Maple Leaf Lodge

Maple Leaf Lodge is a residential care home providing accommodation for people with learning disabilities and autism. The home provides a range of support pathways for up to 12 people. At the time of our inspection there were 11 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence, and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. The service worked with people to plan for when they experienced periods of distress, so that their freedoms were restricted only if there was no alternative. People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and in their best interests. The policies and systems in the service promoted this practice. People were presented with choices about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community.

Right Care: Some of the records relating to people’s care and health and safety required updating. Medicines were not always administered as prescribed. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people's individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had received training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture: People received good quality care, support and treatment because suitably trained staff and specialists could meet their needs and wishes. Staff placed people’s wishes, needs and rights at the heart of everything they did. The quality of support provided to people was evaluated, involving the person, their families and other professionals as appropriate. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 10 January 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

We recommend that the provider review their system to record and monitor the administration of medicines.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Maple Leaf Lodge ensured current government guidelines in relation to COVID-19 were being followed and the manager ensured staff had access to and were supported to understand and follow the latest guidance.

The manager had good oversight and an organised approach to recording people’s vaccination status, isolation periods and COVID-19 test results.

Maple Leaf Lodge managed risk in relation to infection well. Where people were unable to social distance or self-isolate plans and additional cleaning was in place to manage this. Cleaning schedules were completed and comprehensive.

The provider had contingency plans in place for if there was an outbreak of COVID-19 and the home and staff had plans in place to reduce the risk of cross contamination.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection site visit took place on 9 November 2017 and was unannounced. It included observations, speaking with people and staff and reviewing records. The inspection was carried out by one inspector and an expert by experience who had experience of a learning disability services. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used information the provider sent us in the Provider Information Return. This is 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. As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law. We also contacted the local authorities who are responsible for funding some people’s care for information.

We spoke with six people who used the service, four care staff and the registered manager. We looked at two records about people’s care, minutes from staff and people’s meetings, complaint and compliments file, incident forms and quality audits that the registered manager and provider had competed.

The provider of is registered to provide accommodation for personal care for a maximum of 13 people. There were seven people living at the home on the day of our visit.

At the time of our inspection there was manager in post who had recently been appointed and has since registered with us. This is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they were safe and with staff support they knew who to talk to about any concerns about their safety. Staff knew the steps to take to reduce the risk of harm or abuse for people. Staff were confident they would protect people and immediately report any concerns to management. People’s risks that related to their safe care and treatment had been looked at and reviewed so all staff knew what they needed to do to help minimise those risks.

People were supported by staff being available at the times they wanted support. We saw that staff responded to people as needed and told us they had time to support people as required. People had been asked about the level of help they needed with their medicines and staff provided people with support and recorded when they had received them.

Staff were confident about how to care for people and that their training and support provided them with the skills needed. All staff told us they felt supported by the management team to carry out their roles effectively. Staff listened and respected people’s decisions about their care and treatment. Staff showed they listened and responded to people’s choice to choose or refuse care.

People’s nutritional needs were met and they had choice in most meals they wanted. People saw other health professionals when needed to support and maintain their health and wellbeing.

People told us they liked living at the home and that staff were friendly and kind. People told us that staff made sure they remained independent and were encouraged to be involved in their care. They knew the staff well and felt they had developed positive relationships with them. Staff were considerate when talking about people and knew it was important to maintain a person’s privacy and dignity.

Improvements were needed to ensure communication with people was right for them. Activities available to people within their home needed to be reviewed and focus on people’s interests and skills. Staff had also been involved to support people when their needs changed and continue to provide care that met people’s needs. The manager was available, approachable and known by people who were confident to raise their concerns. Staff were also supportive to raise any concerns of behalf of people.

The recent change in the management structure will need to demonstrate that people continue to receive care that meets their needs. People knew the management team and felt involved in their home. The management team had kept their knowledge current and the provider ensured regular checks were completed to monitor the quality of the care that people received and looked at where improvements may be needed.

We read care records for three people and other supporting documents for the service. We saw that people were respected by staff. Staff asked people if they were happy with them giving care before they gave it.

People's needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that staff were aware of each person's needs and how to give care and support to meet those needs. People told us that: 'Staff are really good here, they look after me'. We saw that staff were kind and caring in their approach to people who lived in the home.

The registered manager showed us around the home. People told us: 'The home is nice and we help to look after it'. 'I like living here, and I feel safe'.

There was a complaints procedure in place at the home. We found staff knew how to support people to make a complaint if they needed to.

We saw that staff treated people with dignity and respect. We saw that staff were friendly and supportive to people and helped them to make everyday decisions.

We spoke with people who lived at Maple Leaf Lodge who told us that: 'Maple Leaf Lodge is the best place to live'. We were told that staff were: 'Very good and always help us when we need it'.

People's needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff were aware of each person's needs. They knew how to give care and support to meet those needs that ensured people's health and welfare was maintained. People confirmed that staff: 'Give me the help I need'.

We saw that staff had a kind and caring approach towards people they supported. People told us they liked living at Maple Leaf Lodge and that they felt the staff were: 'Very kind and helpful'.

Recruitment procedures made sure that only suitable staff were employed to safeguard people from the risk of harm.

A quality assurance system was in place. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.