CQC report explained · a nursing home
What the CQC found at Maple Leaf House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicine records were incomplete, medicine disposal was not always safe, and risk assessments were not always updated after changes in people's needs. There were enough staff, and safeguarding and infection control arrangements were positive.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality systems did not always lead to effective action, and care records were not consistently accurate or up to date. Some staff and relatives also reported poor communication, low morale and limited management visibility.
What inspectors found, November 2022
Maple Leaf House was rated Requires Improvement; inspectors found risks with medicines and records, alongside kind care and enough staff.
This was an unannounced focused inspection on 25 October 2022. Inspectors spoke with people, relatives and staff, observed communal areas, and checked care, wound, medicine and management records.
The home was not always safe. Medicine records were incomplete, disposal arrangements were not always safe, and risk assessments and care plans were not consistently updated when people's needs changed. There were enough staff, but heavy use of agency staff affected continuity and person-centred care.
The home was not always well-led. Systems did not make sure identified problems were fixed, records stayed accurate, or staff understood who was responsible for key tasks. Communication with relatives and staff was also not always effective.
The overall rating changed from Good at the previous inspection, published on 8 October 2019, to Requires Improvement. The provider took some immediate action after the inspection, and CQC asked for an action plan and said it would continue to monitor the home.
Enough staff
Inspectors found enough staff to meet people's assessed needs, including one-to-one support. Call bells were answered quickly and communal areas were supervised.
“There was enough staff to meet the needs of people using the service.” from the report
Safeguarding
Staff understood how to report safeguarding concerns. The home worked with local safeguarding teams and relatives said people felt safe.
“People were protected from the risk of abuse.” from the report
Kind treatment
Inspectors saw staff treating people kindly and respecting their equality characteristics. Relatives described care staff as dedicated.
“We observed staff to treat people with kindness and respected their equality characteristics.” from the report
Mental capacity
Inspectors found the home was working within the principles of the Mental Capacity Act, with appropriate legal authorisations where needed.
“We found the service was working within the principles of the MCA” from the report
Partnership working
The home shared information appropriately and worked with local authority, commissioning and health and social care professionals.
“The service worked collaboratively with a range of external stakeholders and agencies.” from the report
Medicine safety
seriousMedicine administration records had missing signatures and temperature checks were missing. Some disposal containers were unsafe, creating a risk that medicines could be taken from them.
“Medicines were not always managed safely. Risks to people were not always reviewed when their needs changed.” from the report
Out-of-date care records
seriousCare plans and risk assessments were not always reviewed after incidents, hospital stays or changes in need. This meant staff did not always have current guidance to provide safe care.
“The provider failed to keep accurate and up to date records of people using the service.” from the report
Agency staff and continuity
needs fixingThe home relied heavily on agency staff. Relatives and staff said this meant less continuity and made it harder to provide person-centred care for people with dementia.
“There are always a lot of agency staff and it feels like there is a lack of continuity for residents with dementia.” from the report
Communication and morale
needs fixingSome relatives did not feel connected to the home, and some staff felt their feedback was not acted on. Staff also reported stress and low morale.
“Not all staff spoke of a positive culture within the home.” from the report
- 01What changes have been made to make medicine administration records complete and medicine disposal safe?
- 02How will you make sure care plans and risk assessments are updated promptly after incidents, hospital stays or changes in need?
- 03How many permanent nurses and care staff are now in post, and how are agency staff given clear information about each person's needs?
- 04How will you show relatives that communication with management has improved?
- 05How are staff concerns and feedback recorded, acted on and checked for improvement?
This was a focused inspection of Safe and Well-led, including infection prevention and control under Safe; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 19 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, December 2020
Inspected but not rated; inspectors were assured that infection prevention and control arrangements were safe during a COVID-19 outbreak.
This was an announced, targeted inspection on 12 November 2020. It was carried out because the home had a COVID-19 outbreak and focused on infection prevention and control.
Inspectors found good practice. They were assured that the home used PPE safely, had enough supplies, increased cleaning, arranged testing and followed guidance on visiting, shielding and social distancing.
The home was inspected but not rated. This means the inspection did not provide an overall rating or full ratings for the five areas of care.
PPE and infection control
Staff had been trained to use PPE, and inspectors found that it was being put on, removed and disposed of safely.
“Staff had received training in the use of personal protective equipment (PPE) and ensured these measures were followed putting on, taking off and disposing of PPE.” from the report
Testing and outbreak response
The home tested staff and residents so that people could be isolated quickly when needed.
“Testing was completed within the home for staff and people using the service, this ensured swift action could be taken to isolate and to reduce any further risks to others.” from the report
Cleaning and supplies
Cleaning had been increased in areas that people often touched, and the home had a good supply of PPE.
“The cleaning within the home had been increased to cover high touch areas and the cleaning products reviewed to ensure they had the required properties to eliminate the virus.” from the report
Staffing and visiting
Inspectors found enough staff to meet people's needs. Relatives were kept informed about visiting guidance and safety checks were used when visits could take place.
“There were enough staff to support the needs of the people, when required consistent agency staff were used, this reduced the risk of transition between homes.” from the report
Inspectors raised no specific concerns in this report.
- 01How are PPE supplies, staff training and safe use of PPE checked now?
- 02How is testing arranged for residents and staff, and what happens if someone tests positive?
- 03What cleaning schedule is used for high-touch areas, and how is it checked?
- 04What are the current visiting arrangements and what safety checks are required?
- 05What recent information can you provide about the home's ratings for Effective, Caring, Responsive and Well-led?
This was a targeted inspection of infection prevention and control under Safe only; it did not assess the other four areas or provide an overall rating. This explanation was written from the published report of 5 December 2020 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
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
62 live-in carers within about an hour of Derbyshire
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 £1,010 to £1,260 a week. 51 can care for a couple. 12 years' experience on average.
“Ernest is an amazing professional carer who delivers care from the heart.”
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
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.