Maer Lane

Maer Lane is a residential care home providing accommodation and personal care to nine people with learning disabilities at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercomS, cameras, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Risks to people’s safety were assessed however a key risk area was identified in relation to the management of a person’s behaviour. The registered manager has since updated the person’s care file and we have recommended staff training is reviewed to ensure both people and the staff team remain safe. Accident and incident forms were completed but we were not confident all incidents were being recorded, based on how staff viewed a specific situation.

Staff took a lot of responsibilities for updating care files, but we were unclear if they had the most up to date knowledge of best practice in learning disability care.

People were supported by a staff team who had received training in safeguarding people from abuse and staff were recruited following safe recruitment procedures. At the last inspection this was highlighted as a concern however action had been taken to rectify shortfalls.

People received their medicine on time by trained staff. Infection control was well managed, and staff had access to the equipment they needed.

People’s needs were assessed prior to admission and care plans were developed and reviewed on a regular basis. Staff received the training in the compulsory subjects required in social care. We were advised furthermore health specific courses were coming. People were supported to maintain a balanced diet and had access to healthcare service, whenever needed. The service worked well with other agencies.

The building had been adapted to meet people’s needs and plans for redecoration were in place.

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. We requested a care plan was updated to ensure agreements made at best interest meetings were fully reflected.

People were well treated. Staff supported people to express their views and understood people’s individual communication needs. People’s privacy was respected.

People’s care plans contained personalised information and people were supported to maintain relationships that were important to them. A complaints process was in place however there had been no recent complaints raised. At the time of inspection, the service did not deliver end of life care.

The culture in the home was open and staff reported feeling supported by the management team. The team understood their duty of candour and worked in partnership with others.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 17 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Maer Lane provides accommodation and personal care for up to nine people who have a learning disability. At the time of the inspection, eight people were living at the home.

The service is required to have a registered manager and there was a registered manager in post when we inspected. 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 suitability of prospective staff to work with people had not always been checked by the provider. Due to miscommunication between the provider’s human resources department and the registered manager, three recently employed staff had been permitted to start work, under supervision, without the appropriate pre-employment checks.

Staff understood how to recognise and report abuse, and supported people to raise any concerns about they may have about their safety or wellbeing. The risks associated with people’s individual care and support needs had been assessed, recorded and plans put in place to manage these.

Key workers involved people in decisions about risks and staying safe. Staffing levels at the service enabled staff to meet people’s needs safely. Systems and procedures were in place to make sure people received their medicines safely.

Staff had the knowledge and skills needed to perform their duties effectively in line with good practice. Staff received effective induction, training and supervision to support them in their job roles. People’s rights under the Mental Capacity Act 2005 were understood and promoted by staff. People had enough to eat and drink, and their individual dietary requirements were assessed with appropriate input from dietary specialists. Staff played a positive role in helping people to maintain good health and access healthcare services as required.

Staff treated people with kindness and compassion, and took the time to get to know them well as individuals. People’s involvement in decision-making that affected them was encouraged and facilitated. People were treated in a dignified and respectful manner, and their independence was actively promoted.

People received personalised care and support that reflected their individual needs and requirements. Care plans provided detailed guidance for staff on how to meet people’s individual needs, and included information about what was important to them. People were supported to pursue interests and spend time doing things they found enjoyable. People and their relatives knew how to raise concerns and complaints with the provider, and felt confident these would be acted upon.

The management team promoted an open and fair culture within the service. People’s relatives felt the management team was approachable and had confidence in their ability to deal with issues fairly. Staff understood what was expected of them, and felt supported and valued by the management team. The provider had developed quality assurance systems to assess, monitor and improve the quality of the service people received.

Staff spoke passionately about the people they supported. They demonstrated a clear understanding of the individual needs of the people whose care we looked at in detail. They shared examples of how they offered people choices in their daily lives and how they promoted their independence.

People were supported to maintain positive health. We saw people's health and wellbeing was closely monitored and reviewed in people's best interests.

Staff received a range of training to give them the skills and knowledge they needed to keep people safe and to meet their individual needs.

Systems were in place to gain people's views and to monitor and assess the quality of the service.

Staff demonstrated a good knowledge and understanding of the needs of the people they supported. They shared excellent examples of how they offered people choices, respected their privacy and dignity and promoted their independence. They knew people's preferences, communication methods, likes and dislikes well. People told us they were supported to attend health appointments to maintain their health and welfare.

Staff were able to describe abuse and knew how to respond to protect people in their care. They told us they had received training on protecting vulnerable adults and would not hesitate to report any concern to the manager.

Staff told us there were enough staff on duty to meet the needs of the people they supported. Some staff had worked at the home a number of years providing continuity of care and support. We saw staffing was planned in advance and that this was flexible and dependent on activities and events.

People said if they were not happy they would speak with the staff. Staff told us they were confident in raising concerns on behalf of the people they supported.