CQC report explained · a nursing home
What the CQC found at Maitland Park Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some people may not have received medicines as prescribed. Risk assessments and monitoring charts were not always complete or followed, and staffing levels were sometimes insufficient.
- Effective?
- Good
- People's needs were assessed and care plans were reviewed. Staff supported people's healthcare, dietary, cultural and communication needs, and worked within the principles of the Mental Capacity Act.
- Caring?
- Good
- People and relatives said staff were kind and respectful. Staff promoted dignity, independence, religious and cultural needs, and involved people and relatives in decisions.
- Responsive?
- Good
- Care was personalised and staff responded to changing needs. Activities, communication support, complaint handling and end-of-life care were provided, although some people were observed sitting alone.
- Well-led?
- Requires improvement
- The management culture had improved, but audits did not identify most of the medicines and risk-management problems. Daily care notes were sometimes incomplete, and the provider remained in breach of good governance requirements.
What inspectors found, November 2022
Rated Requires Improvement; inspectors found kind, responsive care, but medicines, risk management and oversight were not reliable enough.
This was an unannounced follow-up inspection on 30 August and 1 September 2022. Inspectors spoke with people, relatives, staff and a visiting professional. They observed care and mealtimes, checked records and medicines, and toured the home.
The home was rated Good for Effective, Caring and Responsive. People were treated kindly, supported to make choices, helped to stay independent, and offered activities. Staff supported healthcare needs and worked with other professionals.
The home was rated Requires Improvement overall, and also for Safe and Well-led. Inspectors found medicines were not always managed safely, risk assessments and monitoring records were sometimes incomplete, staffing was not always sufficient, and quality checks did not identify or correct these problems. The home remained in breach of Regulations 12 and 17.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors observed friendly interactions and found that staff promoted dignity and independence.
“Staff treated people kindly and with respect.” from the report
Personalised care
Care plans included people's health, communication, diet, life history and personal preferences. Staff reviewed needs and updated care plans.
“People received care and treatment that met their individual needs.” from the report
Healthcare support
Staff recognised changes in people's health and contacted appropriate services. The home worked with GPs, district nurses, speech and language therapists and other professionals.
“The service ensured people received appropriate healthcare promptly when needed.” from the report
Activities and relationships
The home provided group and one-to-one activities, including exercise, singing, artwork and music. People and relatives had regular opportunities to share their views.
“A wide range of activities was available for people to engage in.” from the report
Infection prevention
Inspectors were assured about infection prevention, the use of protective equipment, visiting arrangements and the home's ability to manage outbreaks.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Medicines were not always safe
seriousInspectors found medicines were not always given in line with dispensing instructions. Some covert medicines plans were out of date, and unwanted medicines were not always separated from current medicines.
“Trained staff managed people's medicines safely but we found a few instances where some people may have not received their medicines as prescribed.” from the report
Risk information was incomplete
seriousSome risk assessments lacked important details, including support for eating and drinking. Inspectors also saw a person assessed as needing constant monitoring walking unsupervised, and found gaps in monitoring charts.
“Some risk assessments lacked details and staff did not always follow guidance from existing risk assessments.” from the report
Staffing levels
needs fixingSome people, relatives and staff said there were not enough staff at times, particularly on nursing units and at weekends. Inspectors recommended that staffing arrangements be reviewed.
“However, there were times when staffing numbers were insufficient.” from the report
Food did not suit everyone
needs fixingThere was a varied menu and dietary needs were recorded, but some people were unhappy with the food and some said drinks were not offered unless requested. Inspectors recommended reviewing menus.
“Meals at the service did not always meet people's expectations.” from the report
Quality checks missed problems
seriousAudits did not identify most of the problems with medicines and risk management. Daily care notes were sometimes incomplete, making it harder to identify patterns in people's care.
“Audits were not always effective as they had not identified most of the issues we found around safe management of medicines and assessing people's risks.” from the report
- 01What specific checks now make sure medicines are given according to dispensing instructions, including crushed and patch medicines?
- 02How do you make sure risk assessments for choking, falls, food and fluids are complete and followed by every shift?
- 03What staffing levels are planned for nursing units, nights and weekends, and how do you respond if staffing falls below plan?
- 04What changes have you made to menus and drinks support after the mixed feedback about food?
- 05How do managers now check that audits lead to prompt action and that daily care records are complete?
This was an unannounced follow-up inspection covering all five key questions, including infection prevention and control, with checks of care, medicines, records, staffing, the premises and management systems. This explanation was written from the published report of 15 November 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2021
Rated Requires Improvement; inspectors found unsafe medicines management, incomplete care information and weaknesses in staff culture and oversight.
This was an unannounced focused inspection on 1 December 2020. Inspectors looked mainly at safe and well-led care, and checked whether earlier problems in effective care had improved. They spoke with people, staff, families and professionals, and reviewed care, medicine, recruitment and management records.
The home was not always safe. Medicines were not consistently managed properly. Inspectors also found incomplete care records, care plans that did not give enough individual guidance, weak handovers and delays in reporting some safety concerns. Staff said they could be too busy to complete care records or take proper breaks.
The overall rating was Requires Improvement. Safe, effective and well-led were also rated Requires Improvement. The rating had not improved since the previous inspection in 2019, and the home remained in breach of some regulations. Managers had improvement plans, had employed a deputy manager and were introducing electronic care records, but the inspection found that more work was needed.
Infection control
Inspectors were assured that the home had suitable measures to prevent and manage infection, including during the COVID-19 pandemic.
“We were assured that the provider was using PPE effectively and safely.” from the report
Clean and maintained home
The building was clean, in good order and supported appropriate health and safety checks.
“The home environment was well maintained. It was clean and in good order.” from the report
Safe recruitment
The recruitment records reviewed showed checks such as references, identity checks and DBS checks had been completed.
“New staff were safely recruited.” from the report
Risk assessments
Apart from medicines, inspectors found that risks such as falls, moving and handling, bed rails and emotional wellbeing were assessed at suitable intervals.
“Other risk assessments were in place, these were related to the use of bed rails, moving and handling, falls, manual handling, emotional well-being.” from the report
Managers were taking action
Managers understood the main problems and had improvement plans, staff training and team-building work in progress.
“The management team at the home was fairly new.” from the report
Medicines were not always safe
seriousRecords did not show that some as-required pain medicines had been offered or given. Records for creams were missing or incomplete, and staff did not always recognise or act on possible medicine side effects.
“We were not assured that people had received their PRN (as required) medicines as intended by the prescriber.” from the report
Care plans and records were incomplete
seriousCare plans did not always explain how to support individual needs. Daily records did not consistently show what personal care had been provided.
“People's care plans needed to improve to provide staff with individualised information on how to meet the specific needs of people who used the service.” from the report
Concerns were not always reported promptly
seriousA serious incident was reported five days later, even though several staff knew about it. Staff did not always feel confident raising concerns about poor practice.
“Staff had not always acted quickly to report issues of concern around people's safety.” from the report
Weak communication and handovers
needs fixingHandover records often contained very little information. There was no formal process to check whether referrals happened, and transfers between units were not managed robustly.
“The handover form completed by staff during shift changes gave very limited information about each person, often just saying that there was no change or no concerns.” from the report
Staff culture was not always open
needs fixingSome staff described hostility and said they did not feel comfortable raising concerns. Families also gave mixed feedback about how friendly and caring staff were.
“The staff culture at the home was not always positive, open and inclusive.” from the report
- 01What has changed since the inspection to make sure PRN medicines, creams and ointments are given and recorded correctly?
- 02How do you check that staff notice and report possible side effects from medicines promptly?
- 03How will you make sure each person’s care plan gives clear, individual instructions and that daily care records are completed?
- 04How do you ensure there are enough staff on every shift for care, record keeping and proper breaks?
- 05What is the current process for reporting safeguarding concerns and making sure important information is passed on at handovers and unit transfers?
This was an unannounced focused inspection of Safe and Well-led, with limited checks on Effective; Caring and Responsive were not rated in this report. This explanation was written from the published report of 17 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Maitland Park Care Home
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2018Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- June 2013
Registered with the Care Quality Commission on 11 June 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Camden
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,300 a week. 75 can care for a couple. 12 years' experience on average.
“The quality of life that she's given my parents has been priceless. The peace of mind she's given my sisters and I, through a very difficult time, has been invaluable.”
“The interaction she gives my mother is incredible, singing, dancing, taking her to groups, on plenty of walks which mum always loves.”
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