CQC report explained · a nursing home
What the CQC found at Mapleford Nursing home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Requires Improvement overall, with Well-led rated Inadequate; the home is in special measures because medicines, consent and management systems still had serious gaps.
This was an unannounced follow-up inspection on 20 and 21 September 2023. Inspectors observed care, spoke with people, relatives and staff, and checked care records, medicines, recruitment, training, safety checks, incidents and management audits.
The home had improved from Inadequate to Requires Improvement overall. Staffing, recruitment, risk management, infection control, staff training and the home environment had improved. People said they felt safe and had no complaints.
Important problems remained. Medicines were not always managed safely. Consent was not always properly recorded or obtained. Care plans were not always accurate or developed with people and relatives. Management checks had failed to find or fix these issues.
The home remained in breach of regulations about consent, safe care and treatment, and good governance. Its Well-led rating was Inadequate, and the home was placed in special measures for continued Inadequate ratings across inspections.
Staff training
Staff had the induction, training and support needed for their roles. Training records showed a high completion rate and regular refresher training.
“Staff received the induction, training and support they needed to carry out their roles effectively.” from the report
Improved environment
The home had been redecorated and new furniture had been bought. Bedrooms were spacious and personalised, with secure gardens available.
“Significant improvements had been made to the design and decoration of the home.” from the report
Risk and safety checks
Individual risks were managed safely, equipment was maintained and emergency evacuation plans were in place. Accident and incident records showed that action was taken to reduce risks.
“Individual risks were managed safely, and staff were aware of people's specific care needs.” from the report
People felt safe
People told inspectors they felt safe at the home. Staff had safeguarding training and understood how to raise concerns.
“People told us they felt safe living at Mapleford Nursing Home.” from the report
Medicines management
seriousInstructions were not always available for variable doses, and records for skin treatments were not always accurate. Medicines were not always disposed of promptly, and audits missed some problems.
“Information was not always available to support the administration of medicines when there was a variable dose, for example an option to give 1 or 2 tablets.” from the report
Consent and best-interest decisions
seriousPeople and relatives were not always involved in best-interest meetings. Consent forms were sometimes missing or unsigned, putting people at risk of receiving care without proper consent.
“People and their relatives had not always been consulted when best interest meetings took place.” from the report
Care plans and referrals
needs fixingCare plans and risk assessments had improved but were still not always accurate. Some referrals about dietary needs were not made promptly, and relatives were not always involved in care planning.
“Although we saw an improvement to people's care plans and risk assessments, there were still shortfalls in this area.” from the report
Weak management oversight
seriousAudits did not reliably identify or correct problems with medicines, consent and referrals. Some staff had not received supervision for over a year, and staff did not always feel able to raise concerns.
“The provider had failed to assess, monitor and improve the quality of the service.” from the report
- 01How do you check variable medicine doses and records for topical treatments before medicines are given?
- 02How will you make sure consent forms are completed and signed, and that relatives are involved in best-interest decisions?
- 03How will you review care plans so they are accurate, reflect dietary needs and involve the person and their relatives?
- 04What actions are being taken in response to the Regulation 17 warning notice, and how will you show that audits are finding and fixing problems?
- 05How often will staff receive supervision, and how can staff and relatives raise concerns if they feel issues are not being resolved?
This was an unannounced follow-up inspection focused on the areas requiring improvement; the report gives ratings for Safe, Effective and Well-led but no separate ratings for Caring or Responsive. This explanation was written from the published report of 7 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, March 2023
Rated Inadequate and placed in special measures; inspectors found serious problems with staffing, medicines, safety, care planning and management.
Inspectors visited on 19, 23 and 24 January 2023. The first visit was unannounced. They spoke with people, relatives, staff and healthcare professionals, and checked care records, medicines records, staff files and management audits.
They found that staffing was sometimes too low to keep people safe or help them when needed. Medicines records were incomplete, risks were not always recorded properly, and the environment was unsafe, unclean and in poor condition. Staff training and induction were also not always adequate.
The home was rated Inadequate overall. Safe and well-led were rated Inadequate, while effective was rated Requires Improvement. Caring and responsive were not separately rated in this report. The previous overall rating was Good, published on 5 November 2020.
Safe recruitment
The home carried out appropriate checks before staff started work.
“The provider ensured staff were recruited safely.” from the report
People felt safe
Some people and relatives told inspectors they felt safe and believed staff cared about them.
“People told us they felt safe and relatives felt their family members were safe at the home.” from the report
Safeguarding awareness
Staff spoken to knew what action to take if they were concerned about abuse. Safeguarding investigations and relevant notifications had been completed when appropriate.
“Staff we spoke with were aware of the action to take if they had any concerns about abuse.” from the report
Links with healthcare services
Staff worked with community professionals when people needed additional support, including GPs, nurses, speech and language therapists and dietitians.
“The management, nurses and care staff worked in partnership with community professionals when people needed additional support.” from the report
Visiting arrangements
Friends and family could visit in line with government and public health guidance, and visitors were made welcome.
“Friends and family were able to visit people in line with Government guidance and local Public Health advice.” from the report
Too few staff
seriousThere were times when staff could not monitor communal areas or respond promptly to people's needs. Inspectors saw people asking for help to use the toilet and being told no staff were available.
“We observed people asking for support to go to the toilet being told there were no staff available to support them.” from the report
Medicines records
seriousRecords for medicines, prescribed creams and restricted fluids were not always complete or accurate. This meant inspectors could not be sure people received medicines as prescribed.
“Medicines administration records were not always completed correctly, so we could not be sure people received their medicines as prescribed.” from the report
Unsafe and unclean environment
seriousInspectors found damaged furniture and fixtures, dirty laundry in bathrooms, rusty bins, odours, sticky flooring and damaged kitchen worktops. Repairs and improvements had not been completed promptly.
“There was a lack of effective infection prevention and control processes and practices at the home.” from the report
Risks not properly recorded
seriousCare plans did not always show important risks, including falls, choking and special diets. Staff therefore did not always have accurate guidance on how to keep people safe.
“One person on a pureed diet, who was at risk of choking, did not have a choking risk assessment in place.” from the report
Staff training
seriousMany staff had not completed required training, or their training was overdue. This included moving and handling, fire safety, safeguarding and medicines training.
“Many staff had either not completed any of the provider's required training or it was overdue.” from the report
Weak management oversight
seriousManagers and the provider had not identified or acted on many problems. Audits were missed or ineffective, and the provider had carried out very little monitoring.
“There was a lack of effective oversight by the provider.” from the report
- 01What staffing levels are now in place on each unit, and how are they matched to people's current needs?
- 02How do you check that medicines, prescribed creams and fluid restrictions are recorded correctly every time?
- 03Which repairs, cleaning improvements and infection control changes have been completed since the inspection?
- 04How many staff have now completed medicines, safeguarding, moving and handling and fire safety training?
- 05How are people and relatives now consulted before changes are made to bedrooms, units or care arrangements?
This inspection was prompted by concerns about medicines, infection control, the environment, staffing, support and management; it rated Safe, Effective and Well-led, while Caring and Responsive were not separately rated. This explanation was written from the published report of 22 March 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.
Every inspection of Mapleford Nursing home
7 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- March 2023Inadequatedown from GoodSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- November 2020GoodSafe: GoodEffective: GoodWell-led: Good
- November 2020Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Inspected but not ratedSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2020
Registered with the Care Quality Commission on 15 July 2020.
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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.