The Maples

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.

This is the first assessment for this registered service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 81 (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.

Systems were in place and were effective in analysing incidents to drive improvements in the home. All incidents were reviewed by management and the senior management team to ensure actions were taken where needed to mitigate future risks. Any learning from incidents were shared internally with the staff team and across the provider’s other services. This shared the learning and reduced the likelihood of recurrence of similar incidents.

The registered manager told us learning was shared monthly in ‘lessons learned lab’ meetings which were held with representatives from the provider’s other homes. Minutes from these meetings were shared with us and showed risks such as medication, and falls, had been previously discussed. Most recent meetings showed record keeping and the use of door gates had been discussed. The registered manager told us, “It is a supportive meeting where we can share learning and discuss how we can prevent risks and learn from each other.”

Audits were completed and all incidents including complaints and safeguarding concerns were analysed for patterns and trends.

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.

The home had a separate rehabilitation unit where people could be assessed and supported following a deterioration in their needs and following hospital admission. The staff worked in collaboration with social and healthcare professionals to ensure a smooth transition to and from the home. A health and social care professional told us, “There has been some bumps and hurdles since the home opened but the home has made amazing progress especially on the blossom household (rehabilitation unit) where a high number of people end up returning home.”

For people living in other households (units), needs assessments were completed with their involvement and the involvement of those important to them; care plans were then developed based on these assessments. Staff ensured communication between agencies was maintained and any key information was shared when people were supported by different services.

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 when being supported by staff. One person told us, “I feel safe here there is always someone around, for me to call upon and the staff check on me during the night to make sure I am safe.” Another person said, “Yes, I feel safe here and when the staff support me. They are kind and gentle and I would say if they weren’t and they had hurt me.” Family and friends we spoke with also confirmed they felt assured people were being supported safely.

Staff and leaders knew the procedures to follow if they had any concerns about people and if they saw any warning signs that may suggest a closed culture was developing. (Closed cultures are where people may be at risk of deliberate or unintentional harm, and people are not listened to.) A staff member told us, “I would raise any concerns about the way people are treated immediately. We have safeguarding procedures to follow, and I have completed training, so I know how to respond. I know action would be taken by the management team if I raised any concerns.”

The registered manager understood how to respond to concerns, and notifications were shared with relevant agencies where needed. Any recommendations from partner agencies were implemented to improve the care provided.

When a person was deprived of their liberty, all restrictive practices were recorded in people’s Deprivation of Liberty Safeguards (DoLS) applications and authorisations. This information was documented in people’s care plans to ensure staff awareness. 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). In care homes, this is usually through MCA application procedures called DoLS. Systems were in place to maintain oversight of all authorisations in place to ensure they were lawful and in people’s best interests.

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.

People and those important to them told us they were involved in the planning of how risks were managed to keep people safe. People had a variety of risk assessments in place applicable to their individual needs. We found these were regularly reviewed and updated in response to changes in needs. People who had health conditions such as diabetes, and heart conditions, were supported effectively to protect them from the risk of avoidable harm. People who liked to move around the home were able to do so with clear risk assessments and strategies to maintain their independence and dignity. A relative told us, “The staff know [person], and they follow the procedures we have agreed, so they know what to do, they manage [person's] needs really well.” Care plans contained guidance for staff to follow to ensure people’s needs were met safely.

The home supported people living with dementia. Staff we spoke with understood there were times when people may become distressed. Staff were able to tell us what steps they took to understand and to support people to express their emotions.

The home used technology to help manage risks to people. This included acoustic monitoring, and the use of sound sensors to monitor people’s movements when they were alone in their bedroom. This enabled staff to respond to people’s needs in a timely manner if they had not sought assistance or in the event of potential emergencies. We found some people have chosen to have a door gate fitted to their bedroom door to reduce the risks of other people in the home entering their bedroom. This had been risk assessed and included in their care plan. The records did not clearly indicate what alternative options had been discussed.

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 told us the home was well maintained, and any repairs were completed in a timely manner. One person told us, “This home is lovely, all new and lots of natural light and easy to get around, I love it here.” We observed where carpets in people’s bedrooms had frayed this had been reported and replaced by the second day of our inspection.

The home had been designed following best practice. There was lots of natural light and wide corridors, to help people to safely navigate to and from their bedrooms. People had access to an external garden which was paved and had seating areas for people to sit and enjoy the surroundings and watch the ducks moving around. We observed the garden being used on both days of our inspection. The provider told us the garden had been risk assessed to ensure it was safe to use by people.

The home had a maintenance person who undertook repairs in a timely manner and completed safety checks such as checking water temperatures, and fire doors. We found records were not in place to support the routine checks undertaken on the door gates fitted on people’s bedroom doors to ensure they remained safe for use. The provider was receptive to this feedback and action was taken to address this following our inspection.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People and those important to them told us there was enough staff available to meet their needs. One person said, “Yes there are enough staff. I’m never left waiting long if I need anything I can just call them or use the buzzer by my bed. At night it makes me feel ok and I can sleep better.” A relative told us, “I think there is enough staff they are visible on the unit in communal areas and always available to provide support when this is needed.” We observed people visited different households within the home. On one household we observed this could have the potential to impact on the staffing levels due to the increase in people requiring support. This was discussed with the management team who were receptive to this feedback and confirmed this would be monitored. The provider used a dependency tool which was kept under review to ensure people’s needs were met in a timely manner.

People were supported by staff who had been recruited safely. We found the recruitment journey for staff was a positive process and included exploring staff’s emotional intelligence, and their ability to express themselves and understand the impact their emotions had on others. This was a fundamental value the provider looked for in staff who worked within their services. A staff member told us, “It was such a positive experience. I was invited to attend an assessment day first where we completed team tasks and talked about our emotions and what was important to me. I then completed the interview and provided recruitment information. During the induction I was able to shadow staff in every role which was really good, and I had some face to face training. I think it was really good and gave me the skills, and knowledge I needed for my role.” Records we reviewed demonstrated all required recruitment checks had been completed to ensure staff were suitable for their role.

People told us they were confident staff had received training for their role. One person said, “The staff most definitely know what they are doing they are wonderful at their job so attentive and kind.” Training information demonstrated staff had completed all core training suitable for their role. This included training to support people living with a dementia and to meet people’s communication needs.

The provider invested in staff and provided opportunities for staff to develop in their roles. This included a comprehensive induction programme, advanced dementia training, apprenticeships, and mentoring programmes where staff could learn clinical skills. Some staff were completing courses to be able to deliver training internally to the whole staff group in areas such as ‘Soul Midwifery’ which focused on providing holistic and spiritual support to people on a palliative care pathway. Workshops were provided for staff in relation to providing person centred care and to discuss how emotions could impact on staff behaviour and communication when supporting and responding to people. Nurses received ‘Resilience based clinical supervisions’ which helped nurses manage stress, reflect on practice, and build emotional strength in demanding care environments. All staff completed training called ‘Remember our why’ when they had worked at the home for a year. This training revisited the values and ethos of the home.

The provider demonstrated how training was essential for staff to deliver high-quality care, ensuring they had the skills, knowledge, and confidence to meet the diverse needs safely and compassionately.

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.

People told us they were happy with the cleanliness of the home. One person said, “My bedroom is cleaned to a good standard as is the rest of the home. There are no smells here.” A relative told us, “The home is always clean and tidy and if there are ever any issues they are dealt with quickly.”

We observed the home to be clean in all areas. The housekeeping staff were called home makers, and we observed home makers were deployed across the home. Discussions with the home makers demonstrated they had received training and had sufficient equipment to clean the home effectively. The home makers completed cleaning schedules to record the areas they had cleaned.

The provider completed regular internal infection control audits to maintain oversight of the cleanliness of the home and the integrity of the equipment used, such as pressure cushions and mattresses.

Staff confirmed they had received training in relation to infection control practices and there was enough Personal Protective Equipment (PPE) available for their use.The staff and management worked closely alongside the infection control team (IPC) at the Local Authority. The provider told us their last report was positive reflecting positive IPC outcomes.

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 when they needed them. One person said, “I am very happy with how my medication is administered. The nurses are very good; they come round like clockwork.” Care plans and risk assessments were in place to guide staff on how each person liked their medicines to be given. This included guidance for staff on when they could give ‘as required’ medicines such as when people expressed pain or distressed emotions.

Staff also used equipment such as PainChek which is a digital pain assessment tool. This used AI technology to assess pain in people who may be unable to express pain themselves. The tool analyses facial muscle movements, to help identify and record pain levels, supporting better pain management.

We observed people received their medicines safely. Medication was securely stored in people’s bedrooms which the provider told us enabled staff to focus more on the person. Opportunities for self-administration were discussed and assessed with people upon moving into the home. For individuals lacking mental capacity, and covert medication administration was required, clear care plans were in place. These plans were informed by a mental capacity assessment and a best interest meeting involving the person’s representative, GP, and staff at the home.Both care companions and registered nurses administered medicines. A staff member told us, “I have had training which was very comprehensive, and I was assessed 3 times to make sure I administered medicines safely.” Where errors occurred, action was taken to address this and to learn lessons to prevent future occurrences.

The provider told us all nurses were completing a course in sustainability which offers a holistic approach to improving healthcare. Nurses learn the impact the overuse and over prescribing of medicines has on the environment. The provider also told us they have a strategy to reduce medication waste by 50% in the next year.