Archived: The Maples

A registered manager was responsible for the home. 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.

This inspection took place on 21 and 22 January 2016 and was unannounced. It was carried out by one inspector.

People had communication difficulties associated with their learning difficulty. One person was able to share their views with us. We therefore used our observations of care and our discussions with people’s relatives and staff to help form our judgements.

The home was a safe place for people. Staff understood people’s needs and provided the care and support they needed. One relative said “The care is super.”

People were supported to make as many choices about their own lives as they could. People used community facilities and were encouraged to be as independent as they could be. People appeared happy with the care they received and interacted well with staff.

Staffing levels were good and people also received good support from health and social care professionals. Staff were skilled at communicating with people, especially if people were unable to communicate verbally.

Staff had built close, trusting relationships with people over time. One relative said “The staff have really gotten to know [their family member] well. This is really important as you really need to understand her.”

People, and those close to them, were involved in planning and reviewing their care and support. There was a very close relationship and good communication with people’s relatives. Relatives felt their views were listened to and acted on.

Communication and morale throughout the staff team was good. Staff were well supported and well trained. All staff spoken with said the support they received was very good. Staff spoke highly of the care they were able to provide to people. One staff member said “I think the support we provide is really good. What always strikes me is how nice the atmosphere is here and all the staff really do care. I think people here pick up on that.”

There was a management structure in the home which provided clear lines of responsibility and accountability. The management team strived to provide the best level of care to people and improve the service where possible. The aims of the service were well defined and adopted by the staff team. One relative said “It’s a nice relaxed home; I can’t fault it at all.”

There were effective quality assurance processes in place to monitor care and safety and plan ongoing improvements. There were systems in place to share information and seek people’s views about the running of the home.

A single inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service caring?

We saw people were being supported by kind and attentive staff. We observed people using the service smiling and making regular eye contact with staff. One relative told us 'he is happy in the home."

We saw that care workers were patient and gave encouragement when supporting people. We heard one staff saying "you can have a hot drink or a cold drink or both."

We saw different types of communication regularly being used between staff and people using the service. Communication included pats on the back, smiles and appropriate touching. Some of the language used between staff and people using the service could be misunderstood by a visitor but the registered manager explained certain phrases were used because they got a positive reaction from the person using the service. A relative told us 'the staff are friendly and approachable."

We observed staff knocking on people's bedroom doors before entering and then keeping the door closed whilst providing personal care. Some of the bedrooms had en suite bathroom facilities as well as access to two well equipped, communal bathrooms. This environment helped to maintain people's privacy and dignity.

Is the service responsive?

The care files set out people's preferences, interests, their individual needs and the support needed from the staff to meet their needs. Two relatives told us that staff "know how to look after the residents."

The ways people expressed their likes and dislikes had been recorded so that staff could understand people's wishes. Relatives told us that staff contacted them on a regular basis to discuss any changes to care and support.

Some relatives were involved in contributing towards people's annual care review and their views were taken into consideration. One relative said "the staff, ring me to invite me to the reviews."

People could make choices. We regularly heard staff asking people to make a choice. One staff asked a person "Would you like your cereal now or a milky drink?" The staff then waited until they got a verbal or non-verbal response.

Is the service safe?

We found the home safe at the point of entry. To enter the home we had to ring, wait for the door to be opened, we were then signed in and signed out. However due to structural changes the manager planned to review security to the side of the house which accessed onto the home's car park.

People were cared for in an environment that was well maintained and clean. At the time of inspection we saw several flies in most areas of the home and the registered manager informed us that action was being taken to remove them. We found the environment in good decorative order and the equipment we tested in working order.

We saw from the completed records that equipment at the home had been well maintained, serviced regularly and therefore safe for people to use. The records showed that the home's minibus was regularly checked to ensure it was safe for people to use. On the day of our inspection two staff went out with one person to help ensure the person's safety in the community.

Staff we spoke with were able to tell us what action they would take if they saw abuse taking place and where to find the correct contact information and procedures. One staff told us "I treat people like I would like to be treated."

Staff carried out a range of health and safety checks to ensure people were kept safe. Records showed that fire drills were carried out and people had their personal emergency evacuation plans.

People ate food which had been safely supplied and prepared. The catering facilities had been assessed by an environmental health officer and were given the top star rating.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which apply to care homes. The Deprivation of Liberty Safeguards are in place to protect people's human rights. The records showed the service had regularly recorded the decisions taken after best interest meetings. These meetings were held to ensure the best outcome and the minimum restrictive practices for people living in the home. This included the giving of influenza vaccinations and going out into the community.

Is the service effective?

People's relatives told us that they were happy with the care they saw and felt people's needs had been met. One relative said 'yes they know what they are doing.' Staff involved professionals in decision making about people using the service. We saw that relatives and professionals were involved in some of the best interest meetings.

Relatives were asked to share their views, some of which appeared in the care plans. One relative told us "Staff always react positively to what I say." Relatives we spoke with said they saw staff treating people as individuals. One relative said her daughter 'was always happy when she returns to the home." This indicated relatives were satisfied with the care and support being provided.

Is the service well-led?

The manager was registered with the Care Quality Commission as the registered manager for the service. Two relatives said they were "happy with how the home was run."

The training chart we viewed and the staff confirmed they had received regular training to meet the needs of the people living at the home. The staff regularly updated their training and were reminded when the updates were due by their supervisor.

The home had a range of quality control processes in place. The records needed for the safe and smooth running of the home were in good order and up to date.

Relative's views to formally assist in getting feedback on the quality of the service were not being collected annually.

We found the home was well equipped. There were assisted baths to make access easier for people. Bedrooms had ceiling hoists to help in the moving and handling of people in their rooms.

There was a range of written information for staff to use and read to help ensure good communications between staff. Staff told us relevant information was passed on when the shifts changed. However one relative said 'sometimes messages do not get passed on between staff.' and planned to discuss it with the manager.

People who lived in the home were well cared for. One person said "yes" when we asked them if they were happy living at the home. We saw that staff supported people in a kind, respectful and unhurried way.

We saw that people displayed signs of wellbeing throughout our inspection. People engaged positively with staff. People were seen to be happy and relaxed. They were treated with dignity and respect. People were protected from the risk of abuse.

Thorough checks were carried out before new staff started working in the home. This meant that people were protected from being cared for by unsuitable staff.

People who lived in the home were provided with information which explained how they could make a complaint or raise concerns about the service. They were supported to use the complaints procedure when necessary. Their complaints or concerns were listened to and acted upon appropriately by the provider.

We were told by a family member that the service provided was "very good" and that "I'm very happy with them". We found the provider assessed the individual needs of people and had plans in place to meet those needs.

Through looking at arrangements for staff training, talking to staff and reviewing care plans. We found that people were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff rotas, staff training records, talking to staff and observing staff supporting people demonstrated that there were enough qualified, skilled and experienced staff to meet people's needs.

The provider had in place systems that sought people's views, took account of complaints and comments and learnt from investigations into accidents and incidents. This meant the provider had an effective system to assess and monitor the quality of service.