Background to this inspection
Updated
21 September 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. 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
The inspection was carried out by one inspector and an Expert by Experience who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Mauricare is a ‘care home’. People in care homes receive accommodation 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the Provider Information Return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spent time with people who use the service. We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with a registered manager from another service location, owned by the provider, who facilitated the inspection. We spoke with five care staff.
We spent time with people who use the service. We spoke with five people and a visiting family member.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including minutes of meetings.
After the inspection
We requested the provider submit information to the Care Quality Commission, to evidence their requests to the landlord of the building, for the carrying out of maintenance. This information was not provided.
Updated
21 September 2019
About the service
Mauricare is a care home providing personal and nursing care to 13 people aged 65 and over at the time of the inspection. The service at the time of the inspection was not providing nursing care.
The service can support up to 17 people, in one adapted building.
The registered manager was on planned leave at the time of the inspection site visit. The inspection was facilitated by a registered manager from another of the provider’s services, at the request of the provider.
People’s experience of using this service and what we found
Ineffective monitoring of the service by the provider and registered manager, and a lack of oversight by the provider, meant shortfalls in the service were not identified. Plans to bring about improvement were not in place, this impacted on the quality outcomes for people.
An external organisation had issued an enforcement notice, to bring about improvement to promote people’s safety, and bring about compliance.
Systems to promote people’s safety, which included assessment of risk, and safe recruitment practices for staff were not robust. Staff did not fully understand their responsibilities in safeguarding, all of which had the potential to place people at risk.
Audits on infection control were not an accurate reflection of the service. The audits recorded the service was clean, and furnishings and fixtures were in good condition. We found the service was not sufficiently clean, and some soft furnishings, floor coverings and mattresses to be damaged and stained.
People lived at a service that was not sufficiently maintained, both internally and externally.
People’s needs were not regularly reviewed, and their care plans were not written with their involvement. This meant people were not supported to have maximum choice and control of their lives, and staff did not always support them in the least restrictive way possible. The policies and systems in the service did not support this practice.
Opportunities for people to engage in social activities, develop interests within the service and the wider community were limited. Activities, as detailed on the notice board did not take place.
People’s health and welfare were kept under review by staff, who organised health care referrals and appointments on people’s behalf. Staff supported people to access health care appointments, and implemented the guidance given to them to promote people’s well-being.
People’s views about the service were sought. People we spoke with expressed satisfaction with the care they received, and spoke favourably about the staff who worked at Mauricare.
Staff were supported to perform their role through training and supervision.
People’s medicines were managed safely and people were supported to access a range of health care professionals, to monitor and promote their health.
People who were able, accessed the wider community independently or with support from family members.
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 22 February 2017)
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to: The effective governance of the service. Effective systems and practices to prevent and control the spread of infection. Maintenance of the premises, to promote the safety of people and their well-being. Effective assessment of potential risk, including staff recruitment practices. And, person centred care, enabling people to be involved in the development and review of their care.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mauricare on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.