Background to this inspection
Updated
15 November 2022
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 Health and Social Care Act 2008.
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 was carried out by one inspector, a member of the CQC medicines team, a specialist advisor nurse and three Experts by Experience, including two Experts by Experience who contacted people’s relatives by telephone for their feedback. 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
Maitland Park Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Maitland Park Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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 and professionals who work with the service. We reviewed the information we gathered as part of our monitoring activity that took place on 12 May 2022. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 14 people who used the service and one visiting relative about their experience of the care provided. We also spoke with one visiting professional.
We observed mealtimes and interactions between people and staff.
We spoke with staff on duty, which included kitchen staff, housekeepers, activity coordinators, care workers, nurses and the management team.
We reviewed a range of records. This included six people’s care records and medicines records for 15 people. We also reviewed additional care records and monitoring charts for people.
We looked at six staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, complaints log, accidents and incidents records, staff training records, audits, health and safety checks and meeting minutes, were reviewed.
We conducted a tour of the premises and looked at equipment and medicines storage.
Following our visit to the service, we spoke with the relatives of 19 people on the telephone.
Updated
15 November 2022
About the service
Maitland Park Care Home is a residential care home providing personal and nursing care to up to 60 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 52 people using the service.
The service is spread across three floors and comprised of six units. People had en-suite facilities and access to communal lounge/dining areas on each floor. People also had access to outdoor paved areas.
People’s experience of using this service and what we found
We found shortcomings in relation to how the service managed medicines. There was a risk people did not always receive their medicines as prescribed.
The service assessed risks to people but risk assessments were not always consistent. Some risk assessments lacked details and staff did not always follow guidance from existing risk assessments.
Staffing levels were assessed regularly but were not always appropriate. Some of the feedback we received from people, relatives and staff suggested that there were times when not enough staff were on shift.
People’s eating and drinking needs were catered for but not everyone was satisfied with the meals they received.
People felt safe at the service, and staff understood their responsibilities regarding safeguarding people from abuse and improper treatment. Processes were followed to protect people from the risk of catching and spreading infections.
People’s needs were assessed and care was delivered in line with best practices. Staff supported people to have access to healthcare services when they needed them.
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.
Staff received the support they needed to perform their roles.
People received individualised care and were encouraged to make decisions about their care. Staff were kind to people and treated them with respect. Staff helped people to be more independent where possible.
Staff were responsive to people's needs. A variety of activities were provided to people to reduce social isolation.
There was an open and inclusive culture at the service. People, relatives and staff spoke positively of the management and the support they received. The team worked in partnership with healthcare services and other professionals to achieve good outcomes for people.
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 requires improvement (published 16 February 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection the provider remained in breach of regulations, and their rating remained requires improvement.
At our last inspection we recommended that the provider arranges further training and ongoing supervision for staff on safeguarding, and assesses and reviews the level of staff deployed to support people at the home. At this inspection we found the provider had improved staff training and supervision, but staffing levels remained an issue.
This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last 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.
Recommendations and enforcement
We have identified two continued breaches of regulations in relation to safe care and treatment and the governance of the service.
We have made two recommendations. These were in relation to staff deployment and supporting people with eating and drinking.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will also 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 continue to monitor information we receive about the service, which will help inform when we next inspect.