Maples Care Home

Updated 8 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team on the first day consisted of 3 inspectors. One inspector returned to the service on the 2nd and 3rd day and an Expert by Experience made telephone calls to relatives to gather their views about the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Maples Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. [Care home name] is a care home [with/without] nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed information we held about the service since our last inspection. The provider was asked to complete a provider information return (PIR). The PIR is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people and 4 relative face to face. We also spoke with 16 relatives on the telephone about their experience of the care provided. We spoke with 12 members of staff including the registered manager, the clinical manager, nurses, medical technicians, care workers, activities coordinator, kitchen, and house-keeping staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not express their views about their care to us.

We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We continued looking at care plans and risk management plans, as well as quality assurance records.

Updated 8 December 2023

About the service

Maples Care Home is a care home set over three floors and provides residential, nursing and dementia care and support for up to 75 older people. At the time of our inspection, 61 people were using the service.

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

Risks were not always assessed, identified and/or updated and risk management plans were not always in place to manage risks safely. Records were not always completed and monitored in line with people's individual needs. Medicines were not always safely managed. Staff were not always available when needed. Accidents and incidents were not analysed and learning from this was not disseminated to staff.

People were not always supported to eat and drink when required. Staff training was not up to date, with no training provided for Epilepsy. Supervisions and appraisals were not carried out in line with the provider’s supervision policy. People’s privacy and dignity was not always respected. People were supported to have maximum choice and control of their lives. People's needs were not always met by the design and decoration of the home. We have made a recommendation about sourcing designs and decoration that would be conducive to people who live with dementia.

People and/or their relatives were not always involved in planning their care needs. Complaints were not managed in line with the provider’s complaints policy. People’s communication needs were not always met. People’s end of life wishes, were not always documented. There was a lack of activities on offer to stimulate people. Systems in place were not effective to assess and monitor the quality of the service provided. Feedback was sought from people, their relatives and staff to improve on the quality of the service provided.

Assessments were carried out prior to people joining the service to ensure their needs could be met. People were protected from the risk of infection. The service worked in partnership with key organisations and health and social care professionals when required.

Rating at last inspection and update

The last rating for this service was Good (published 23 December 2020). At this inspection we found the provider was in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from Good to Inadequate. This is based on the findings at this inspection.

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 Maples Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing, person-centred care, dignity and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow-up

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.