Maple View

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The manager was committed to ensuring there was 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.

Processes were in place to support learning from incidents. For example, 1 record highlighted that hot weather had contributed to an increase in incidents for a particular person. Staff were provided with specific guidance on how to mitigate this, demonstrating a responsive and preventative approach to care.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Hospital and communication passports were in place, containing key information about individuals to share with healthcare and social care professionals during appointments. This supported effective communication and ensured information was consistent across different settings. A professional told us, “I had no concerns in relation to the care and support of my allocated service user during the time I worked with [person] and with good communication between all stakeholders, we were able to successfully undertake a dental check for the service user concerned.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately.

The manager kept oversight of safeguarding concerns and was actively investigating a recent issue raised where people’s safety may have been compromised. Records reviewed during the assessment indicated a thorough and methodical approach to the investigation, demonstrating a commitment to exploring any risks to people’s safety.

A relative told us, “[Family member] safe with them, yes. They ring me if there’s any problem and have been spot on and know [family member] too well.” Another relative said, “Yes (is safe) and recently there were new locks put on the doors and generally [family member] is safe in this provision. All the [staff] know their little quirks and they get on well with the staff.”

Staff had received safeguarding training and understood the correct reporting procedures. Information about how to identify and report abuse was available to staff.

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, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

The service worked with people to understand and manage risks by thinking holistically. However, recent concerns had indicated people were not always being supported safely by staff.

As stated in the safeguarding section, an ongoing investigation was taking place related to people’s safety in the community. We were assured all appropriate actions were being taken by the manager to investigate these concerns.

Support plans included detailed information about risks to individuals and provided clear guidance to staff on how to mitigate these risks. The service had changed to an online care planning system, making support plans and risk assessments easily accessible and straightforward to read. For example, 1 person had specific risks related to eating, and their support plan included a photograph of them demonstrating how their food should be cut to ensure safety. However, some work was still required to ensure all information was transferred from paper care plans and reviewed.

Staff demonstrated an understanding of what was important to people who used non-verbal communication. This helped ensure that people’s views about any risks to their care were considered and included. One staff member told us, “[Person] does respond better to staff they know well, but most of us know [person] very well. They have a lot of triggers, but we’re aware of almost all of them and can respond quickly to de-escalate.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Processes were in place to manage environmental risks, with regular checks carried out to ensure fire, gas, and water safety. Each person had a Personal Emergency Evacuation Plan (PEEP) outlining the support they would require in an emergency. Fire drills were conducted regularly.

A water leak had caused damage to a person's room and the adjacent corridor; however, the manager was actively addressing the issue, with repair plans already in place. The manager had also identified several areas within the service that required improvement. These were incorporated into the service improvement plan, along with proposed dates for action.

Most relatives we spoke with were happy with the environment at Maple View. A relative told us, “Yes, funny enough my friends have visited, and they say it’s just like somebody’s home. It’s a big airy bungalow, with pretty curtains which [person] may not notice. I can go in and nothing is hidden.” Another relative we spoke with had concerns about recent changes, “The whole home seems to have changed and there are too few pictures but more noticeboards everywhere, and that isn’t like home.”

Staff were positive about working at Maple View. They worked together well to provide safe care that met people’s individual needs.

However, we received mixed feedback from staff in relation to staffing levels. A staff member told us, “Staffing levels are ok, but the service users in maple view need the same staff as they struggle with change and new staff coming over (due to annual leave).” Another staff member said, “There is not enough staff to cover shifts when staff are on annual leave which has an effect on the service users.”

Relatives we spoke with were happy with the consistency of staff. A relative told us, “I recognise the staff, and its only familiar staff that stay with the most complex people. It’s only the odd occasion that you see a different staff member.”

The provider had robust recruitment procedures in place, and recruitment records were fully completed. Recruitment processes in place included the completion of appropriate pre-employment checks such as identification, references from previous employers and disclosure and barring service checks (DBS). This helps employers make safe recruitment choices.

A staff member told us they had recently completed refresher training and were positive about the training. The staff member added, “I have just completed my yearly updates on the online training, the learning is quite good really.”

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.

The service was clean, and staff had personal protective equipment (PPE) available when they needed it. A relative told us, “The place is very clean, and the bedroom is fully fitted out with a really nice ensuite and there’s also a lovely bath onsite that’s very new.”

People were involved in day-to-day housekeeping tasks such as cleaning their rooms and doing their laundry.

Senior staff undertook regular infection control audits, and a staff member took the role as an infection control champion to ensure standards were maintained.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

People usually received their medicines safely and as prescribed. Staff followed person-centred approaches to medicines administration, with individual medication profiles in place that reflected people’s preferences and needs. Staff recorded medicines administered on paper records. When these were transcribed, staff weren’t always following best practice to ensure that two people prepared the documents and they used the pharmacy labels rather than prescriptions for the instructions which could lead to potential errors.

We found some inaccuracies in these charts which could lead to avoidable errors. We raised this with the staff at the time of the inspection. Staff were knowledgeable about the people they supported and demonstrated understanding to meet their individual needs and preferences when managing medicines. PRN (as required) protocols were in place for most prescribed medicines and provided staff with the relevant information they needed to administer these medicines safely and record their use.

Fire risk assessments were completed for paraffin-based skin products and were found to be in place for all relevant prescriptions. Medicines audits were completed weekly and included checks on stock levels, expiry dates, and usage. Medication reviews were completed with GP involvement and included physical health checks and side effect monitoring. Staff had access to support from a range of healthcare professionals, and care plans were in place for people with complex needs, including epilepsy and anxiety.

Relatives did not express any concerns about the way people’s medicines were administered.