CQC report explained · a nursing home
What the CQC found at Maple Leaf House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, staff knew how to report abuse, recruitment checks were completed, and medicines and infection control were managed safely.
- Effective?
- Good
- People had assessments before moving in, staff had suitable training and support, and people were helped with food, drink and access to health services. Inspectors recommended more work on orientation around the home.
- Caring?
- Good
- Staff knew people well and treated them with kindness, patience, dignity and respect. People and relatives were involved in care planning and daily choices.
- Responsive?
- Good
- Care plans included people's preferences, communication needs, interests and life history. Visitors were welcomed, activities were adapted to individuals, and complaints were handled in line with the home's policy.
- Well-led?
- Good
- Inspectors found an open and supportive culture, regular quality checks and good partnership working. Staff said communication had improved, and the manager was working on further improvements.
What inspectors found, August 2019
Rated Good; inspectors found safe, kind and personalised care, with further work needed to help people find their way around the home.
This was an unannounced planned inspection on 27 June 2019. Inspectors spoke with three people using the service, two relatives and seven staff. They also reviewed care, medicine, training and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, medicines were managed safely, staff were trained, and people's health and care needs were planned and reviewed.
People were treated kindly and with respect. They were supported to make choices about daily life, food, activities and care. Relatives and professionals gave positive feedback about the care and communication.
Inspectors recommended further work to help people orientate themselves in communal areas. The home was being refurbished, but there were few pictures or objects to help people engage with their surroundings. The overall Good rating was unchanged from the previous inspection published in December 2017.
Safe medicines and risk checks
Risk assessments were reviewed, and inspectors saw trained staff follow safe procedures during a medicine round. Storage, records and as-needed medicine guidance were also checked.
“Medicines were managed, stored and disposed of safely.” from the report
Kind and respectful care
Staff knew people well and supported their dignity, privacy, independence and personal choices. Relatives gave strong positive feedback about the staff team.
“We observed shared smiles and laughter, staff demonstrated kindness and were patient with people.” from the report
Personalised support
Care plans included people's health needs, communication, culture, religion, food preferences, interests and life history. Activities were adapted to people's mood and choices.
“Care and support plans were written with the person at the centre of their care.” from the report
Supportive management and staff
Staff received induction, training, supervision and appraisals. The manager used checks, meetings and feedback to monitor and improve the service.
“The provider, management team and staff had developed an open and honest culture, people and staff found them friendly and supportive.” from the report
Orientation in communal areas
needs fixingThe home was being refurbished, but there were few pictures or objects in shared areas to help people engage with the setting. Signs had been added to bedroom doors but not carried through into communal areas.
“Some work had taken place in the form of signage on people's room doors to assist them with orientation, However, this had not been followed through to communal areas and required further development.” from the report
Communication aids
minorPeople's communication needs were recorded, but the manager agreed to explore further methods and aids to support communication.
“We discussed with the manager the use of other methods and aids to support people to communicate.” from the report
- 01What changes have been made to signs, pictures and other orientation aids in the communal areas?
- 02What communication aids are available for someone who has difficulty speaking, hearing or understanding information?
- 03How will you make sure my relative's food, drink, health needs, culture and personal preferences are recorded and followed?
- 04How are activities adapted if my relative does not want to follow the planned schedule?
- 05How will relatives be involved in care plan reviews and kept informed about changes?
This was an unannounced planned inspection covering all five CQC questions, and the home was rated Good in each; the previous inspection rating was also Good. This explanation was written from the published report of 20 August 2019 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, December 2017
Rated Good; inspectors found safe, kind and responsive care, with improvements sustained since the previous inspection.
This was an unannounced comprehensive inspection on 14 June 2017. Inspectors reviewed care, medicines, staff records and quality checks. They spoke with eight people, six relatives and 13 staff, and observed care.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training, kind relationships and care plans that reflected people's wishes.
The home had previously been rated Requires Improvement, with breaches linked to medicines and governance. Inspectors found the required improvements had been made and sustained. However, after the visit the manager left, and a new manager was registering. A safeguarding investigation into an injury was still unfinished when the report was published.
Medicines were safer
Inspectors found that the earlier medicines problems had been corrected. Records were complete for the medicines reviewed, including stronger medicines needing tighter controls.
“The medicine administration records had been completed correctly for all medicines we reviewed, this included records for stronger medicines which required tighter controls and recording.” from the report
Kind and dignified care
People and relatives spoke positively about staff. Inspectors saw staff respond promptly and help people while protecting their dignity.
“Staff knew the people who lived at the home well and treated them with kindness and consideration.” from the report
Staff understood people's needs
Staff had relevant training and knew how to support people with dementia and behaviour that could challenge. They used reassurance and de-escalation techniques.
“Staff had a detailed knowledge and understanding of people's needs which further supported their training and helped to provide personalised care.” from the report
Quality checks had improved
The provider introduced checks and action plans covering areas such as medicines, care plans, accidents and incidents. Inspectors found the earlier governance problems had been addressed.
“At this inspection we found that improvements had been made to the governance within the home and the provider was meeting their legal requirements.” from the report
Activities were not yet fully personal
minorInspectors found people had activities, but the manager had identified that these were not always personalised to individual interests. An activity programme and co-ordinator were being introduced.
“The registered manager at the time of our inspection had identified that the activities offered were not personalised to individual interests” from the report
Safeguarding investigation was unfinished
needs fixingAfter the inspection, the home reported an injury that was being investigated by the local safeguarding team. The report did not give the outcome.
“At the time of publishing the report the outcome of the safeguarding investigation has not been decided.” from the report
- 01How many staff are planned for each night shift, and what happens if a member of staff calls in sick at short notice?
- 02What activities are now available that match my relative's interests, history and abilities?
- 03Has the safeguarding investigation into the injury been completed, and what actions followed?
- 04Who is the current manager, and has their registration with the CQC been completed?
- 05How will my relative and family be involved in reviewing the care plan and making decisions about care?
This was an unannounced comprehensive inspection covering the overall quality of the home and all five CQC questions on 14 June 2017. This explanation was written from the published report of 16 December 2017 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 Leaf House
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementstayed Requires improvementSafe: Good
- May 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2014
Registered with the Care Quality Commission on 26 November 2014.
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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