Maryland Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service registered on 15 December 2021. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

As people’s care plans and reviews of their care plan were incomplete, we were not always assured the provider worked in direct partnership with people to respond to any changes in their care. As regular reviews of care plans were not always carried out, any changes in people’s needs were not properly recorded.

Staff we spoke with were knowledgeable of people’s needs and the day to day care they required but we found this information was not well documented. Some people’s care plans were incomplete and lacked sufficient person-centred information personalised to the needs, risks and preferences. This aspect of care planning required improvement so staff had clear information about people’s individual needs and preferences, and to help ensure people were involved in making decisions about their care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

We saw how for some people, health care needs which had been identified on a pre-admission assessment or information which had been provided by external agencies prior to the person’s admission to the home, was not always captured in their plans of care. This meant there was a risk the people’s health care needs may not be fully understood by staff.

For example, 1 person had been identified as prone to wandering and had some issues with their mobility, but a falls risk assessment had not been completed for the person, to help guide staff on how to manage and meet the person’s needs.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care records were not always fully complete so we could not be assured people had been provided with information in a way in which they fully understood. We could not be assured the provider had fully utilised the Accessible Information Standard to identify, record, share and meet people’s communication requirements.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider did not hold resident meetings for people to enable people to have a say in the running of the service and air their views. The last recorded minutes of a residents meeting was in 2021. Similarly, questionnaires were not provided to people to enable them to provide their feedback in a more confidential way.

Despite the lack of more formal methods of obtaining people’s feedback, people told us they felt comfortable to feed back their views either to the registered manager or staff. One person told us, “If I was not happy, I would talk to a staff member. I am happy here and there are no problems."

The provider made sure people could access the care, support and treatment they needed when they needed it.

Where people required care and support from external agencies and partners, for example, GP’s and dieticians, the provider recognised this need and ensured people had access to these services.

Relatives told us, “I have generally instigated and asked for a GP if Mum is not right, but staff are getting better at that and recognising that” and “If [Name] needs a doctor, they [staff] would get one out. I am kept fully updated."

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Despite any limitations people may have had, the provider ensured people were able to access the support they needed. The registered manager told us about how with close working with the GP, they had been able to reduce a person’s long-term reliance on medicines.

We could not be assured people were always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s care plans were either incomplete or did not capture sufficient detail to record people’s advanced wishes or end of life wishes. We could not be assured the provider had properly recognised and considered people’s values and wishes and how these may influence decisions about their end-of-life care. This was particularly important for people with a DNA CPR in place, to help ensure people had a pain free, sensitive and dignified death. A DNA CPR, (Do Not Attempt Cardiopulmonary Resuscitation) is a medical decision made in advance, usually with a person and their doctors, that specifies they should not receive CPR if their heart or breathing stops.