Maria Care Services

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.

People were supported by staff who had a positive view of safety as they documented incidents and concerns when required. However, we found improvements were needed to the provider’s quality assurance systems as these had not documented all incidents so they could be reviewed for any themes and trends.

For example, we found 3 people had experienced a fall. These had not been collated within the provider’s analysis of incidents that had occurred for that month. It was also unclear if and what action had been taken following this incident. We raised this during our inspection and were provided confirmation of the actions and referrals made by the service for these incidents. This meant actions were being taken to support people when required, although improvements were needed to the provider’s quality assurance system to ensure this information was collated so the provider could demonstrate their oversight of all incidents and accidents.

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.

People felt staff supported them with their individual needs and wishes. Staff made referrals to health care professionals if needed, such as to the person’s GP or other health and social care professional. One person told us staff had done this for them on various occasions. They said, “They have done that many times.” All people felt supported with their care, and care plans contained information about people’s individual health needs.

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. Although, we found some improvements were needed to ensure all people had a mental capacity assessment and best interest decisions in place where they lacked capacity.

For example, 1 person’s care plan had no information to confirm if they had capacity or not. Another person had a completed mental capacity assessment that confirmed they lacked capacity. Although best interest decisions had not been undertaken for all aspects of their care and support, these had started to be undertaken. Documentation also confirmed they had a Deprivation of Liberty Safeguards in place, although no information was documented within their care planning information. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the capacity to do so for themselves. Any decisions made on their behalf must be in their best interests. 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 MCA. We shared this feedback with the registered manager and the management of the service so they could review this and take any actions needed.

Staff received training in safeguarding adults, and they knew how to raise concerns and how to identify abuse. Staff felt people got safe care.

The provider used a quality assurance system to review safeguarding concerns along with what actions were taken including referrals and notifications made.

People were supported by staff with their individual needs. Although, we found improvements were needed to people’s care plans and associated guidance and risk assessments.

For example, 2 people’s moving and handling risk assessments needed information on what equipment staff were to use and how to use this to support the person with their mobility. One other person had possible risks associated with their diet, but they had no completed risk assessment on how to support them with their individual diet or guidance for staff on how to manage this. We raised this with the manager for the service who confirmed following our inspection they had reviewed these people’s care plans and had taken action to address these shortfalls.

People had any risks identified and equipment provided so they received safe care. The provider made sure equipment and technology supported the delivery of safe care.

People’s care plans contained important information such as what equipment the person used and any emergency contact details. There was also information within people’s care plans on where the person’s utility supply was. Referrals were made to health and social care professionals and other organisations when any risks were identified or equipment was needed.

People were supported by enough staff who they knew well. Although some improvements were needed to the providers recruitment procedures and ensuring staff had suitable training and refresher training suitable for their role.

For example, during our inspection we found 1 member of staff had been employed prior to suitable checks being undertaken before their employment. As they had completed their induction prior to a disclosure and barring service check (DBS) being undertaken. The provider’s recruitment policy confirmed a disclosure and barring service check should be completed prior to their employment at the service. One other member of staff’s recruitment documentation had varying information on when they had started their employment and induction training. Another member of staff had all satisfactory checks undertaken prior to starting their employment. We shared this feedback following our inspection so the provider could review their recruitment procedures.

Although some improvements were needed to ensure staff received training and knowledge to support people with their individual needs. For example, not all staff had received training in how to support people with a learning disability or autism. This training is a requirement for all staff to complete, including practical training if required.

Improvements were also needed to ensure staff received refresher training relevant to their role. For example, some staff needed refresher training in dementia care, equality and diversity, administering medicines, mental capacity and nutrition and dietary training. Some staff were unable to explain their knowledge around equality and diversity when asked. We raised this feedback during our inspection, and the provider confirmed staff were scheduled to complete any outstanding refresher training they required. Staff had bespoke training provided to them such as how to support people with their oral care, diabetes, catheter care and epilepsy.

Staff felt supported with supervision, team meetings and observed direct practice reviews and all felt it was a nice place to work. One member of staff told us, “They are very supportive, I can always go to the (registered manager) or other managers. They are all really good.” The provider had oversight of when staff supervisions, appraisals and observed practices were due.

People were supported by enough staff, who they knew. People were happy with the support provided by staff. When asked if staff were consistent, people told us, “We have consistent carers” and “It’s the same group of core carers.”

The provider assessed and managed the risk of infection. They ensured staff had access to personal protective equipment (PPE) and that staff received training in how to use this equipment and prevent infections.

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 received their medicines safely from staff who had competency reviews and who had received training. People’s care plans confirmed if people needed support with their medicines and risk assessments were in place where emollients posed a possible fire risk. Documentation confirmed people had received their medicines and information was also available to staff on where to apply the topical cream and how often. The provider had a quality assurance system in place to identify any shortfalls in the management of medicines.