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Maiden Castle House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 December 2019

About the service

Maiden Castle House is a residential care home providing personal care to 63 people aged 65 and over at the time of the inspection. The service can support up to 66 people.

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

Overall, peoples’ needs were assessed prior to them starting to use the service. However, risk management and care plans were not put in place where people faced known or new risks. This meant staff did not have all the information they need to be able to safely care for people.

Records to monitor the amount of food and fluids people had were incomplete and not been reviewed to ensure people were drinking enough. There were multiple shortfalls in people’s care and monitoring records. This was important because most people were living with dementia and were not able to tell us their experiences. People relied on staff to provide the care they need so accurate records were essential to support this.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes this is through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Some people had conditions on the authorisations to deprive them of their liberty. There was not a robust system in place to ensure that these were being met or known by staff. Some people’s conditions were not being met which meant they were not being lawfully deprived of their liberty.

The quality assurance and oversight systems had not been effective in identifying the shortfalls found at this inspection in relation to people’s assessments and management of risks, record keeping and the monitoring of people’s DoLS conditions. The reassurances given by the registered manager at the last inspection in June 2019 to address areas for improvement were not effectively implemented.

People enjoyed the food and there was a relaxed atmosphere at mealtimes. Staff supported people to eat and drink well during the inspection.

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’s health needs were well managed, and people were referred to health care professionals appropriately.

The environment had been adapted with dementia friendly signage and décor.

Relatives and staff spoke highly of the registered manager and management team. There was a positive culture at the service and staff felt listened to and supported.

The management team was responsive to the feedback and arranged for additional staff training in relation to record keeping.

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

Rating at last inspection The last rating for this service was Good (published 18 July 2019) insert date last report published in brackets.

Why we inspected

We received concerns in relation to people’s experiences whilst staying at the service for short stays, people’s fluid monitoring and the meeting of people’s Deprivation of Liberty Safeguard (DoLS) conditions.

As a result, we undertook a focused inspection to review the Key Questions of Effective and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Effective and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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Inspection areas

Safe

Good

Updated 18 July 2019

The service was safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 14 December 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 18 July 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 18 July 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 14 December 2019

The service was not always well-led.

Details are in our well-Led findings below.