We carried out a review of the data available to us about Maple Tree Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Maple Tree Court, you can give feedback on this service.
People’s experience of using this service:
People felt safe living at the service. Peoples risks were documented, and staff were knowledgeable about how to mitigate them. Staff knew to how protect people from abuse and what to do should they suspect it. People were cared for by suitable numbers of staff who had been recruited safely. People told us they received their medicines as prescribed.
People were cared for by staff who had the knowledge and skills to ensure they received effective care. Staff sought the advice of healthcare professionals when people’s health deteriorated. People had sufficient food and drink to meet their nutritional needs. Staff had the knowledge to ensure people’s rights were protected through applying the principles on the Mental Capacity Act.
People told us, and we saw staff were kind and compassionate in their approach with people, and caring relationships had developed. Staff understood the importance of protecting people’s privacy and dignity. Staff encouraged people to be independent as possible.
The care people received was responsive to their individual needs. People had the opportunity to partake in activities of their own choice. People and their relatives knew how to complain should they need to. The provider had a system in place which meant that people would be listened to when a complaint was raised.
People were very happy living in the service and would recommend it to other friends and family. Staff told us they were happy working in the service because they felt supported by managers. A positive culture had developed as a result of the good governance. The provider had an effective system which monitored the care people received and when problems were identified action was taken to ensure lessons were learnt.
Rating at last inspection: At the previous inspection we rated the service as Requires Improvement overall. (30.05.2018)
Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found the service met the characteristics of Good in all areas.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme; if any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.
Maple Tree Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Maple Tree Court accommodates up to 64 people across four separate units, each of which have separate adapted facilities. One unit is a residential unit supporting people who are able to be more independent. The other three units support people living with dementia. At the time of the inspection there were 36 people using the service.
There was not a manager who was registered with us at the time of the inspection. The recently appointed manager was in the process of completing their registration with us. 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.
We found that improvements were needed to the way topical medicines were managed.
Improvements were needed to ensure risks to people’s health and wellbeing were assessed and managed consistently.
The provider had systems in place to assess, monitor and improve the quality of care. However, improvements were needed to ensure that the all the systems were effective in identifying issues to enable these to be rectified.
There were enough suitability recruited and skilled staff to provide support to people. Staff had received training to carry out their role effectively.
People were protected from the risks of abuse because staff understood and had followed the provider’s policy for recognising and reporting possible abuse.
People were protected from the risk of infection because the provider had policies and systems in place to control infection risks at the service.
People enjoyed the food provided and were supported with their nutritional needs. Action was taken to ensure people at high risk of malnutrition were supported effectively.
People’s past lives, cultural and diverse needs were assessed and considered to enable individualised care that met all aspects of people’s needs.
Systems were in place to ensure that people received the least restrictive care and treatment to keep them safe. Staff understood and followed the Mental Capacity Act 2005.
Advice was sought from health and social care professionals when people were unwell, which was followed by staff.
There were systems in place to ensure people received consistent care from staff within the service and also from staff from external agencies.
The environment promoted people’s independence, safety and orientation.
People received support from staff that were kind and compassionate. People’s dignity was respected and their right to privacy upheld. Staff supported people to make choice in their care in line with their individual communication needs.
People received care that met their individual preferences. People’s care was reviewed and updated when needs changed.
People had the opportunity to be involved in social activities to ensure their social needs were met.
People and their relatives knew how to complain. Complaints received had been investigated and responded to in line with the provider’s policy.
People’s end of life wishes were taken into account to ensure people were supported in line with their preferences at this time of their life.
People, relatives and staff felt able to approach the manager and the feedback gained from people about their care had been acted on.
People, relatives and staff felt that improvements had been made since the last inspection which had impacted on the care people received. This showed that the provider was working towards improvements to the quality of the service provided.
The manager understood their responsibilities of their registration and worked in partnership with other agencies to make improvement to the way people received their care.
The overall rating for this service is ‘Inadequate’ and the service has therefore been placed into ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
The service is registered to provide accommodation and personal care for up to 64 people. Care is delivered to people across four separate units. People who use the service may have a physical disability and/or mental health needs, such as dementia. At the time of our inspection we were informed that 50 people were using the service.
The home had a registered manager. 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 and associated Regulations about how the service is run.
At this inspection, we found that the provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant that unsafe and unsuitable care was not always being identified and rectified by the registered manager or provider.
The safe staffing levels set by the provider were not maintained to ensure staff were available to keep people safe and meet people’s care needs.
Risks to people’s health, safety and wellbeing were not consistently identified, managed and reviewed to promote their safety. Effective systems were not in place to protect people from the risks associated with infections.
Safety incidents were not always reported and responded to effectively, which meant the risk of further incidents was not always reduced.
The legal requirements of the Deprivation of Liberty Safeguards (DoLS) were not followed. This meant people were at risk of being restricted in an unlawful manner.
People were supported to access health and social care professionals. However, this was not always facilitated in a timely manner to promote people’s health, safety and wellbeing.
Staff received some training to help them support people. However, there were significant training gaps that left people at risk of receiving poor, unsafe care.
People’s feedback about their care was not always acted upon to improve the quality of care.
Most people described the staff as kind and caring. However, some people were not always treated with dignity and their right to privacy was not always respected. People were not always supported to make every day decisions about their care.
People did not always receive care in accordance with their care preferences and the information staff needed to provide consistent, effective care was not always available for them to follow. This meant some people were at risk of receiving unsuitable, inconsistent care.
People were supported to engage in leisure and social based activities. However, these did not always meet people’s individual needs and were not always enjoyable experiences.
Staff were recruited safely and they knew how to recognise abuse. However, improvements were needed to ensure potential abuse was consistently reported.
People received their regular medicines as prescribed. However, improvements were needed to ensure medicines were managed safely.
People were supported to eat and drink. However, people did not always have positive mealtime experiences.
Staff told us they felt supported by the management team. However some people and the staff did not have confidence in the managers. This meant some people were reluctant to complain about their care.
People’s consent was sought before support was provided. Staff understood and applied the requirements of the Mental Capacity Act 2005 which meant people were supported to receive care that was in their best interests when they were unable to make decisions for themselves.
Formal complaints were investigated in accordance with the provider’s complaints policy.
The service had a registered manager. 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.’
Staff understood how to support people to make decisions and when they were unable to do this, support was given; however, the provider did not consistently follow the principles of the Mental Capacity Act 2005 (MCA).
There were systems in place to monitor quality of the service; however some of these were not always effective in identifying issues where required.
There were sufficient staff to people's needs. We saw that people's needs were responded to promptly. Staff had undergone pre-employment checks to ensure they were suitable to work with the people who used the service.
People's risks were assessed and managed to help keep them safe and we saw that care was delivered in line with agreed plans.
People felt safe and staff knew how to protect people from avoidable harm and abuse. Medicines were safely managed, stored and administered to ensure that people got their medicines as prescribed.
Staff were suitably trained to meet people's needs and were supported and supervised in order to effectively deliver care to people.
People knew how to complain and complaints were dealt with in line with the provider's procedure. People and their relatives were encouraged to give feedback on the care provided. The registered manager and provider responded to feedback and changes were made to improve the quality of the service provided.
People told us they enjoyed the food and drink and had enough to maintain a healthy diet. People had choices about their food and drinks, and were provided with support when it was required to ensure their nutritional needs were met.
People were supported to maintain good health and had access to healthcare professionals when they needed them. People told us that staff arranged access to healthcare professionals such as the GP promptly when required.
There was a homely atmosphere at the service and people felt the manager was approachable and supportive.