Maryville Care Home

Maryville Care Home is a residential care home over three floors, providing nursing and personal care to up to 39 people, and was at capacity at the time of the inspection.

People’s experience of using this service and what we found

During the inspection we observed there were not always enough activities or meaningful activities to engage people and interest them. We recommended the provider ensure there are a range of activities that meet the needs of all people using the service.

People and their relatives told us they were satisfied with the service provided.

There were systems in place to identify risks. Safe recruitment procedures were in place and there were enough staff on duty to meet people’s needs. Staff followed appropriate infection control practices to help prevent cross infection.

Staff received supervisions, appraisals, relevant training and competency testing to support them in providing safe and effective care to people. People's needs were assessed to ensure these could be met. People were supported to maintain health and access healthcare services appropriately. People were also supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Families were welcomed to the service. There was a complaints procedure in place and people felt able to raise complaints with the registered manager. People, relatives and staff reported the registered manager was approachable and listened to their concerns.

The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people.

Rating at last inspection

The last rating for this service was requires improvement (published 28 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Maryville is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 37 people were using the service.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

During the inspection we found the door to the sluice room, where cleaning materials were stored, was open and the main door to the kitchen and laundry room was unlocked. This meant people were not protected from the potential hazards and risks in these rooms.

The provider had a number of systems in place to monitor, manage and improve the care and support provided to people. This included a complaints system and service audits. However, these were not always effective in identifying concerns such as the ones identified during the inspection.

The provider had policies and procedures in place to protect people from abuse. Staff we spoke with had received training and knew how to respond to safeguarding concerns. People had risk assessments and risk management plans in place to minimise risks.

Safe recruitment procedures were followed to ensure staff were suitable to work with people and we saw there were enough staff to meet the needs of people using the service.

Medicines were managed safely and staff had appropriate training and competency assessments to manage medicines safely.

Staff had up to date training, supervision and annual appraisals to develop the necessary skills to support people using the service.

Staff had completed training in infection control and food hygiene so they could reduce infections and cross contamination.

People's dietary and health needs had been assessed and recorded so any dietary or nutritional needs could be met. People were supported to maintain healthier lives and access healthcare services appropriately.

The provider generally worked within the principles of the Mental Capacity Act (2005). People were supported to have choice and control over their day to day decisions and staff were responsive to individual needs and preferences.

Before coming to the service, the provider undertook an assessment to determine if the service could meet the person’s needs. Care plans were personalised and kept up to date. Some people’s end of life care wishes were recorded. In other cases, no information was available about end of life care or about whether people should be resuscitated in an emergency and if they stop breathing. We have made a recommendation about this.

There was a complaints procedure in place and the provider responded to complaints as per their procedure.

People using the service and staff told us the registered manager was available and listened to them.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance. You can see what action we told the provider to take at the back of the full version of the report.

The last inspection was 25 October 2013 at which time the service was meeting the assessed standards.

Maryville Care Home is part of the Frances Taylor Foundation and is registered to provide accommodation and personal care for up to 39 adults over three floors. The service was at capacity on the day of the inspection. Some people who used the service were living with dementia and others required nursing care.

There was a registered manager in post. 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.’

We saw the majority of the medicines were stored safely, however we observed an unsecured fridge with medicine in it accessible to people who used the service and visitors.

Staff were sufficiently deployed and appropriately trained.

The service had a safeguarding policy and procedures in place.

The environment was clean and well maintained.

There was evidence of regular meetings with staff, people who used the service and their families.

Staff had regular supervisions and yearly appraisals.

Health needs were being met through assessments, monitoring and support from the relevant professionals.

Staff were kind and caring. They knew the people who used the service well and were able to meet their needs.

The majority of people had person-centred care plans and we saw evidence that staff followed them to meet people’s needs.

The service did not have an activities co-ordinator. There were activities but staff did not always feel they had enough time to support people with activities.

People who used the service, staff and relatives told us the manager was approachable and they could raise concerns with them.

Monitoring and auditing records were well maintained.

We received an action plan on the 20 March 2013. The provider told us they would update people's care records to ensure all needs were planned for and would provide training to staff. We were also told medication practices would improve by introducing further quality audits to ensure unused medication was brought forward on a monthly basis and people who self-medicated had appropriate risk assessments in place. The provider told us they would ensure additional monitoring of the service was implemented.

We carried out our recent visit to ensure improvements had been made and we also checked that other standards were being met. People told us since our last visit that improvements had been made. One person told us "we had a meeting with the manager she seemed to listen to what we had to say, she is good".

A person who had recently been admitted to the home said "it's very nice here, it's not like

my own home but the staff are good, they make sure I am safe."

Following our recent visit we found that improvements had been made to the running of the service, we also found standards were being met in additional areas that had not been previously inspected.

People who spoke with us said they were pleased with the care and support they received at the home. We saw that people appeared well cared for and that their privacy and dignity was respected and their independence and rights were promoted by staff. One relative said 'we are lucky that our family member is in the home'. A person said 'if there is something wrong I can tell staff and they will do something about it'. The standard of care planning was however not adequate to demonstrate that people's care was planned and delivered in line with their assessed needs.

Staff supported people with their healthcare needs and monitored their conditions when they were not well to ensure their wellbeing. We however found that the management of medicines did not always ensure that people were protected against risks associated with medicines.

People had opportunities to express their views and make suggestions about the provision of the service in a number of ways such as in meetings that were arranged for them and in satisfaction surveys. We however found that the provider did not have an up to date quality assurance procedure and effective quality management systems to assess and monitor the quality of services provided to people.