CQC report explained · a nursing home
What the CQC found at Maple Manor 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
- People were protected from abuse, there were enough staff and medicines were managed safely. However, risk assessments and records were not always complete or up to date, and some parts of the home needed better cleaning and maintenance.
- Effective?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried over from the last inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Inspectors did report that people received kind and compassionate care and that staff respected people's privacy and dignity.
- Responsive?
- Good
- This key question was not inspected during this visit. Inspectors reported that people were supported with meaningful activities, travel and involvement in care planning.
- Well-led?
- Requires improvement
- The provider's checks had not identified important risks, and the home had not made enough improvement over a prolonged period. There had also been no registered manager in post for approximately 18 months.
What inspectors found, September 2022
Maple Manor Care Home is rated Requires Improvement; inspectors found kind care and enough staff, but risk records and management checks were not reliable.
This was an unannounced inspection on 22 July 2022. One inspector reviewed records, observed care, spoke with four relatives and talked with managers and staff. The inspection focused on whether the home was safe and well-led.
People were protected from abuse, had enough staff support and received medicines safely. Staff treated people with kindness and worked with other professionals. However, some areas needed better cleaning and maintenance, and care plans did not always fully describe people's needs.
Inspectors found missing or incomplete risk information, including plans for choking and epilepsy. Staff did not always record distress as required. The home's own checks had not identified these problems, and there had been no registered manager for about 18 months.
The home remains rated Requires Improvement. This was its fourth consecutive rating at this level. The provider was required to send an action plan, and CQC said it would monitor progress and return for another inspection.
Enough staff
Inspectors found there were enough staff to meet people's needs and keep them safe. Relatives had no concerns about staffing levels or delays in support.
“There were enough staff to meet people's needs and ensure their safety.” from the report
Safe medicines
Staff who administered medicines were trained, medicines were stored correctly and records were accurate. Regular checks were used to help prevent errors.
“Staff responsible for administering medicines received appropriate training and managed medicines consistently and safely.” from the report
Kind and respectful care
People received compassionate care. Staff protected people's privacy and dignity and responded to their individual needs.
“Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs.” from the report
Working with other professionals
The home made prompt referrals and worked with dieticians, mental health professionals and advocacy services to support people.
“The provider worked well and effectively with other agencies.” from the report
Incomplete risk plans
seriousSome important risks were not fully assessed or recorded. Inspectors found no mitigation plans for one person's choking risk and another person's epilepsy, increasing the risk that staff would not know how to respond in an emergency.
“The provider had failed to robustly assess the risks relating to the health safety and welfare of people.” from the report
Distress was not always recorded
needs fixingStaff did not consistently record episodes of distressed behaviour, even though the care plan required this. This could make it harder to identify triggers and the best support.
“The staff did not consistently record the person's distressed behaviour.” from the report
Weak management checks
seriousThe provider's audits did not identify some problems before the inspection. Inspectors said the home had failed to improve over a prolonged period and that its systems placed people at risk of harm.
“The provider failed to make improvements over a prolonged period of time.” from the report
No registered manager
needs fixingThere had been no registered manager for approximately 18 months, despite this being a legal requirement for the service.
“There has not been a registered manager in post for approximately 18 months.” from the report
Premises needed attention
minorSome communal areas had marked or scuffed skirting boards and door frames, and taps needed descaling. Inspectors said this could reduce the effectiveness of cleaning.
“Some areas of the home, for example skirting boards and door frames in the communal areas were marked and scuffed and the taps needed descaling.” from the report
- 01What has been done to create and regularly review clear plans for choking, epilepsy, weight loss and other health risks?
- 02How do staff record and review periods of distressed behaviour, and how is this information used to identify triggers?
- 03What checks now make sure care plans fully reflect each person's needs?
- 04What action has been taken to improve the provider's audits and prevent the same risks being missed again?
- 05Who is currently responsible for management while there is no registered manager, and when will a registered manager be appointed?
This was an unannounced focused inspection of Safe and Well-led; the report says ratings for key questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 13 September 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, November 2021
Requires Improvement; inspectors found improvements in medicines, incidents and management, but ongoing risks in care records, staffing and activities.
This was an unannounced focused inspection on 28 September 2021. Inspectors visited the home, observed care, spoke with staff and one person, reviewed records and contacted four relatives.
The home had improved since the previous inspection. Medicines, infection control, incident recording and management oversight were better. The provider was no longer in breach of Regulations 12 and 17.
However, some care plans and risk assessments were not reviewed regularly. High staff turnover affected relationships with people, and more meaningful activities and positive interactions were needed. The overall rating remained Requires Improvement.
Improved medicines management
Inspectors found that medicines were managed safely, including ordering, storage, returns and as-required medicines.
“The medicines were managed safely. Procedures for ordering, storing and returning unused medicines followed best practice guidance.” from the report
Better incident learning
Incident and behaviour records had improved, helping the home understand patterns and reduce future risks.
“Behavioural incident records and ABC records were of good quality.” from the report
Infection control
Inspectors were assured about the home's arrangements for preventing and managing infection, including PPE, testing and visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Improved staff support
Staff said they felt more confident and better supported following changes in management.
“Staff told us they felt more confident and better supported to meet people's needs since the changes in the management structure.” from the report
Care records were not always current
needs fixingSome care plans and risk assessments were not reviewed regularly. This meant they did not always reflect people's needs and could increase the risk of needs not being met.
“not all care plans and risk assessments were reviewed regularly.” from the report
Agency staff checks
needs fixingNot all agency staff had completed profiles showing that appropriate suitability checks had taken place.
“not all agency staff had an Agency Staff Profiles in place.” from the report
Staff turnover
needs fixingThe high turnover of staff affected morale, teamwork and the ability to form positive relationships with people.
“The high turnover of staff impacted on staff's ability to form positive rapport with people.” from the report
Activities and personal spaces
minorThe home needed more meaningful activities inside the home. Some bedrooms were not personalised, and the building's size and design did not follow best practice guidance.
“The service size and design were not in line with the best practise guidance and some people's bedrooms were not personalised.” from the report
- 01How often are each person's care plans and risk assessments now reviewed, and who checks that they reflect current needs?
- 02Have completed suitability profiles now been obtained for every agency worker?
- 03What is being done to reduce staff turnover and increase the number of permanent staff?
- 04What meaningful activities are now available inside the home, including for people who do not go out?
- 05What changes have been made to personalise bedrooms and improve the home environment?
This was a focused inspection of Safe and Well-led, including infection prevention and control under Safe; the report does not give ratings for the other three questions. This explanation was written from the published report of 9 November 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 Manor Care Home
5 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2021Requires improvementSafe: Requires improvementWell-led: Inadequate
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2017GoodSafe: GoodWell-led: Good
- February 2016
Registered with the Care Quality Commission on 24 February 2016.
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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