Background to this inspection
Updated
8 January 2020
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.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Maer Lane is a ‘care home’. People in care homes receive accommodation and personal care as 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.
During the inspection-
We spoke with two people who used the service and observed the care provided to others living at the home. We spoke with five members of staff including the registered manager and care workers. We also spoke with a visiting health professional.
We reviewed a range of records. These included two 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 audits and maintenance records were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and updated care records.
Updated
8 January 2020
About the service
Maer Lane is a residential care home providing accommodation and personal care to nine people with learning disabilities at the time of the inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercomS, cameras, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Risks to people’s safety were assessed however a key risk area was identified in relation to the management of a person’s behaviour. The registered manager has since updated the person’s care file and we have recommended staff training is reviewed to ensure both people and the staff team remain safe. Accident and incident forms were completed but we were not confident all incidents were being recorded, based on how staff viewed a specific situation.
Staff took a lot of responsibilities for updating care files, but we were unclear if they had the most up to date knowledge of best practice in learning disability care.
People were supported by a staff team who had received training in safeguarding people from abuse and staff were recruited following safe recruitment procedures. At the last inspection this was highlighted as a concern however action had been taken to rectify shortfalls.
People received their medicine on time by trained staff. Infection control was well managed, and staff had access to the equipment they needed.
People’s needs were assessed prior to admission and care plans were developed and reviewed on a regular basis. Staff received the training in the compulsory subjects required in social care. We were advised furthermore health specific courses were coming. People were supported to maintain a balanced diet and had access to healthcare service, whenever needed. The service worked well with other agencies.
The building had been adapted to meet people’s needs and plans for redecoration were in place.
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. We requested a care plan was updated to ensure agreements made at best interest meetings were fully reflected.
People were well treated. Staff supported people to express their views and understood people’s individual communication needs. People’s privacy was respected.
People’s care plans contained personalised information and people were supported to maintain relationships that were important to them. A complaints process was in place however there had been no recent complaints raised. At the time of inspection, the service did not deliver end of life care.
The culture in the home was open and staff reported feeling supported by the management team. The team understood their duty of candour and worked in partnership with others.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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 17 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.