16 February 2023
During an inspection looking at part of the service
Mapleton is a residential care home providing personal care for to up to 20 people. The service provides support to older people, including people living with a diagnosis of dementia and people with a learning disability. At the time of our inspection there were 15 people using the service. Mapleton has secure accommodation over two floors. People living at the service long term live on the ground floor. The first floor has been developed to be used as a short stay assessment unit to support people, who may have complex needs, moving from hospital to a longer-term setting. Both floors have kitchen, lounge and dining space and access to outside space. Peoples' bedrooms are en-suite and all rooms have ceiling track hoists.
People’s experience of using this service and what we found
The management team had addressed the concerns identified at the last inspection and were continuing to drive service improvement. They had created a culture which was person-centred, open, inclusive and empowering. A relative told us, “There were a few issues previously, but the management has changed completely since [family member] has been there and it seems well managed now. The staff seem happy. The home feels nice, homely and comfortable.”
There was a robust and effective quality assurance programme in place. People, relatives and staff were consulted and asked for their views. This enabled the provider and registered manager to identify issues and take prompt action to address them.
People felt safe living at Mapleton. They were supported by a stable and consistent staff team who knew them well. We saw kind and caring interactions during the inspection.
The provider and registered manager used a dependency tool to ensure there were sufficient numbers of staff deployed to meet the needs of the people at the service. Staff were recruited and selected safely.
New staff completed a thorough induction and received the training and supervision necessary to carry out their roles. There was a culture of continued learning and reflection. Staff told us, “If you make mistakes, they don’t come down on you like a ton of bricks. They ask what support you need to move forward. To reflect and learn from it.”
Risks to people's health and well-being were assessed and reviewed appropriately. There was clear guidance in place for staff to follow. Staff worked closely with a range of external health and social care professionals to meet people’s needs and help them work towards their goals.
Measures were in place to prevent the spread of infection, and safety checks on the environment were in place and robust. Medicines were safely managed. Incidents and accidents were appropriately recorded and analysed for patterns and trends. Safeguarding processes were in place to help protect people from abuse.
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.
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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
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 27 June 2022) 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 we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended the provider consider using a dependency tool to ensure staffing levels reflect peoples' level of care and support needs. At this inspection we found the provider had acted on this recommendation and made improvements to how staff were deployed.
Why we inspected
We carried out an unannounced focused inspection of this service on 19 May 2022. 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 their support of people in line with The Mental Capacity Act 2005, and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. 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.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mapleton on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.