relatives told us the service was very friendly, responsive and very well managed. Comments received included “its home from home”. The service sought people’s views and opinions and acted on them.

The management teams’ ethos was echoed by staff and embedded within the culture of the service.

We conducted a Short Observational Framework for Inspection (SOFI) and saw that people were respected and involved. People were able to make choices about their care and day to day lives and their choices and preferences were respected. We saw that people were well cared for and their planned care was appropriate and person centred.

The provider had taken steps to ensure people were safe from the risk of abuse. All care staff in the home had received training in safeguarding vulnerable adults. They also received refresher training every year. The provider had a robust policy on safeguarding that was available to all care staff.

The provider had appropriate recruitment and selection procedures in place. All care staff had provided references before starting work and we saw evidence that background checks had been conducted. This meant the provider had checked to ensure that care staff were of good character.

The provider had a complaints policy that was available to people and their relatives. Comments were recorded and people's opinions sought. Accidents and incidents were recorded and appropriately managed. This meant the provider monitored the quality of service they provided.

People told us they and/or their family had been given the opportunity to visit the home before they moved in. This ensured it met their needs and expectations. They said the staff treated them as individuals and respected their views and choices. They were consulted about any changes to their care and could choose how they spent their day.

Care plans were in place to document people's individual needs. They were detailed, reviewed and updated regularly. Risk assessments had been written to identify and reduce the likelihood of injury or harm, with guidelines in place for staff.

People had access to healthcare professionals and specialist support to ensure they kept healthy and well.

Daily activities were provided for those who wished to take part. They included one to one activities and group sessions. They were tailored around people's likes, dislikes and individual needs.

During our visit we saw staff assisted people in a kind and compassionate way and were treated with dignity and respect.

Systems were in place to regularly assess and monitor the quality of service that people received to ensure people benefitted from safe quality care and support.