Maplebrook Care Home

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 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.

Improvements had been made to the way incidents and events were recorded and reviewed. Staff were now clear about their responsibilities in terms of documenting incidents and understood how the information they recorded was used by the management team.

The deputy manager shared with us learning following our previous inspection. They told us daily meetings were now held with senior managers which included a review of any incidents and events that had taken place. The deputy manager told us they found this process supported decision making and highlighted any additional actions that were required to reduce future risk.

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.

Information about people’s needs were detailed in their care plans. The deputy manager gathered information about the support people required from external agencies such as other providers, social workers, community mental health teams, and hospitals.

We were aware of some concerns about people having continued access to their GP when moving to Maplebrook, particularly when they were living at the home on a temporary basis. The deputy manager told us they were working with partner agencies to try and reduce the impact of this issue.

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.

People told us they felt safe living at Maplebrook. One person said, “I have been living here for around 2 years. The staff are kind and caring, they take care of all the residents.”

Staff were aware of their responsibilities to report concerns for people’s safety and wellbeing. One staff member told us, “We have to report any signs of abuse. We have had training in abuse and understand the signs to look out for.”

The provider had processes in place to ensure any safeguarding events were recorded, reviewed and managed in line with their policies. Where incidents had taken place, the provider had notified The Care Quality Commission (CQC) as required by law.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS withinthe service. We found that DoLS application were made when necessary to ensure people who lacked mental capacity were lawfully supported.

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.

Improvements had been made to the way risks to people’s health, safety and wellbeing were assessed and managed. Information about people’s risks in relation to distressed behaviours, skin integrity, mobility and eating and drinking were clearly documented in their care plans. Staff we spoke with had a good understanding of people’s risks, including those associated with a diagnosis of epilepsy and diabetes, and told us what action they took to manage those risks and reduce the likelihood of incidents occurring. One staff member told us, “[Person] can become distressed and they have a modified diet. We need to be patient and remain calm as this helps them stay calm. At times we have to leave [person] and try again later.”

We observed staff supporting people with their mobility, eating and drinking and distressed behaviours and found this was done safely and in a dignified way. Where people’s needs had changed, information about how risks should be managed was updated to ensure the support staff provided met their current needs.

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

People and relatives shared positive feedback about the home environment. One person said, “I think the home is kept clean.” The home environment was clean and the maintenance team carried out regular checks on fixtures, fittings and equipment to ensure they were safe for people to use. Where previously there had been a shortage of equipment this had now been resolved. We saw equipment was available for people to use when they needed it.

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.

People told us staff were available to support them when needed. One person said, “If I need support the staff do support me quickly.”

Changes had been made to staffing arrangements to ensure there were enough staff deployed to respond to people’s needs as well as carry out planned care. The deputy manager told us the provider had introduced a new tool to improve the ways people’s needs were considered in relation to staffing requirements. Although this was relatively new, the deputy manager and operations manager told us they felt this would enable them to better plan for staffing allocations, as it allowed people’s individual and sometimes complex needs to be better reflected.

Staff told us they felt there were enough staff to meet people’s needs. One staff member commented, “Staffing levels are good. If we have any gaps then agency staff are brought in to make the staffing levels right. The agency staff work here regularly and are very good.”

Staff had been safely recruited and received training relevant to their role. They told us they felt equipped to support people. One staff member said, “I am experienced, but the induction and training here is good.”

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 staff team followed safe infection control practices. The environment was clean and systems were in place to ensure regular cleaning took place. Staff understood how to reduce the risk of cross infection and used Personal Protective Equipment (PPE) to help keep people safe from the risk of infection. One staff member told us, “We have access to PPE, this is all around the building. We have training and guidance on things like hand washing.”

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.

People told us they received their medicines as prescribed. One person said, I am supported with my medication. I know what medication I take and the reason for taking them I have never had any issues with my medication.”

Staff had received training in the safe administration of medicines and had their competency regularly assessed to ensure they were up to date with current good practice. Where errors had taken place, these were investigated and any learning was shared with the staff team.

Checks on administration records showed people were supported with their medicines as prescribed, and stock balances were accurate. Controlled drugs, which are subject to specific storage and recording guidelines were managed in line with good practice guidance.

Where people were prescribed ‘as required’ medicines there were clear protocols in place to ensure these were given safely. We reviewed the use of medicines prescribed to support the management of distressed behaviours and found these were being managed safely and were not overused. Where people’s medicines were given covertly, records showed people’s best interests had been considered to ensure this was done lawfully.