Maryland Care Home

Updated 2 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal

requirements and regulations associated with the Health and Social Care Act 2008.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a review of infection control and prevention measures in care homes.

This inspection took place on 12 November 2020 and was announced, shortly before the inspection visit.

Updated 2 December 2020

This unannounced inspection took place on 9 March 2018.

The home was last inspected in July 2017 where breaches of legal requirement were found. The home was rated as 'requires improvement' overall.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve their rating to at least good. We found during this inspection that sufficient improvements had been made and the provider was no longer in breach of regulation.

Maryland 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.

Maryland accommodates up to 30 people in one adapted building.

A registered manager was 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.

During our last inspection in July 2017, the provider was in breach of regulations relating to safe care and treatment. This was because risk assessments relating to the health and safety of people living at the home had not always been completed appropriately. We saw during this inspection that there was a new process for assessing risk and risk management and the provider was no longer in breach of regulation.

During our last inspection in July 2017, the provider was in breach of regulations relating to governance and records. This was because some information was not recorded appropriately or clearly in care plans, and audits were not always effective when identifying issues of concern. with service provision. During this inspection, a more robust auditing system had been introduced, and records were clear and concise. The provider was no longer in breach of this regulation.

People told us they felt safe living at the home. We observed there were enough staff to provide safe, effective care.

Medication was safely managed, stored and administered. People received their medications on time.

Staff were recruited and selected to work at the home following a robust recruitment procedure. The registered manager retained comprehensive records of each staff member, and had undertaken checks on their character and suitability to work at the home.

The home was clean and tidy. There was provision for personal protective equipment stationed around the home, and staff were trained in infection control procedures.

Staff were able to describe the process they would follow to ensure that people were protected from harm and abuse. All staff had completed safeguarding training. There was information around the home which described what people should do if they felt they needed to report a concern.

The training matrix showed that staff were trained in all subjects which the provider considered mandatory to their role, and as stated in the provider's training policy. New staff with no experience in health and social care were enrolled on an in depth induction process.

Staff received regular supervision and appraisal.

People were supported to eat and drink in accordance with their needs. People, who were assessed as at risk of weight loss had appropriate documentation in place to monitor their food and fluid intake. Where specialist diets were needed for some people, the chef had knowledge of this.

The service worked in conjunction with physiotherapists, and psychiatrists to ensure people had effective care and treatment.

Everyone had records in their files relating to external appointments with healthcare professionals such as GP's, opticians, dentists or chiropodists. The outcome of these appointments was recorded in people's records.

Most areas of the home and some people's bedrooms had been refurbished to a high standard. The provider was also making further improvements to the home.

The service was operating in accordance with the principles of the Mental Capacity Act (MCA). Applications to deprive people of their liberty had been appropriately made following best interest decisions.

There were positive examples of person centred information in people’s care plans. Since our last inspection the registered manager had introduced new documentation. The new documentation was more in depth with regards to finding out more information about people, their likes, dislikes and how they wanted their support to be delivered.

There was a procedure in place to document and address complaints. Everyone we spoke with said they knew how to complain. The complaints procedure was displayed in the communal areas of the home.

Feedback was regularly gathered from people who lived at the home and their relatives and used to improve their experience of living at Maryland.

Everyone told us they liked the registered manager and there had been clear improvement in the home in the last six months.