Maple Cottage

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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of the legal regulations in relation to assessing people’s capacity to consent to care and treatment.

This service scored 46 (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 not always ensured people’s care and support was meeting their needs and preferences effectively. The provider had completed an initial assessment of people’s needs. However, this information was not adequately personalised and detailed to provide a comprehensive view of people’s health, care, wellbeing and communication needs. There was a lack of evidence to demonstrate how people and those important to them had been involved in assessing their care needs. Feedback had not always been requested from people or their relatives. This meant it was not clear how people’s views and opinions were captured or documented.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s care did not meet the expectations outlined in the ‘Right support, right care, right culture’ guidelines in relation to supporting people with a learning disability and autistic people. For example, people’s care records did not evidence their involvement or demonstrate how staff should support them in line with their preferences. People were not consistently supported to plan and engage in activities which were meaningful and important to them. The provider did not demonstrate a focus on reducing restrictive practices to improve people’s quality of life. For example, incidents had not been reviewed to understand what could have been done differently to minimise interventions and reduce the risk of a reoccurrence.

The provider did not always work proactively with teams and services to support people’s needs. Information relating to incidents and potential changes in people’s needs was not always shared promptly with relevant health professionals to ensure people received the right healthcare input and support.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. For example, people’s care plans did not contain sufficient detail about how to promote and monitor their health and wellbeing. People’s care records had not always been updated when people’s health needs changed and this meant staff did not have up to date guidance about how to support them appropriately. We received mixed feedback from people’s relatives about how well people’s emotional wellbeing was supported.

People and their relatives were not routinely involved in monitoring the care and support provided by the service. The provider was not able to demonstrate how they talked to people about what they were happy with or what they would like to change. This meant it was not clear how they were ensuring people were living life as they chose to.

People’s care plans did not include information about their skills and strengths. For example, in 1 person’s care plan the ‘strengths’ sections noted, ‘None at all’. People had not been supported to plan any short, mid and long term life choices, goals and ambitions. This meant it was not clear how the provider was supporting people to achieve good outcomes.

The provider had not acted in accordance with the requirements of the Mental Capacity Act 2005 and the associated code of practice. At the time of the inspection, people did not have any up to date, decision specific capacity assessments in place. This meant the provider was not able to demonstrate how they had considered people’s capacity to consent or supported them to make their own decisions about their care.

People had DoLS (Deprivation of Liberty Safeguards) in place. However, the provider had not ensured the conditions listed on people’s DoLS were followed. For example, 1 person’s DoLS had a condition detailing the specific mental capacity assessment which must be completed. At the time of the inspection, these were not in place.