Maples Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At the last inspection in July 2023 the provider was in breach and continues to be in breach of regulation; good governance as not enough improvement had been made at this assessment. Monitoring systems in place did not always ensure effective oversight of the service to assess and monitor the care provided. The provider had not identified when risk assessments had not been undertaken, people’s care plans contained conflicting information or when there was insufficient information and guidance in place for staff to support people. Staff were asked to use frameworks (VERA) that they had no knowledge of or guidance for. Audits had either not been carried out or failed to identify the shortfalls we found at this assessment

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us there had been improvements in relation to the management team since the last inspection, they told us that managers were visible within the service and the culture of the home was improving and positive changes were starting to take place. Staff said they felt able to approach managers and felt that they would be supported. One staff member said, “Management is happy to help. Another staff member said, “Things are improving, I can go to the registered or deputy manager and know they will listen.”

The service had a new registered manager who has been in place since November 2023. We received mixed feedback from people and relatives about the contact they had with the registered manager. One person said, “I don't know [the registered manager] by name. I think I have seen [them].” Another resident said, “I’ve not needed to speak to [registered manager], but I'm sure they would come to speak with me if I needed.” A third person said, “[The registered manager] would come and see me if I had a complaint.” Relatives we spoke with said that they could talk to the registered manager if required. One relative said, “I don't engage with [registered manager] much but now I don't need to.” Another relative said, “Yes, when I walk in, [the registered manager’s] door is always open and they will always speak to me.”

We saw the provider held regular relatives’ meeting, these were both face to face and via Zoom. Dates of these meetings were advertised in advance to ensure relatives had the opportunity to attend if the chose to. One relative said, “There are monthly meetings. They now alternate between in person and via zoom. The dates are on the board so now you can plan ahead which is good.” Another relative said, “We did have a couple with [registered manager].”

Staff told us that since the last inspection they felt able to approach management and felt able to speak up about concerns they had and felt listened to.

We saw the provider had a whistle-blowing policy in place. Whistle-blowing is a law that protects staff from being treated unfairly by their employer if they have raised genuine concerns about a person’s care.

Staff said the new registered manager had started to make improvements to the home. Staff did not raise any concerns with us about equality and diversity issues. We saw the home had a diverse staff group with a range of age, gender and cultural backgrounds. Staff told us that they attended regular staff meetings.

The provider had up to date policies and procedures relating to equality, diversity and inclusion.

The management team were open in acknowledging that although improvements had been made since the last inspection, further improvements were still needed. A service improvement plan was sent to us following the last inspection in July 2023. However, at this assessment, we found that some areas of concerns around care plans and risk assessment had not been rectified. The management team told us they would ensure that they took immediate action to address this and other concerns we found at this assessment.

At the last inspection we identified a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this assessment this was still the case. Although some improvements had been made since the last inspection, there was a failure by the provider to implement effective systems and processes to ensure oversight of the service. This resulted in a lack of monitoring to manage risk and had the potential to cause an impact to the safety and quality of people’s care.

The provider's governance processes were not robust to assess and improve the care provided. For example, the registered manager did not have oversight in identifying that food, fluid and repositioning charts had either not been completed adequately to identify poor practice and ensure that people health was not negatively impacted.

Care records had not been consistently reviewed or updated. We identified concerns risks to people's health and wellbeing, this meant people did not always receive safe and good quality care. The provider was not aware of all the concerns we found during our assessment. Audits carried out did not identify shortfalls we found at this inspection.

During the assessment the provider did take action to mitigate some of the risks to people we had identified and following the assessment, the registered manager sent us an updated service improvement plan with timescales.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager and the regional manager confirmed that although improvements following our last inspection had been made, further improvements were still needed.

The provider's systems for monitoring and improving quality were not always effectively implemented.

At this assessment we saw that the service improvement plan, the provider sent to us following the last inspection in July 2023 had not been met in all areas. For example, not all care plans and risk assessments had been updated by September 2023. People did not always have fluid targets in place, and there was no follow up when people were not drinking enough. Staff still had not received Epilepsy training as identified at the last inspection.

Audits were not always effective and therefore, the provider had not always been able to identify the shortfalls we found at this assessment.

At this assessment the management team were responsive about the improvements still needed. They told us they were committed to improving deployment of staff, ensuring all care records were updated when required, (these included food, fluid and repositioning charts). Understanding and using the VERA framework effectively when required, ensuring all staff were aware of all health conditions people lived with. Ensuring learning from accidents and incidents WAS been disseminated to staff and ensuring people were provided with regular and meaningful activities and conversations, including people living with dementia.