Mapleton Road

Mapleton Road is a residential care home providing personal care to up to 24 people. The service provides support to older people some of whom maybe living with dementia. At the time of our inspection there were 22 people using the service. The care home accommodates 22 people across two separate units, each of which has separate adapted facilities. Both units specialise in providing care to people living with dementia.

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

The service kept people free from harm as much as possible including the spread of infections. Staff were confident in how to manage safeguarding concerns and how to raise them. People had risk management plans in place and staff understood people's needs. We observed some poor moving and handling procedures, we have made a recommendation about moving and handling. Medicine was managed safely. Staff were recruited safely. There was a system in place to learn lessons when things went wrong.

People had up to date care plans and guidance was available for staff to follow should they need it. People had enough to eat and drink to maintain a balanced diet. Staff promoted a healthy lifestyle. People had access to health care professionals when needed. The home was adapted to support people's needs. Relatives told us the home was nice and comfortable. Staff told us they were well supported. Staff had a good induction and training program in place to carry out their role competently. The provider was working within the principles of the Mental Capacity Act.

Relatives, staff, and people told us the home was well managed. Managers were available and kept them involved in running the service. Staff praised the management team stating they had lots of support. The registered manager understood their role and responsibilities. The home checked the quality of care on a regular basis through an auditing schedule.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 09 April 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mapleton Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Mapleton Road is a residential care home providing accommodation and personal care to 13 people aged 65 and over at the time of the inspection. The service can support up to 24 people, mainly elderly people with dementia. Mapleton road is purpose-built accommodation operating across two units.

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

We found the environment clean and infection control procedures in place. However, infection prevention and control (IPC) practices were not always followed by staff in relation to wearing personal protective equipment (PPE). Staff knew how to manage risks posed by people, however, risk assessments were not always reviewed and did not identify the risk.

People were safe because staff knew what action to take should they suspect or witness any kind of abuse. Relatives felt people were safe and staff knew how to care for people.

Systems were in place for reporting and recording incidents and accidents and dealing with complaints. Regular audits were carried out by the service, however, improvements were required to ensure all care records were accurate and up to date.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 August 2019) and there were two breaches of regulation. 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 some improvements had been made, however the service remains rated requires improvement.

Why we inspected

We undertook this focused inspection to follow up on breaches of legal requirements in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The provider completed an action plan after the last inspection to show what they would do and by when to improve. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained rated requires improvement. We found improvements were needed in relation to IPC practice, risk management and quality assurance. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mapleton Road on our website at www.cqc.org.uk.

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.

Mapleton Road is a residential care home providing accommodation and personal care to 24 older people, most living with dementia. The home accommodates people across two units, each of which has separate adapted facilities. At the time of our inspection there were 18 people living at the home.

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

Medicines were stored safely and PRN (as and when required medicines, for example paracetamol) protocols were in place; however, we found improvements were needed to ensure expired medicines were removed in line with manufacturers guidelines. We have made a recommendation about the management of some medicines.

We were told staffing levels were based on level of need, however, we found staff appeared rushed during busier times.

Quality assurance and audits were in place, however, these had not always been effective.

People were protected from the risk of abuse or harm. Staff received training in abuse and knew the signs to look for. People were cared for in an environment that was clean. Staff followed good infection control practices to minimise the risk of cross infection. There was learning from incidents and accidents.

People were cared for by staff who felt supported by the registered manager. Staff received training and supervision to help them to effectively carry out their role. People’s nutritional and hydration needs were met by the home. People were 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.

Staff worked with other professionals to meet people’s health needs. People’s needs were assessed, and care individualised to meet those needs. The service had a complaints policy in place. Relatives knew how to make a complaint if not happy with care provided to their relative.

People took part in various activities provided at home and of their choice.

People and relatives spoke highly of the registered manager and staff and felt the service was well run.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 16 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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.

We previously inspected Mapleton Road in January 2014 and at the time of the inspection we found the service to be meeting all standards except that they did not have sufficient quality assurance practices in place. Upon our inspection in November 2016, we found that the service was carrying out robust quality assurance practices.

The service had 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.

The service was safe and people using the service communicated this to us. Staff demonstrated their knowledge of safeguarding adults and what action to take if they had any concerns. The service reported any accidents and incidents as well as safeguarding's to the relevant local authority and to the Care Quality Commission (CQC).

The service had risk assessments in place and people using the service were protected from harm where risks were identified. Risk assessments contained clear mitigation plans and were updated on a monthly basis.

Staffing levels were efficient in meeting the level of need at the service and staff told us that any absences were always covered. Staff were recruited safely and in line with the relevant checks.

People’s medicines were managed, stored and administered safely and audits were completed to ensure consistency.

The service was effective and we saw that people received care based on best practice from staff who had the knowledge and skills through training and supervision to carry out their roles and responsibilities. Staff told us they were supported in their roles and that they received regular training.

Consent to care and treatment was sought and we saw examples of this in people’s care plans and in practice. Staff demonstrated a sound understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and the registered manager had notified CQC of DoLS authorisations.

People were supported to have sufficient to eat and drink and maintain a balanced diet. People told us they enjoyed the food and that it was varied. Dietary needs were adhered to and monitored where relevant and the cook had good understanding of people’s dietary requirements and preferences.

People were supported to maintain good health and have access to on-going healthcare support. Referrals to healthcare professionals were prompt and records of people’s health needs were documented.

The service was caring and we observed positive caring relationships with staff and people using the service. People told us they were happy with their care. People were supported to express their views and be involved in making decisions about their care, treatment and support. People were given choice and independence was promoted. People’s privacy and dignity was respected.

The service was responsive and care planning was detailed. People’s preferences, wishes and aspirations were identified and people were supported to follow their interests. Care plans were reviewed on a monthly basis and changes were recorded accordingly.

Concerns and complaints were encouraged and responded to and people knew how to complain and share their experiences. People using the services were encouraged to provide feedback, as were professionals. Compliments were received in abundance and displayed on a notice board.

The service was well led and management promoted a positive culture that was open and transparent. The service demonstrated good visible leadership and the registered manager understood their responsibilities. Quality assurance practices were robust and records and data were collected and used to strive for improvements at the service.

People told us that they liked the food and there was plenty to eat and drink. We found that the staff spent time with the residents during mealtimes and monitored what they were eating and drinking. People were offered meals appropriate to their needs, for example soft food. People were able to eat in their rooms if they wished.

The home was clean and tidy. There was a programme for cleaning, including the daily cleaning of the rooms, toilets, bathrooms and the kitchen. Some areas such as the kitchen also received deep cleaning weekly. One relative said, "It smells nice here."

The staff were experienced and were trained in relevant subjects such as safeguarding, manual handling and dementia care. They received regular supervision and an annual appraisal. Staff told us that the provider supported their learning and development.

We found that the provided acted on complaints and took them seriously. The provider followed up recommendations from incidents. We did not see any evidence of monitoring the quality of service provision through the use of audits or residents' survey.

We spoke with people who used the service and made observations. Most people were unable to tell us about their experiences but in our observations we saw staff showing warmth and kindness towards people. Some people who were able to communicate verbally told us, 'I've got the greatest respect for all the staff' and "I would feel comfortable talking to any of them (staff) about any problems."

Before people came to live at Mapleton Road, they were asked for their signed consent for their care plans. People's care plans contained health needs assessments detailing their medical and other requirements, which were reviewed regularly. Staff were trained and knowledgeable about people's individual needs and preferences.

People who used the service were protected from the risk of abuse and people said they felt safe. People were made aware of the complaints system and complaints were investigated and resolved, where possible, to their satisfaction.