Maplewood Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were protected from the risk of potential abuse; risk of infection and the service’s environment was maintained safely. Accidents and incidents were managed to reduce risk of harm from future re-occurrences and learning was implemented to support this. There were enough staff with the right skills to meet people’s needs safely. Not all risks to people were always managed safely and we identified some issues with the documentation of medicines that were administered. We fed this back to the registered manager at the end of our visit to the service and they took action to address this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives felt the staff supported them well if things went wrong and made changes to prevent future recurrence or improve their experiences. One person told us, “I did have a fall and the staff were here to help me.” A relative shared, ‘There was an incident recently but this was dealt with immediately with a call to myself and explanation of what they had put in place for safeguarding and reported to [Kent County Council]. They did everything they needed to do, and this was reassuring. I cannot praise this home enough and everyone is amazing.’

Staff told us they knew what to do if there was an accident or an incident whilst they were at work. Staff told us they received feedback from management with improvements to implement from the services governance processes.

Accidents and incidents were reported appropriately. Investigations were undertaken by one of the managers and lessons learned were shared with the staff team. Information was entered into an accident and incident tracker and the tracker produced a quarterly analysis so that trends and patterns could be monitored and acted upon.

People told us where required they felt their care pathway was managed well by staff. One person said, “I need a lot of support as I have appointments at hospital, staff arrange everything for me, so it all goes smoothly.” People and their relatives reported that transitioning to the service was a positive experience. One person said, “I came for lunch with my daughter and was shown around to make sure it was suitable for me.” A relative told us, “They knew [loved one] was anxious and explained everything to [them] and made everything ok.”

Staff and leaders told us that they ensured people had access to appropriate care pathways to meet people’s diverse needs. The manager told us there was a weekly ward round with the GP and that appropriate referrals were completed to ensure people’s needs were met.

Feedback from partners was that the staff at Maplewood Court Care Home were good at ensuring people received appropriate care. One healthcare professional shared, ‘Maplewood are very good at identifying deteriorating patients. The nurses email us in good time and appraise us on the situation.’

People were admitted to the service safely. An initial assessment was completed on admission and care plans were developed over the first few days in partnership with the person and those important to them. When people were admitted to hospital, appropriate records were shared to ensure safe transitions between services and a smooth care pathway.

People told us they felt safe. One person said, “I feel very safe and happy.” Relatives also told us they felt their loved ones were safe. One relative said, “Lots of people around, staff that know [loved one] well, security is good, I don’t have to worry anymore.”

Staff understood safeguarding concerns, they told us they had received training and felt confident to raise any concerns and that management would take action to keep people safe. Staff also knew other external bodies they could raise concerns to, where appropriate. The registered manager and general manager spoke to us about the safeguarding processes and procedures and shared a recent example of a safeguarding they had appropriately raised.

We observed people looked happy and relaxed living at Maplewood Court Care Home. Staff attended to people in a timely manner and were responsive to their needs.

There was a safeguarding policy in place. The managers raised safeguarding concerns with the local authority safeguarding team and took appropriate actions to reduce risks. Safeguarding concerns were regularly reviewed as part of the service’s governance processes and any learning was shared with the team. The managers had made applications to the local authority to deprive some people of their liberty (DoLS). This is a necessary legal procedure to follow when a person who lacks capacity to consent to their care and treatment, requires restrictions in order to keep them safe from harm.

People we spoke with were aware of their own risks and told us they were involved in managing them. One person told us, “I have to use a walker but sometimes I forget I need to use it and they are there to remind me.” Relatives we spoke with also told us they felt involved in their loved one’s risk assessments.

Staff were generally knowledgeable about the people they cared for, they knew their care needs and most associated risks. Staff told us about some people’s individual risks, how they monitored and managed those to reduce harm or deterioration such as risk of pressure damage or supporting people’s emotional and psychological wellbeing. However, we asked staff about some specific risks in relation to particular health needs and staff confirmed some information was not available or up to date in individual care records.

We saw that staff supported people safely to manage risks such as risk of falls, risk of choking, malnutrition or dehydration. We observed staff encouraging people to mobilise at a level that was safe for them. We saw staff were sitting with people, also having their lunch with them so they were available if anyone needed assistance whilst creating a more inclusive environment.

Some people’s records contained very detailed risk assessments and care plans to help staff support people safely, for example the risk of choking or risk of pressure damage. People were supported to manage some of their own risks where they wished to do so such as administering their own medication or catheter care. Some people’s records did not contain enough information for staff to provide safe care and manage their risks fully. For example, one person’s specific health care need did not have a risk assessment or guidance in place to make staff aware of potential signs of a critical condition and what action to take. Some care plans did not contain the most up to date information in relation to people’s care, though people were receiving safe care in these areas. Some monitoring records for people’s specific conditions had not always been consistently completed or sometimes lacked in detail. We saw no evidence that people had been harmed however we shared this feedback with the registered manager during our assessment as there was potential to cause harm. The registered manager took immediate action to address the examples found.

People told us they felt safe living at Maplewood Court Care Home. People and their relatives commented on the security of the building positively and spoke highly of the maintenance personnel. Comments included “very good, very helpful”, “very cheerful” and “always about”.

The registered manager told us that all staff help to keep the environment safe. They said managers including those from housekeeping and maintenance walked around the home to identify issues quickly so action could be taken to resolve concerns and improve the environment. The registered manager said maintenance staff kept the home, “Fantastically compliant with everything.”

We saw the environment was well maintained during our visit to the service. There was a maintenance team on site who we saw maintaining the gardens for people to use. We saw relevant safety equipment in place and in good working order around the service to support people’s safety such as fire equipment, equipment to support people to mobilise and window restrictors.

Environmental and health and safety checks were completed appropriately such as gas and electrical safety. There were systems in place to support good communication around the service’s safety including daily meetings attended by heads of all departments including maintenance. Staff reported concerns on the system, which put an alert on the maintenance team handset. The maintenance team fixed the issues or got contractors if necessary. Once the issue had been fixed it was marked complete. Records had been maintained on the system appropriately. There were audits and checks in place to assess compliance with health and safety regulations which ensured a safe environment for people living at the service. Any improvement had been identified and actioned.

People and relatives told us generally they felt there were enough staff. Both people and relatives told us occasionally there was a wait or difficulty finding staff if they were busy or there was staff sickness. People we spoke with said they did not mind waiting and did not report any negative impact to their experience of care. People and relatives were very complimentary about the staff. A relative shared, ‘The staff are friendly, and handle the residents with warmth and care.’

Staff told us they felt there were enough staff. Leaders told us they did not use agency staff and if there was any absence they covered this across the staff team. Staff felt they had the right skills to meet people’s needs.

There appeared to be enough staff to provide safe and effective care for people and meet their individual needs during our visit to the service. Call bells were answered quickly and if the call bell sounded for more than two minutes the tone changed to the ‘emergency’ tone. Staff had time to spend with people, care and support was not rushed.

Recruitment practices were safe. Pre-employment checks which included Disclosure and Barring Service checks (DBS) had been completed, references from previous employers were obtained, where appropriate, and gaps in employment history were explored. Staff’s Right to Work in the UK was also checked before new staff started working at the service. Rotas demonstrated that the service was staffed to the specified levels. Staffing levels were reviewed as required if there were changes to people’s needs and when new people moved into the service. There were systems in place to seek feedback and review staffing levels, for example during staff meetings; the minutes did not indicate any concerns with the staffing levels. Staff had completed appropriate training to their roles and there were processes in place to ensure there was a high level of training compliance across the service, in all roles, which was regularly reviewed.

People and relatives told us they felt the home was kept very clean. One relative commented, “Everything is always clean and tidy, just like new.” A person said, “The cleaning lady is lovely and always up for a chat.”

A member of the housekeeping team told us they prevent and control infections by, “Follow[ing a] cleaning rota, have all the right chemicals and things that [they] need.” Care staff told us they followed all health and safety processes including infection control. Staff gave examples of wearing personal protective equipment (PPE) such as gloves and aprons, cleaning up spillages and using appropriate cleaning equipment. A staff member gave an example of how they tried to manage and control potential spread of infections. They said, “When we have infection in the building, we notify management, we start infection monitoring there is a procedure we monitor everyday. It would be [shared] on handover, depending on [type of] infection [there might be] barrier nursing or asking people to stay in their room. [We] encourage hand hygiene.” Barrier nursing refers to the use of physical barriers and strict measures to prevent the transmission of infections.

We observed the service was clean with a pleasant odour and corridors were wide and clear from obstructions. We saw housekeeping staff were active throughout the visit to the service, cleaning communal areas such as lounges as well as people’s rooms. We saw staff bringing people freshly pressed clothing, putting it away with a smile and chat.

Staff had received training about infection prevention and control. Housekeeping staff followed cleaning schedules that were in place. There were systems and processes in place to ensure everyone’s rooms were deep cleaned regularly. Audits and staff meetings discussed what was working well and where things could improve.

People told us their medicines were managed well by the service. One person said, “Very well [managed] nighttime and the morning.” Some people and relatives fedback there had been issues with medicines due to other professionals, but the home had resolved this for them.

Staff understood the importance of safe medicines management. A member of staff told us the electronic system had made it easier to safely monitor and manage medicines. The registered manager said there were systems and processes in place before staff were deemed competent to administer medicines such as training, observations and competency assessments.

Medicines were generally managed safely. People received their medicines from staff who were trained and had their competencies assessed. Medicine Administration Records (MAR) were fully completed without issue. There were systems in place to monitor the safe management of medicines such as medication audits, learning was shared with the team from these to help prevent future recurrence. Any medicine errors were recorded, and these were reviewed by the managers for any patterns, trends and to promote lessons being learnt. There were some issues around documentation for example, temperature checks to ensure medicines were stored correctly had not been consistently recorded. However, a new system had been implemented which automatically checked the temperature every 30 minutes and alerted the manager if action was needed. We were also not assured that the electronic system allowed for medicines that were administered via a skin patch to have the location recorded. Recording the site of the skin patch enabled staff to vary the site to minimise the risk of skin irritation. However, this was rectified before our second day at the service.