Maitland House

Updated 5 February 2020

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.

Inspection team

This inspection was carried out by one Inspector and one Expert by Experience with experience. 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

Maitland House is a ‘care home’. People in care homes receive ccommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We also sought feedback from the local authority and professionals who work with the service.

During the inspection

We spoke with seven people who used the service and six relatives about their experience of the care provided. We spoke with nine members of staff including the operations manager, regional manager, registered manager, deputy manager, senior care workers, care workers and the cook. We also spoke with two healthcare professionals.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at records in relation to recruitment and staff supervision. We also reviewed a variety of records relating to quality and safety monitoring of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 5 February 2020

Maitland House provides accommodation and personal care and support for up to 24 older people, some who may have a mental health need. At the time of our inspection there were 18 people who lived in the service.

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

Systems were in place for the supply of medicines, staff were trained, and competency assessed. We identified shortfalls in the management of people’s medicines whereby we could not be assured people had received their medicines as prescribed. The current system for auditing medicines was not robust at identifying all medicines management errors.

Environmental risks had been identified and action taken to reduce risks. Where we identified potential risks to people’s safety from unsecure wardrobes the provider responded immediately to rectify this.

Risk assessments detailed people's individual risks such as, mobility, risk of falls and managing behaviours that may present a risk to the individual and others. Further work was needed to ensure robust assessment and monitoring for people where medicines were covertly administered and effective monitoring where people were at risk of losing weight.

There was an open and transparent culture within the management team demonstrated throughout the inspection. There were systems in place to monitor the quality and safety of the service. Incidents and accidents were investigated, trends analysed, and actions were taken to prevent recurrence. However, whilst we were reassured action was taken to rectify the shortfalls we found at this inspection, we recommended the auditing system is reviewed to provide more effective oversight of medicines management, weight monitoring and environmental risks.

People told us staff were kind, caring in their approach and supported their independence. People, their relative’s and staff were positive regarding the management of the service.

People had access to a complaints process and provided with the information they needed to raise a concern should they need to do so. People's feedback was considered through a range of systems such as surveys, care reviews and meetings.

People were supported by skilled staff with the right knowledge and training. Staff told us they were supported by the management team with their training and development needs.

Personalised care plans had been developed, which provided the staff team with guidance about the needs of people and how these needs were to be met.

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.

People had access to a variety of nutritious meals and snacks. Meals were freshly prepared and pleasantly presented.

There was a varied range of social activities on offer. Work was in progress to improve links with the community. We recommended further work is carried out to ensure planning and monitoring of people cared for in bed to provide social stimulation and reduce their risk of isolation.

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 27 July 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.