We carried out a review of the data available to us about Maitland House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Maitland House, you can give feedback on this service.
People’s experience of using this service and what we found
Systems were in place for the supply of medicines, staff were trained, and competency assessed. We identified shortfalls in the management of people’s medicines whereby we could not be assured people had received their medicines as prescribed. The current system for auditing medicines was not robust at identifying all medicines management errors.
Environmental risks had been identified and action taken to reduce risks. Where we identified potential risks to people’s safety from unsecure wardrobes the provider responded immediately to rectify this.
Risk assessments detailed people's individual risks such as, mobility, risk of falls and managing behaviours that may present a risk to the individual and others. Further work was needed to ensure robust assessment and monitoring for people where medicines were covertly administered and effective monitoring where people were at risk of losing weight.
There was an open and transparent culture within the management team demonstrated throughout the inspection. There were systems in place to monitor the quality and safety of the service. Incidents and accidents were investigated, trends analysed, and actions were taken to prevent recurrence. However, whilst we were reassured action was taken to rectify the shortfalls we found at this inspection, we recommended the auditing system is reviewed to provide more effective oversight of medicines management, weight monitoring and environmental risks.
People told us staff were kind, caring in their approach and supported their independence. People, their relative’s and staff were positive regarding the management of the service.
People had access to a complaints process and provided with the information they needed to raise a concern should they need to do so. People's feedback was considered through a range of systems such as surveys, care reviews and meetings.
People were supported by skilled staff with the right knowledge and training. Staff told us they were supported by the management team with their training and development needs.
Personalised care plans had been developed, which provided the staff team with guidance about the needs of people and how these needs were to be met.
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 had access to a variety of nutritious meals and snacks. Meals were freshly prepared and pleasantly presented.
There was a varied range of social activities on offer. Work was in progress to improve links with the community. We recommended further work is carried out to ensure planning and monitoring of people cared for in bed to provide social stimulation and reduce their risk of isolation.
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 27 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection, in April 2015 the service was rated Good. At this inspection we found the service remained Good.
The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 Care Act and associated Regulations about how the service is run.
People were kept safe from harm or potential abuse by staff who had been trained and knew how to recognise and report concerns. Information about the risks to people's safety was communicated and equipment was in place to meet their needs safely.
Staff were recruited in a safe way and had received induction and training. Staff felt they were well supported in their roles.
The health and welfare needs of people were met because the manager ensured that there were sufficient numbers of staff with the relevant skills and experience on duty. This included staff with appropriate knowledge so people's care and support needs were met in the least restrictive way.
People were supported to access healthcare services to maintain and promote their health and well-being. People were also helped to take their medicines by staff who knew how to manage these in line with recommended practice.
The manager and staff were aware of how to make an application where people's freedom was potentially restricted however no one was subject to this on the day of inspection.
People were provided with appropriate food and drink to meet their health needs. People were happy with the food they were provided with and staff helped people to make their own choices so people's personal preferences could be met.
Staff were caring and respectful towards people with consideration for people's individual needs. Staff were attentive, polite and sought consent before providing care and support so people were in control of their lifestyle as much as possible.
People were provided with opportunities to participate in activities which were personalised to meet their individual recreational interests.
People knew how to make a complaint and felt able to speak with staff or the manager about any issues they wanted to raise. People were involved in providing their views about their care directly to the manager and staff.
There were a range of checks in place to make sure the quality of the services people received were of a good standard. We saw the manager had identified and was taking action to drive through improvements and strengthen their monitoring of the service overall.
Further information is in the detailed findings below and you can also see our previous comprehensive inspection report for this service.
The inspection took place on 08 April 2015 and was unannounced. Maitland House provides accommodation and personal care and support for up to 24 older people, some who may have a mental health need. At the time of our inspection there were 21 people who lived in the service.
The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 Care Act and associated Regulations about how the service is run.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.
The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.
There were risk assessments in place and people’s health care needs were assessed appropriately. Care was planned and delivered to meet people’s needs safely and effectively. People were provided with sufficient quantities to eat and drink and their nutritional needs were met. People’s privacy and dignity was respected at all times.
People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people’s healthcare needs were well managed. Staff interacted with people in a caring, respectful and professional manner, and were skilled at responding to people’s care and support needs.
People were supported to follow their own chosen hobbies and interests and encouraged to take part in activities that interested them. They were supported to maintain contacts with the local community so that they could enjoy social activities outside the service. There were systems in place to manage concerns and complaints. There was an open culture and the manager and staff provided people with opportunities to express their views. There were systems in place to effectively manage concerns and complaints.
The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits completed by the provider and registered manager and subsequent actions had resulted in improvements in the service.
We saw that Maitland House provided a relaxed and homely environment for people. Staff were friendly and respectful in their approach and interacted with people who used the service in a confident and considerate manner. During the course of our inspection we saw that people were supported to express their views and choices by whatever means they were able to, and staff clearly understood each person's behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.
We noted that the environment at Maitland House had sufficient communal areas to meet the needs of people who lived there. We saw that people were comfortable in their surroundings.
The staff team were well trained and supported to carry out their role. The provider had effective systems in place to monitor the quality and safety of service that people received.
The provider had a recently changed their medication management process that was regularly audited and the forms were completed according to the process.There was a robust system in place to ensure that the quality of service was assessed, monitored and evidence of this system was seen
You can see our judgements on the front page of this report.
respected and that their views on the support and care they receive are taken into
account.
They also told us that generally they were able to make choices about aspects of their
care. For example, we spoke with three people about how they are supported to
choose what to eat each day. They told us that staff offer them a choice of meals each
day and they can choose where they have these. They are also able to make a
decision as to whether or not they participate in social activities.
One relative with whom we spoke confirmed they were happy with their relative's care
and support and found staff to be kind and caring.
One person said, in relation to personal care, "Oh they are very good I always need help."
People spoken with were not all able to tell us whether they had been involved in the development of their care plans or not.
People with whom we spoke made the following comments:
"It's a nice home", "The staff and manager cannot do enough for you" and "I can eat what I like here and I feel safe".
Those people with whom we spoke said they could choose whether or not to join in
activities and could spend time alone in their room pursuing their own interests if they
preferred.
People using the service told us that staff helped them with their medication when they needed it.
People told us when we visited that they liked the home and that they liked living there.
People told us that they liked their rooms and found them comfortable. People with whom we spoke during the inspection were happy at the home and liked the way it was
presented.
People told us that they feel well looked after by the staff at Maitland House. One person with whom we spoke said "I feel safe here and the staff and manager are like my family"
People told us that they felt comfortable talking with the staff about any issues that they had and that the manager was also always available for them to talk to.