Archived: Mappleton House

Updated 3 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 10 and 12 May 2016. The inspection was unannounced. The inspection team consisted of two inspectors.

Prior to our inspection we reviewed information we held about the service. This included previous inspection reports, information received and statutory notifications. A notification is information about important events which the provider is required to send us by law. We sought feedback from health and social care professionals who have been involved in the service and commissioners who fund the care for some people who use the service.

During the visit we spoke with one person who used the service. Some people who used the service had limited verbal communication and some were out so we also relied on observations and spoke with the relatives of four people to get their views.

We spoke with seven members of support staff, the manager and the compliance manager. We looked at the care records of six people who used the service, medicines records of eight people, staff training records, as well as a range of records relating to the running of the service including audits carried out by the registered manager and registered provider.

Updated 3 November 2016

We inspected the service on 10 and 12 May 2016. The inspection was unannounced. Mappleton House provides accommodation for up to 11 people with a learning disability. People are accommodated in one of two houses or a bungalow on the same grounds. On the first day of our inspection 11 people were using the service, however two people were supported to move into another service on this day and so on the second day of our inspection nine people were using the service.

The service did not have a registered manager in place at the time of our inspection and has not had one since June 2015. 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.

Although people were supported by staff who knew how to recognise abuse, action was not always taken to protect people from the risk of harm. People were at risk in relation to how they were supported and from risks from the environment. There were insufficient numbers of staff deployed in the service and medicines were not always managed safely.

People were supported by staff who did not have the knowledge and skills to provide safe and appropriate care and support. People who lacked the capacity to make certain decisions were not protected under the Mental Capacity Act 2005 and had unauthorised restrictions placed upon them. People were not supported to maintain their nutrition and hydration.

People lived in a service where staff were not always respectful of their privacy and didn’t treat them with dignity. People’s emotional needs were not always recognised and responded to and people were not supported to enjoy an active social life.People knew who to raise concerns with but concerns were not always responded to or acted on.

There was a lack of appropriate governance and risk management framework and this resulted in us finding multiple breaches in regulation and negative outcomes for people who used the service. There were no effective systems in place to develop and improve the service, based on the needs of the people who used it, their families and staff.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.