Maylands

Updated 1 December 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 was carried out by two inspectors.

Service and service type

Maylands 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.

This service also provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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. We did not request a provider information return. 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 of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and two relatives about their experience of the care provided. We are improving how we hear people's experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we tried using this communication tool with one person to tell us their experience.

We spoke with six members of staff including the registered manager, deputy manager, senior care worker and care workers. 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 policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 1 December 2021

About the service

Maylands is registered with the Care Quality Commission (CQC) to provide two services. Maylands is a residential care home providing personal and nursing care to 16 people who have a learning disability and some people are living with dementia at the time of the inspection. The residential care service can support up to 18 people.

Maylands is also registered to provide a supported living service which delivers personal care to people in their own homes. The service was supporting 17 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. One person was in receipt of personal care.

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

People and their relatives told us they were happy and safe living at Maylands residential home. However, we found that medicines were not always managed safely. When people were living with health conditions, there was not always guidance for staff when people became unwell, to keep them safe. Accident and incident oversight was not robust and did not consider factors such as time incidents took place. Information was not reviewed for the service as a whole to look for trends and patterns. We found that people had not been harmed, however management oversight in these areas had failed to identify these issues.

There were systems in place to protect people from abuse. The registered manager ensured there were sufficient numbers of staff to keep people safe. There had been amendments made to the environment to keep people safe. For example one person had a lower bed to allow them to get into and out of bed independently. The service was clean, and the risk of infection had been mitigated.

Staff had the training and skills to meet people’s needs. Staff told us they were well supported by the management team. People were supported to eat and drink enough to keep them healthy. When people’s needs changed they were reviewed by healthcare professionals such as speech and language therapists.

We observed staff to be kind and caring towards the people they supported. There was a clear mutual respect and fondness between people and staff. Staff advocated on behalf of people, but ensured people made the decisions they could for themselves. People were supported to as independent as possible.

People, relatives, staff and healthcare professionals had been asked to give feedback on the service. This feedback was used to improve the quality of the service. Feedback from all stakeholders was positive and we observed a positive culture within the service.

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 did this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Whilst the size of the service is not in line with best practice guidance would recommend for people with learning disabilities, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence. People had been encouraged and supported to maintain their independence.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. We observed staff to be kind and caring towards people.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. There was a positive culture within the service, which supported 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

The last rating for this service was Outstanding (published 31 March 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.