Maids Moreton Hall

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. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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.

Staff reported safety events which were routinely investigated by management. Lessons learned were identified and communicated to staff during team meetings and supervisions. The provider demonstrated compliance with the duty of candour by being transparent when things went wrong. The provider ensured all notifiable incidents were reported as required by regulation. People and their relatives told us they felt safe in the service. A person told us, “I feel safe here, I have not had any falls at all.” Another person’s relative told us, “[Person] had a couple of falls at home, but never here.” This meant people were kept safe from repeated safety events.

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 provider worked closely with local healthcare services and staff supported people to access the healthcare they needed. This included arranging for the local GP to visit and see people in the home. One person told us, “My doctor is coming to see me,” and another confirmed they were waiting to see the doctor.

A professional told us, “In my experience, relevant information regarding residents’ safety, health or changes in their circumstances is communicated to me appropriately and in a timely manner when it may affect the care I provide. Staff are proactive in highlighting concerns before or during my visits, which helps me assess residents safely and adapt treatment where necessary.”

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 were supported by staff who had completed safeguarding training and understood their responsibilities. The provider worked with professional partners to report and investigate safeguarding concerns. People confirmed they felt confident to speak to staff, or management if they had any concerns. A person told us, “I feel safe. I would speak to staff if I was worried about anything.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people were not always effectively assessed or mitigated. One person identified as at risk of choking did not have clear or consistent guidance about their modified diet. Staff were not always aware of people who were at risk of choking and did not always follow guidance to ensure people were protected. Relatives also told us people did not always receive food appropriate to their dietary needs. A staff member told us, “We have recently had a few close calls where people have had the wrong food and people could have choked.”

One person’s falls risk assessment did not provide clear guidance for staff about how to keep them safe while in bed. We also observed a person being repositioned by 1 carer when their needs assessment stated they required 2 staff to support them with repositioning.

People could not always access assistance when needed. We observed 1 person did not have access to their call bell. Relatives told us call pendants were not always left within reach and, on 1 occasion, a pendant with a depleted battery had not been replaced. The person was unable to use a standard call bell. This placed people at increased risk of avoidable harm and delays in receiving support when needed.

We gave feedback to the provider and they took action to address these concerns.

However, we observed staff supporting people to mobilise and transfer between equipment safely. Staff were able to demonstrate how they supported people to reduce the risk of falls. Some people’s mobility and falls assessments contained clear guidance as to how to protect people from the increased risk of harm.

The provider did not always identify or manage environmental risks, and some equipment, facilities and technology did not fully support safe care.

People were at an increased risk of harm due to products such as antibacterial spray, shampoo, and hair spray being stored in unlocked cupboards. This meant people who had a cognitive impairment were at an increased risk of accidental ingestion. The hair salon was left unlocked and unattended, where hot water was left in the sink, meaning people were at an increased risk of burns or scalds. This meant environmental risks had not always been effectively identified or managed to keep people safe from avoidable harm.

A staff member shared their experiences of working in the home during recent heatwaves, saying “The central heating has been faulty for a long time, the radiators can’t be turned off. They brought air coolers which just pumped around warm air. I felt that was inadequate, apart from the people [living here], the staff were melting too.”

During our visit, the provider confirmed the central heating could not be switched off centrally, but individual radiators could be turned off. We observed radiators remained on in communal areas while air conditioning units were also in use, including in dining areas and corridors. Staff commented that the home was “hot” and opened windows to reduce the temperature. A person told us, “During the hot spell my radiator would not turn off. I think there was a problem, but it has been fixed and it’s off now.”

We gave feedback to the provider and they took action to address these concerns.

However, checks of people’s equipment, fire safety measures and water checks were completed on a regular basis. People told us they were provided fans in the heatwave, as well as ice lollies and cold water. Maintenance records demonstrated management had taken action to rectify issues raised. The service had ongoing issues with the front door, which was not working at the time of the inspection. The provider confirmed a risk assessment had been in place since it had broken to ensure people could access and exit the building in an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. The provider did not always support staff to work together well to provide safe care that met people’s individual needs.

Staff described workload pressures which affected their ability to complete all required tasks. During a mealtime, we observed staff were not always able to provide people with timely encouragement and support to eat while also serving meals, for example, 1 staff member asked a colleague for assistance with serving food. Two people being supported to eat had to wait for further encouragement while staff attended to other tasks.

Management told us staffing levels had recently been increased in response to staff feedback. Staff said this had helped but told us they did not always have sufficient time to complete everything required. Some staff described staying beyond their scheduled shifts to ensure people’s needs were met safely. A staff member told us, “Sometimes we have enough staff, but quite often we are short staffed. People feel rushed and have to wait for care, sometimes people have to wait until late morning for breakfast or to get up, and it’s not acceptable.”

Although the provider had responded to concerns by increasing staffing levels, our observations and staff feedback showed staff were not always deployed effectively to provide people with timely support and meet their needs.

We gave feedback to the provider and they took action to address these concerns.

People and their relatives gave mixed feedback about how staffing levels, as well as how quickly staff responded to call bells. Call bell audits showed most calls were answered within the provider’s expected timescales.

Staff had received training in areas including safeguarding, moving and handling, and infection prevention and control. Staff received regular supervision and appraisals. Recruitment processes were safe, with Disclosure and Barring Service checks and two references obtained before staff commenced work. Staff also described completing a period of shadowing before working independently. This meant people received support from competent staff who held the appropriate knowledge to carry out care.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Areas of the home were visibly stained and marked, including doorframes, skirting boards and walls. We observed accumulations of dust and hair in the salon, indicating that this area had not been effectively cleaned. Hair from previous use was present on hair-cutting equipment, and there was no clear process in place to demonstrate that equipment was cleaned between people. This increased the risk of cross-infection. A staff member told us, “I’m concerned about cross contamination and infection control.”

We gave feedback to the provider and they took action to address these concerns.

However, we observed staff using and disposing of personal protective equipment (PPE) appropriately. People and their relatives also told us staff wore PPE when required. We observed staff provide people with clean cutlery when items had been dropped on the floor. The provider told us there had been no recent outbreaks of infection. People and their relatives were supported to make choices about whether to receive vaccinations against viral and infectious illnesses.

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.

Staff supported people to receive their medicines safely. Medicine Administration Records (MARs) were up to date, and clear protocols were in place for medicines prescribed to be taken as required (PRN). Some PRN protocols provided staff with guidance for interventions to consider before administering medicines, where appropriate. For example, offering one-to-one activities or changes in diet.

People who received medicines covertly had appropriate documentation in place, which was regularly reviewed with relevant healthcare professionals. Medicine stocks were well managed, and staff completed regular temperature checks to ensure medicines were stored safely. People prescribed medicines to support them when experiencing distress had their medicines regularly reviewed by the pharmacist and GP. This meant people were protected from the increased risk of chemical restraint.

The provider had not always ensured risk assessments were in place for people prescribed high risk medicines, such as anticoagulants, blood thinners and flammable creams. We gave feedback to the provider about this, and the required risk assessments were put in place immediately.