The Maples

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 registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 83 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, well being and communication needs with them.

People’s needs were assessed before they moved into the home, and this information was used to develop their care plan. People’s care plans and risk assessments were tailored to their individual needs and considered their protected characteristics, as identified in the Equality Act 2010. This included people's needs in relation to their gender, age, culture, religion, sexuality, ethnicity and disability.

People and those important to them were involved with this process. A person and their relative told us, “We were both involved in the assessment and care plan and we provided lots of information about how my needs needed to be met. I felt involved and listened to.”

Individuals moving into the rehabilitation household receivedpre-admission and post-admissionneeds assessments by the full-time physiotherapist. This enabled the physiotherapist to determine people’s rehabilitation potential and to develop a programme to suit people’s individual needs. People’s progress was monitored closely, and reassessments were undertaken to modify programmes in place for people. Staff supported the physiotherapist by supporting people with daily exercises in accordance with their care plan.

Staff knew people they were supporting well, including their health and well being needs and preferences. People had a communication plan in place which reflected their needs. Staff supported people consistently and understood their communication needs.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

People received care and support which was delivered in line with evidence-based good practice and established standards, ensuring staff actions were guided by current research, sector-specific guidelines, and regulatory frameworks to promote safe, effective, and person-centred outcomes. Staff were given opportunities to attend training and workshops focused on the Kitwood model of care, enhancing their understanding of person-centred approaches and supporting the delivery of compassionate, dignity-driven care for people including those living with a dementia. A staff member said, “The training I have received has made me think about the way I support people and the importance of listening and being patient, particularly when people are confused or upset.”

The provider had introduced assistive technology to enable staff to assess and manage people’s pain more effectively. The use of PainChek meant staff could monitor the signs and symptoms of pain for people who may not be able to express this themselves. This helped to reduced further symptoms of stress and agitation. The home also had a Lifevac device available in the home which is a choking rescue device with the ability to clear airways and is known to have saved many lives. This meant staff had equipment available to them to respond in an emergency.

The provider served decaffeinated tea and coffee to people as a default, unless people’s preference was for caffeinated drinks. The provider informed people of the rationale for this in the information shared with people before they moved into the home. The provider was aware of several evidence-based studies that had made a correlation between serving decaffeinated drinks to people and a reduction in falls in addition to other health benefits including reduced sleep disturbance.

Information shared with people also referred to studies about how people from LGBTQ+ community may feel ‘invisible and marginalised’ when moving into a care setting. The provider promoted their involvement with Stonewall; a human rights organisation and informed people they were part of their diversity champion’s programme. The provider promoted a culture where all people regardless of their gender identity or relationships will be respected and treated equally within the home.

In addition to the above the provider used clinical tools for monitoring people’s health and well-being which were incorporated within peoples care plan and risk assessments. For example,staff used a Malnutrition Universal Screening Tool (MUST) tool to monitor people at risk of malnutrition, enabling timely interventions and support to improve health outcomes.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked in partnership with external agencies to ensure people’s needs were met. The following feedback was shared about the rehabilitation household. “The council has worked closely with Samantha (CEO) and the team at The Maples from the early stages of development through to commissioning enablement of the Blossom Suite (rehabilitation household). This collaborative arrangement, which includes a dedicated physiotherapist, has delivered strong outcomes for individuals progressing through their enablement journey. The integrated approach has supported timely transitions and improved independence.”

People and those important to them who used the rehabilitation unit told us how staff worked with partner agencies. A person said, “The staff are good they sort out appointments and work with other professionals such as occupational therapists to make sure I have what I need to be able to go home and be safe.” Staff worked with healthcare professionals to discuss the future arrangements for people when they were moved from the home.

Information gathered through the assessment of people’s needs and development of their care plans was used to create profiles of people. These could be used to share key information about people when attending healthcare appointments or hospital admissions.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The management team had daily meetings with all heads of department to maintain oversight of people’s health and wellbeing. These meetings addressed a variety of areas, including nutrition and hydration concerns, and skin integrity management issues. Senior staff escalated all relevant concerns to healthcare professionals for necessary action. The staff team on each household completed electronic records of the daily support provided to people. We saw records were in place to support the ongoing monitoring of people’s needs in relation to pressure care, food and fluid intake. Staff recognised changes in people’s presentation which might indicate a deterioration in health or wellbeing. Information of concern was escalated and shared with staff during handovers to support the ongoing monitoring of people’s needs.

People told us staff supported them to maintain their health by arranging health care appointments, for example, opticians, dentist and chiropodist. A person said, “The staff are very good they sort out the regular appointments I need at the hospital, or to the opticians and they get the GP in when I don’t feel well.” Records were in place of the outcomes of these visits and recommendations for staff to follow. For example, where people may have been prescribed supplements in response to weight loss.

The provider told us how they had a stop smoking and vaping campaign across the organisation for people and staff who live and work in their services. The provider also told us how training and information about alternative soft diets has been shared with people and their families to increase their knowledge and understanding.

People gave mixed feedback about the food provided at the home. One person said, “Everything’s the same. Always gravy. It’s so samey. At lunch we do get salads sometimes and I like the sandwiches but it’s the look of the food sometimes. It is not always appetising, its beige food,” Another person told us, “I like the food it is lovely, there are choices, and we can have snacks 24 hours day. There are no restrictions.” Feedback received about the food was shared with the management team who confirmed action was already being taken in response to feedback they had received. We saw systems were in place to gain feedback from people in relation to the food provided.

The kitchen staff were aware of people’s dietary needs and meal preferences. Kitchen staff told us they were kept updated about any changes and about new admissions, particularly for those people using the rehabilitation unit.

We observed efforts were made to ensure the mealtime experience was a positive one for people, tables were laid, and menus were available for people to refer to and music was played in the background. We observed individuals requiring support with meals were assisted in a dignified and respectful manner.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

People who used the rehabilitation household had regular reviews with the physiotherapist, staff and healthcare professionals to monitor their progression and enablement. People usually stayed for 6 weeks on this household. Support was given to maximise people’s potential to regain their skills and independence to enable people to return home which was people’s key goal. Where this was not possible staff worked with people and partner agencies to discuss the progress people had made and their future options. A person told us, “It has been good here, I have received the support I needed from the physio and the staff to make me stronger. I have learnt how to use equipment and am now confident in my abilities. I am looking forward to going home.”

The provider was able to evidence what people had achieved when supported by staff on this household. This included where people had successfully regained their independence and skills to use equipment independently which increased their confidence and self-esteem. People were encouraged to socialise and engage with other people who lived in the home and built friendships which continued when people moved out, preventing isolation. People regained their confidence and ability to be able to mobilise, either with or without the use of aids, increasing their ability and freedom to be able to move independently. The staff on the household had won a ‘Chief Nurse award’ for their achievements and dedication for improving outcomes for people.

People who lived on the other households had regular reviews of their care to monitor their needs and to ensure people retained their skills. Prompt action was taken to review and escalate potential deterioration to healthcare professionals for additional support. For example, referrals to dietitians and the falls team for people who had reduced appetites or may have fallen. This was confirmed by a relative who told us, “I have peace of mind, [person] is so much better in themselves now they are here and being looked after. [Person] is more engaged as they take part in activities now. The staff monitor their mood and general well being and take any action if they think [person] is not well. The staff keep us informed every step of the way. Another relative said, “[Person] has the same two carers (or a second pair) every day which makes such a difference as [person] is very anxious.” People and their relatives were involved as partners in their care, and this was supported by the comments we received.

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

The management team worked within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. 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 Mental Capacity Act (MCA).

People told us staff gained their consent before providing support. One person said, “The staff do ask for my consent such as, if I want to get up, have a shower all things like that. They never assume and do things for me unless I ask them to.” A relative told us, “[Person] cannot make decisions, and I have the authority to help with this. I have provided the paperwork for this, and I am involved in making decisions for them.” Where people required the use of assistive technology or equipment to maintain their safety, we saw best interest meetings had been recorded to demonstrate who had agreed this.

Staff understood the MCA and the impact this legislation had on their role. They confirmed they had received training in this area. A staff member told us, “It’s about assuming capacity, and making choices with or for people which is right for them and in their best interests. If I had any concerns I would raise this with senior staff.”