Background to this inspection
Updated
21 July 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
This inspection took place on 03 and 08 June 2015 and was unannounced. This meant the staff and registered provider did not know we would be visiting on the first day of our inspection.
The inspection team consisted of one adult social care inspector and one pharmacist inspector.
Before the inspection we reviewed all of the information we held about the service. This included looking at the information we held relating to the service’s recent registration process. We spoke with the responsible commissioning officer from the local authority commissioning team about the service. We also looked at the notifications we had received from the service. Notifications are information about changes, events or incidents that the provider is legally obliged to send us within the required timescale.
The provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, information we requested as part of the inspection was provided quickly and professionally.
At the time of our inspection visit the service was occupied by 40 people who received residential care and support. The inspector spent time talking to six of the people who used the service. We also spoke with four relatives and spent time in the communal areas of the home.
During the visit, we spoke with 10 staff members, including the deputy manager, registered manager and area manager, five care staff, the cook and kitchen assistant.
During the visit we spoke with a community nurse and paramedic who were visiting the home.
We used the Short Observational Framework for Inspection (SOFI) during this inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also used general observations of people’s care and support throughout our visit.
During the inspection we reviewed a range of records. This included four people’s care records, including care planning documentation and 17 people's medication records. We also looked at four staff files, including staff recruitment and training records, records relating to the management of the home and a variety of policies and procedures developed and implemented by the provider.
Updated
21 July 2015
The inspection took place on 03 and 08 June 2015 and was unannounced, which meant the staff and registered provided did not know we would be visiting on the first day of the inspection. At the time of our inspection visit the service had 40 people living there.
The Maple is a purpose built care home. It provides residential care and accommodation for up to 63 people, including older people and people with dementia. Accommodation is provided over three floors, with each floor having private bedrooms with en-suite facilities, and communal bathrooms, lounge and dining areas. The home has a secure garden area and private parking facilities.
The registered provider of The Maple changed in March 2015 and is now Ideal Carehomes (Number Two) Limited. The new registered provider took over the existing home, management and staff. The service had a registered manager, who has been registered with us in respect of the service’s new registration since 13 March 2015. Before this they were registered as the manager for the service under the home’s previous registered provider. 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.
People who used the service told us they were safe and could raise concerns if they needed to. Staff were aware of safeguarding and whistle blowing [telling someone] procedures. People using the service, relatives and staff told us that management listened and acted on feedback.
Safe arrangements were in place for staff recruitment and there were sufficient numbers of staff on duty to meet the needs of people using the service.
The service had health and safety related procedures, including systems for reporting accidents and incidents, and maintaining equipment. The care records we looked at included risk assessments, which had been completed to identify any risks associated with delivering the person’s care. However, we found that improvements were needed to ensure that people were kept safe with regard to the frequency of staff fire drills.
We also found that improvements needed to be made in regard to management of medicines, to ensure that people’s medicines were available and administered safely in accordance with their prescription.
People were cared for by staff who were appropriately supported and provided with training to help them carry out their role. People who used the service told us that their staff were competent and looked after them well. Staff told us they were well supported by the registered manager and were provided with the training they needed. Training and staff supervision records were available to evidence this.
The registered manager was aware of their responsibilities under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff were also able to describe the principles of the MCA and how people’s legal rights should be protected. At the time of our visit 3 people living at the home were subject to the DoLS.
People told us that they received plenty of food and drink, with a choice of regular meals and snacks provided. Records showed that people’s nutritional wellbeing was assessed and monitored. We saw that staff were aware of people’s individual dietary preferences and needs. Where people had lost weight systems were in place to monitor this and ensure that action had been taken to support the person to maintain an adequate diet.
People told us that they were supported to access healthcare professionals when needed and the records we saw supported this. A healthcare professional who visited people at the Maple told us that they had no concerns about the care people received and that staff involved them when needed and acted on their advice.
People who used the service told us that staff were caring, treated them well, respected their privacy and encouraged their independence. Staff were able to describe how they worked to maintain people’s independence, privacy and dignity.
People’s care records showed that their needs had been assessed and planned. People told us that they received the care they needed and were well looked after. Staff were able to tell us about people’s individual needs and how they met these. However, the person centred detail that staff described to us was not always written in people’s care plans, which lacked detailed, individual information.
Information about raising complaints was on display and people told us that issues and concerns they had raised had been listened to and acted on. A record of complaints and the actions taken in response was available and showed that complaints have been investigated and responded to by the registered manager.
Activities and social events were provided by care staff on a regular basis. However, the provision of meaningful activities would benefit from further development to help ensure that they were appropriate and accessible to everyone using the service.
The new registered provider was in the process of making changes to the home’s management structure, to provide more management support in the home. People who used the service knew who the registered manager was and told us that they were approachable and visible throughout the home on a regular basis. Staff felt that the registered manager was approachable, supportive and listened to them.
A system of audits and checks was in place to help ensure that people received a good quality service. Regular meetings with people who used the service, relatives and staff took place and included asking people for feedback on their experiences.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.