Archived: Maple Court Nursing Home

Updated 24 August 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of three inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Maple Court Nursing Home 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.

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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service about their experience of the care provided. We spoke with 16 members of staff including the registered manager, deputy manager, unit lead, two nurses, six care staff, two activities coordinators, two kitchen assistants and a member of domestic staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included eight people’s care records and multiple medicines 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 policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records.

Updated 24 August 2021

About the service

Maple Court Nursing Home is a care home providing personal and nursing care to 42 people at the time of the inspection. The service can support up to 80 people in one adapted building, over two floors. At the time of the inspection there were two separate units, one on each floor, providing support to people with differing needs. Saunders unit was upstairs and predominantly supported people living with dementia or other mental health needs and Elizabeth unit was on the ground floor.

People’s experience of using this service and what we found

People felt safe at the service, however some people said there weren’t enough staff to meet their needs. Improvements had been made to the way people’s risks were managed and we saw people’s falls had reduced as a result of this.

There had been improvements to infection control practices though further improvements were required. People’s medicines were now managed safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, there were some inconsistencies in the way staff applied the Mental Capacity Act (2005).

People were treated with kindness and compassion; however, some people felt staff deployment impacted on their choice and control.

A new registered manager was in post since the last inspection and they had implemented new ways to manage and monitor the quality and safety of the service. These were working well but needed to be further embedded into practice and sustained.

Some staff did not feel well supported and involved in the service, but other staff told us they felt the registered manager had a positive impact on the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 6 February 2021) and there were multiple breaches of regulation. We took enforcement action and the provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made in most areas, though further improvements were required, and the provider was still in breach of some regulations.

This service has been in Special Measures since the last inspection. During this inspection the provider demonstrated that some improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced inspection of this service on 2, 4 and 10 December 2020. Five breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding, staffing, dignity, good governance and notifications to CQC.

We undertook this focused inspection to check they had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Caring and Well-led which contain those requirements.

A rating from a previous comprehensive inspection for the Responsive Key Question was used in calculating the overall rating at this inspection.

The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Maple Court Nursing Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

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