Maplebrook Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated requires improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The registered manager explained the care planning process during the transition of people moving to the service. This included people and relatives being involved in assessments and information obtained being used to ensure people’s assessments and care plans contained accurate information about their needs and how these should be met. However, based on our findings, we were not assured this was always the case.

Most people informed us they had not been involved in the assessment and care planning process and were not aware what was written about them in their care plans, with 1 person saying, “I have not been involved in my care plan.”

Care plans and assessments did not always contain relevant information about people’s health, care, wellbeing or communication needs in order to enable them to receive care or treatment which provided good outcomes. For example, where people had identified health conditions, they did not always have a care plan or assessment which detailed how these conditions presented and impacted them, nor guidance to staff on how they could support people to meet needs associated with these conditions.

While we observed examples of staff demonstrating a good awareness of people’s needs when providing support to them, we also saw examples in which this was not the case and which demonstrated a lack of awareness of how people’s needs should be met. This meant people were at risk of their needs not being fully understood, accurately recorded, or consistently met by staff.

The provider did not always plan and deliver people’s care and treatment with them, including what was important.

People and relatives were not always involved in creating and reviewing their care records. Despite this, relatives told us they were kept informed about changes to their relation’s needs and care. The service did not always ensure people’s care needs were consistently reflected in their care records which is not in line with current best practice guidance. Where people required support to manage identified needs and risks, their care plans and risk assessments did not always include information about these and, where information was documented, it did not always contain sufficient detail or guidance to ensure people’s needs could be met. For example, care plans did not include guidance regarding a number of health conditions a person was detailed as having. Care records showed a person had multiple complex health conditions, however, there was not a support plan or guidance in place which detailed to staff how these conditions affected the person and how they could support the person to meet their needs associated with these conditions. This meant people were at risk of their care and treatment not being delivered to them in ways which reflected their identified needs.

Despite this, we observed healthcare professionals visit people during the inspection and people told us they received the care they required, with 1 person saying, “I see the doctor if I need to, I haven’t seen the dentist, but I don’t have any problems.”
 

The provider worked well across teams and services to support people. Staff members told us there was effective communication both internally within the service and externally with other partners, such as with health professionals. Partners told us there were no concerns with how the service communicated and worked with them. We saw some information to demonstrate staff meetings were used by leaders to ensure there was effective communication and coordination within their own team. This meant the service operated in a way which enabled them to be able to plan and deliver people’s care and support.

The provider did not always support people to manage their health and wellbeing to enable them to live healthier lives.

People’s care records did not always contain relevant information needed to ensure people could be supported to positively manage their health and wellbeing. We found relevant guidance relating to people’s health conditions and needs was sometimes not in place or, when it was in place, did not contain the guidance staff needed so they could support people to live healthy lives. In addition, staff had not always received training to ensure they can understand and meet people’s health and support needs, and some staff were observed not knowing how to support people to achieve positive wellbeing outcomes. This meant people were not always effectively supported to manage their health and wellbeing.

Some staff informed us how they supported people to manage their health and wellbeing needs, demonstrating an awareness of people’s needs and how they met these. For example, staff told us the approach staff adopted with a person, including how they listened and responded to them, determined the kind of relationship they were able to maintain with them and how likely the person is to want to work with staff to manage their health and wellbeing needs.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent.

Although people’s care and treatment was routinely monitored by people’s care plans and risk assessments being reviewed monthly by staff, this monitoring was not effective. These reviews failed to identify many of the concerns we found regarding the lack of relevant information, and so was not always able to ensure people’s outcomes were positive and consistent. As within other sections of the report, this contributed to the care and treatment people received from staff failing to meet their needs.

Staff told us it can be challenging to support people to experience positive outcomes due to staffing level constraints. This meant people were at risk of experiencing outcomes that were not positive and consistent.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Records showed that mental capacity assessments were carried out in most areas and these were being reviewed on a regular basis. Furthermore, people told us staff sought their consent regarding their care, with 1 person telling us, “Staff always ask before carrying out any action; they respect my choices.”

This was supported by our observations, which included seeing people being asked if they wanted support with tasks and staff feedback. Staff displayed a good awareness of the Mental Capacity Act 2005 (MCA) and how they applied this to people they supported, with staff telling us, “We always seek consent from people before doing anything.”

Training records showed staff had received MCA training.