Archived: Field Maple Tree

Updated 21 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was completed by an inspector and an expert by experience who made phone calls on day one and one inspector on day two. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts experience was related to learning disabilities, autism and using services themselves.

Service and service type:

Field Maple Tree is a domiciliary care agency. This service provides care and support to people living in four ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support..

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.

The inspection started on 26 February and ended on 1 March 2019.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit so that people could be informed of our visit and permissions could be sought to arrange home visits.

What we did:

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

We spoke with five people who used the service and visited the four supported living locations. We met with four relatives on site. We received feedback from three health and social care professionals via telephone.

We spoke with the registered manager and nominated individual. A Nominated Individual has overall responsibility for supervising the management of the regulated activity, and ensuring the quality of the services provided. We met with six support workers and one house coordinator. A house coordinator was a senior support worker. We reviewed five people’s care files, four Medicine Administration Records (MAR), policies, risk assessments, health and safety records, incident reporting, consent to care and treatment and quality audits. We looked at three staff files, the recruitment process, complaints, and training and supervision records.

Updated 21 March 2019

About the service:

Field Maple Tree is a domiciliary care agency. It provides a service to adults with learning disabilities and autism. This service provides care and support to people living in four ‘supported living’ settings. At the time of our inspection the service was supporting 20 people. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

Requires improvement (published 29 March 2017).

Why we inspected:

This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People had good community networks which were personal to them. This included, day services and supporting people to access the local amenities and maintaining regular contact with family and friends. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

People and relatives told us they were happy, felt safe and that staff had a good understanding of their needs and preferences. Staff listened to what people wanted and acted quickly to support them to achieve their goals and aspirations. Staff were innovative and looked to offer people solutions to aid their independence and develop their life skills.

Improvements had been made to medicines, supervisions, training, Mental Capacity Act paperwork and quality monitoring since the last inspection. Medicine errors had reduced and safe systems had been introduced through robust quality monitoring. Staff felt they were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people to learn essential life skills. Staff encouraged positive risk taking so people could experience new things and develop. This had led to people feeling fulfilled and living an active life.

People, professional’s and relatives spoke highly about the management and staff had a clear understanding of their roles and responsibilities. Staff told us they felt the registered manager could be more visible and supportive. The registered manager recognised this and wanted to work positively with the staff team to support people to achieve their own goals and to be safe. Checks of safety and quality were made to ensure people were protected. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people's lives.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service was reviewing how best they could meet the values that underpin the 'Registering the Right Support' and other best practice guidance such as 'Building the Right Support'. These values include choice, promotion of independence and inclusion. Also, how people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A full description of our findings can be found in the sections below.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.