CQC report explained · a residential care home
What the CQC found at Maple House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rated Inadequate and placed in special measures; inspectors found serious risks from restraint, safeguarding, staffing, medicines and poor leadership.
Inspectors visited unannounced on 28 September and 4 October 2023. They spoke with a person, relatives and staff, observed care, and checked care plans, risk assessments, medicines, recruitment records, incidents and management checks.
The home was not safe. Inspectors found unsafe and disproportionate physical restraint, weak safeguarding, incomplete risk assessments, fire safety problems, medicines concerns and poor infection control. Staff training and recruitment checks were also not reliable.
Care was not consistently effective, caring or person-centred. Some people had good access to health professionals, food and activities, but inspectors found poor dignity, outdated care records, weak consent arrangements and restrictions that did not support people's rights and independence.
The overall rating was Inadequate. Safe, Effective, Caring and Well-led were rated Inadequate, while Responsive was rated Requires Improvement. The rating had fallen from Good at the previous inspection, published on 2 August 2018.
Health support
People were referred to health professionals and had health action plans or health passports to help professionals understand their needs.
“People were referred to health care professionals to support their wellbeing and help them to live healthy lives, such as the specialist epilepsy nurse, the GP, and physiotherapy.” from the report
Food and nutrition
People were supported with food and drink, involved in meal choices and encouraged to eat healthily.
“People were involved in choosing their food, shopping, and planning their meals, and staff encouraged healthy eating.” from the report
Personalised bedrooms
Inspectors found that bedrooms were clean, decorated and personalised, and that most areas were in good decorative order.
“We saw people's bedrooms were clean, decorated and personalised.” from the report
Unsafe restraint
seriousStaff used ad hoc and disproportionate physical restraint without legal authority. Some staff had not had restraint training since 2019, and there was no restraint policy or detailed guidance.
“Multiple incident reports showed staff using ad hoc, disproportionate and 'non-recognised' restraint without legal authority.” from the report
Safeguarding failures
seriousIncidents and safeguarding concerns were not effectively investigated or analysed. Inspectors said people were placed at significant risk of harm.
“This placed people at significant risk of harm.” from the report
Fire and other safety risks
seriousRisk assessments for areas including choking, restraint and fire were poor or missing. Fire doors identified as faulty had not been repaired, and one person at risk of choking had no choking risk assessment.
“The provider's own audits had identified multiple fire doors which were not working correctly since April 2023, but no action had been taken to repair them.” from the report
Medicines management
seriousMedicine instructions were unclear, authorisation for crushing tablets was missing and a distress medicine dose was changed before consulting a prescriber. Records for some remedies could also be confusing or inaccurate.
“There was no GP or pharmacist authorisation held on file.” from the report
Poor staff support and recruitment
seriousTraining, supervision and recruitment checks were inconsistent. One staff member started before a full employment history and two references had been obtained.
“Safe recruitment checks were not completed to ensure all staff were suitable for the role.” from the report
Weak leadership and culture
seriousGovernance systems did not identify or fix known problems. Staff reportedly felt unable to raise concerns safely, and the home missed required notifications to CQC.
“There were multiple indicators of a closed staff culture, which included leaders, placing people at the ongoing risk of receiving poor care.” from the report
- 01What restraint methods are staff allowed to use now, and how do you make sure every staff member is trained and competent?
- 02What action has been taken on safeguarding concerns, incidents and allegations about staff conduct?
- 03Have the fire doors, choking assessments and personal emergency evacuation plans been corrected and checked?
- 04How are medicines that may need crushing or may be used when someone is distressed authorised and reviewed by a prescriber or pharmacist?
- 05What evidence can you show that care plans, staff training, audits and consent or DoLS records have been brought up to date?
This was a full, unannounced inspection covering all five key questions, including infection prevention and control; the previous ratings were Good in 2018. This explanation was written from the published report of 11 November 2023 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, June 2021
Inspected but not rated; inspectors found good infection control arrangements during the COVID-19 pandemic.
The unannounced inspection took place on 29 April 2021. It was a targeted inspection of infection prevention and control measures in the home.
Inspectors were assured that the home was managing visiting, testing, personal protective equipment, cleaning, social distancing and infection risks. Plans were also in place to manage a possible outbreak.
The home supported people’s wellbeing during lockdown with daily walks or car drives and activities such as art, crafts and baking. The inspection did not give an overall quality rating.
Infection prevention
Inspectors were assured that the home had arrangements to prevent and manage infections, including suitable cleaning, PPE and outbreak plans.
“We were assured the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Testing with consent
People and staff had access to regular testing. The report says consent was sought and testing was not forced when people declined or were likely to become distressed.
“Consent was gained from people each time prior to testing.” from the report
Family visiting
The home arranged visits for two named family members using individual risk assessments, helping people maintain family relationships after lockdown.
“The service adhered to government guidance and arrangements were in place for the safe facilitation of visiting by two named family members.” from the report
Activities and wellbeing
Staff supported people to go out daily and offered activities at home during lockdown, including art, crafts and baking.
“Staff promoted people's wellbeing during lockdown by supporting them to go out for walks or car drives every day.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the home’s current arrangements for family visits and visitor testing?
- 02How does the home support people who become anxious or distressed by testing or other infection control measures?
- 03What are the current plans for managing an infection outbreak, including staffing and limiting staff movement?
- 04What are the home’s current arrangements for daily activities and time outside?
- 05Can we see the latest ratings or inspection findings for care, medicines, staffing and leadership, as these were not assessed in this inspection?
This was an unannounced targeted inspection of infection prevention and control during the COVID-19 pandemic; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 8 June 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 Maple House
4 rated inspections over 8 years: the service has slipped, from Good to Inadequate.
- November 2023Inadequatecurrent ratingSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- June 2021Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 January 2011.
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.
Weigh the report against the rest
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35 live-in carers within about an hour of Essex
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 £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
“She brought fun and stimulation into mums life.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.