Maple House

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 continually identify and embed good practice. Relatives told us their family members were safe living at the service and had been kept informed when incidents happened. They also told us the management team had been professional and proactive when incidents happened.

There had been a recent increase in incidents of behaviour when some people were expressing their anxiety. The incidents had been recorded and analysed, this information had been used to involve healthcare professionals and funding authorities to reduce the risk of the incidents continuing. Records showed there had been a reduction in incidents since other agencies had become involved.Staff had been informed about changes to people’s support and medicines during handovers and they were discussed at staff meetings.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider had a process in place to support people to move into or out of their services. However, there had been no changes in the people living at the service since our last inspection.

When people needed to go into hospital staff printed out an emergency pack from the electronic care plan system. The pack contained all the relevant information needed to support the person. Staff accompanied people to appointments and into hospital. Where possible staff supported people during a hospital stay. A relative told us staff had continued to support their family member during a hospital stay which had been reassuring.

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. The management team had identified incidents and concerns and reported them to the local authority as required. They had worked with the local safeguarding team and other professionals to keep people as safe as possible.

Staff had received safeguarding training, they described how to identify concerns and how to report them. Staff were confident the management team would take appropriate action but knew how to raise concerns outside the service if required.

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. Potential risks to people’s health and wellbeing had been assessed. People’s support plans contained information about how their autism and learning disability shaped their world. There were clear guidelines for staff about how to support people to enable them to participate in daily life.

Staff understood how to maintain people’s routine and how to recognise when they were becoming anxious. We observed staff recognise potential triggers between people and quickly de-escalate the situation, before an incident could occur. Staff followed people’s routines such as taking them out for a walk or drive in the van early as this was part of their routine.

People had full access to the kitchen with staff present. Each person had different abilities, but staff supported each person to take positive risks to do as much as possible. When people were out in the community staff were aware of how to keep them safe and their understanding of risk such as crossing the road.

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 management team completed regular walk rounds to identify any concerns. The decoration of the service needed updating, there are plans in place to update people’s bedrooms. One bedroom had already been completed with the paint colour the person liked. Some areas such as the bathrooms needed updating. The deputy manager told us the upstairs bathroom was being changed into a wet room, to help people’s access in the future. The downstairs bathroom would be decorated and new flooring to improve infection control. These changes were due to start shortly after this inspection.

There were regular checks completed on the building and equipment people used to keep them safe. There was a maintenance team who could be called if there were any issues and completed any general work. During our inspection a member of the team was on site to complete routine work, people welcomed them and were happy to see them.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Relatives told us there were enough staff to support people and the staff team was stable. They confirmed when needed extra staff were deployed to keep people safe. Staff thought there were enough staff, and they were able to take people out to do activities when they wanted.

Staff were recruited safely, checks had been completed, for example, to check staff were of good character. Staff completed training appropriate to their role and they received supervision to discuss their training needs. New staff had completed an induction including shadowing more experienced staff to learn how to support people and their preferences.

Staff worked together as a team and were supportive of each other. They understood people’s needs and how at times a different face helps people to remain calm or agree to do something. “We often ask another staff member to support a person if they are not happy with us, sometimes we ask (deputy or manager) if none of us are having any luck.”

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. There were effective infection control policies in place. The service was clean and odour free, people and staff kept the service clean. Staff wore personal protective clothing such as gloves when appropriate, there was a continuous supply for staff to use.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicines were managed safely, staff had received training, and their competency had been checked. People’s medicines were kept in a locked cabinet in their rooms, the temperature was checked to ensure medicines were kept at the correct temperature. Records were accurate and the number of tablets available were correct.

When people were prescribed ‘when required’ (PRN) medicines such as for anxiety, there was guidance in place, this included when to give, how often and what to do if they were not effective. The PRN protocols were stored on the electronic care plan system, but medicine records were paper based, records showed staff clearly understood the guidance and had given medicine accordingly. However, we discussed with the deputy manager about having a paper copy of the guidance with the paper medicine records, so staff could reference it. This was put in place immediately.