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We are carrying out a review of quality at Maple View. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 5 February 2019

During a routine inspection

About the service:

Maple View is a residential care home that provides personal care and support registered for up to five people with a sensory impairment, learning disability and/or autistic spectrum disorder. People using the service live in a purpose built bungalow, located within a residential community setting alongside four other individually registered services run by the same provider. On the day of our inspection there were five people living in the service.

Rating at last inspection:

At our last inspection, the service was rated ‘Requires Improvement’. Our last report was published on 9 January 2018.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

People’s experience of using this service:

We previously inspected Maple View in November 2017 where the service was rated ‘Requires Improvement’. This was because we found that since our inspection in June 2015 where the service was rated ‘Good’ there had been a deterioration in the quality of care. There was a breach of Regulations 9, 12, 17, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection the provider had made good improvements to the service since our last inspection on 8 and 22 November 2017.

• Staff received better training, induction, supervision and support so they could effectively perform their roles.

• The registered manager had resolved issues surrounding the recording, investigation and analysis of incidents and accidents.

• Governance of the service had improved. Systems had been put in place for auditing the quality and safety of the service with action plans produced.

• People and relatives told us the staff were kind, friendly and supportive of their needs. Staff knew people's needs well.

• People’s safety had been considered and risks had been reduced by improved risk management systems.

• Medicines were managed safely.

• Care plans had been reviewed and systems put in place to enable ongoing review with people’s changing needs updated in a timely manner.

• People told us they were satisfied with the quality and variety of food they were provided with. People were supported to develop skills in food preparation and cooking.

• Referral for specialist support was accessed when needed. For example, in relation to management of behaviours that may present a risk, continence needs and support for people with sight and hearing impairment.

• The outcomes for people using the service reflected the principles and values of Registering the Right Support. People were provided with choice and control with opportunities to gain new skills and become more independent.

• The service met the characteristics for a rating of ‘Good’ in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was ‘Good’.

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

Inspection carried out on 8 November 2017

During a routine inspection

This comprehensive inspection took place on the 08 and 22 November 2017 and was unannounced.

Maple View is a residential care home that provides personal care and support registered for up to five people with a sensory impairment, learning disability and/or autistic spectrum disorder. People using the service live in a purpose built bungalow, located within a residential community setting alongside four other individually registered services run by the same provider. On the day of our inspection there were five people living in the service

At the last inspection, the service was rated Good. At this inspection, we found deterioration in the overall governance of the service and so the overall rating is Requires Improvement.

The registered manager was also one of the organisation’s directors and managed another nearby residential care service. A team leader supported them with the day to day management of the service. 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 Care Act 2008 and associated Regulations about how the service is run.

There were sufficient staff on duty at the time of our inspection. A safe recruitment process was followed to ensure that staff employed were suitable for the work they were employed to perform. However, training for permanently employed staff was not effective. The registered manager provided the majority of training but was not accredited to provide training in British Sign Language to Level one. We identified concerns about staff understanding of current good practice. Staff did not demonstrate knowledge of safe care and best practice in caring for people with sensory needs and those who may present with behaviour that may pose a risk to themselves and others.

Staff did not all receive appropriate training to understand the complex needs of people using the service. Behaviour, which may have impacted on others, was not always managed correctly with clear guidance for staff in responding safely and appropriately. The management of behaviours, which had a negative impact on others, was inadequate and placed people at risk of harm.

There was a lack of learning from incidents and events with action taken to improve safety as the provider’s system for incident reporting and further analysis was ineffective.

Agency staff employed did not always have the skills, knowledge and relevant training to meet people's needs. We found that no check had been carried out which would assure the provider that staff employed from agencies had the skills, knowledge and experience to meet the needs of people who lived at Maple View.

Whilst we found there were safe systems for the management of people’s medicines and prevention and control of infection, further work was needed to ensure robust fire evacuation procedures were in place. Fire safety checks had not been carried out at the regularity as required. We recommend the service follow good practice in the carrying out of fire drills so that these are used as a learning opportunity and to mitigate risks to people’s safety and welfare.

People’s care was not always planned in a manner that was responsive to their needs. People had care and support plans in place but these were not always updated, reviewed or reflective of their current needs. People were supported to access health services but staff had not always been provided with up to date relevant information for people living with complex, medical health care needs. Improvement was required to ensure that the full range of people’s needs were being met.

The views of people were surveyed through monthly, through monthly one to one meetings with their keyworker. Relative and staff satisfaction surveys had been carried out. However, there was little evidence of any learning from thi

Inspection carried out on 12 June 2015

During a routine inspection

Maple View provides support and care for up to 5 people living with learning disabilities and autism. There were two people living in the service when we inspected on 12 June 2015.

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

People received care that was personalised to them and met their needs and wishes. The atmosphere in the service was friendly and welcoming.

Appropriate recruitment checks on staff were carried out with sufficient numbers employed. Staff had the knowledge and skills to meet people’s needs. People were safe and treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff listened to people and acted on what they said. Staff knew how to recognise and respond to abuse correctly. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff understood how to minimise risks and provide people with safe care. Care and support was individual and based on the assessed needs of each person. Appropriate arrangements were in place to provide people with their medicines safely.

Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to attend appointments with other healthcare professionals to maintain their health and well-being.

People were supported by the manager and staff to make decisions about how they led their lives and wanted to be supported. People were encouraged to pursue their hobbies and interests and participated in a variety of personalised meaningful activities.

People voiced their opinions and had their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. People knew how to make a complaint and any concerns were acted on promptly and appropriately.

People were provided with a variety of meals and supported to eat and drink sufficiently. People enjoyed the food and were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities. The manager and provider planned, assessed and monitored the quality of care consistently. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.