CQC report explained · a residential care home
What the CQC found at Maycroft
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safe recruitment checks, suitable medicines systems and processes for learning from incidents.
- Effective?
- Good
- Staff were trained and supported, and people received help with food, health needs and healthcare appointments. Inspectors found that staff sought consent and worked within the principles of the Mental Capacity Act.
- Caring?
- Good
- People were treated with dignity and respect. Staff understood how people communicated, supported their choices and encouraged independence.
- Responsive?
- Good
- Care was personalised around people's needs, preferences and interests. People were supported to keep in touch with family and friends, take part in activities and raise complaints.
- Well-led?
- Requires improvement
- Leadership and the culture had improved, but some important care records were incomplete. This included records explaining best-interest decisions, guidance for some medicines and body maps showing where creams should be applied.
What inspectors found, March 2019
Maycroft was rated Good overall, with kind and safe care, but the home Requires Improvement in how it keeps some management records.
This was a planned, unannounced inspection on 30 January 2019. One inspector and an inspection manager spoke with all five people living at the home, four relatives and staff. They also observed care and checked care records, medicines records, staff files and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were protected from harm, received their medicines as prescribed, and were supported by staff who knew them well. People were treated with respect, involved in choices and supported to stay independent and take part in activities.
Well-led was rated Requires Improvement. Some records did not clearly explain the reasons for best-interest decisions. Records were also missing guidance about giving some medicines and where creams should be applied. The report says action was taken after the inspection, and there was no impact on people.
People felt safe
Staff knew the risks affecting people and understood how to respond to signs of possible abuse or distress. Inspectors saw enough staff to meet people's needs and support them to go out.
“From our observations there was sufficient staff on duty to meet people's needs and to enable people to go out to places they enjoyed.” from the report
Kind and respectful support
Staff treated people with respect and understood their communication, including facial expressions, sounds and body language. Support followed what people wanted rather than being led by staff.
“We saw staff spoke with people with utmost respect. People responded to staff in a positive manner by smiling and holding staff hands, and saying words which indicated their contentment.” from the report
Personalised care
Staff knew people's likes, dislikes and preferred ways of receiving support. People were encouraged to make choices, keep relationships and be as independent as possible.
“People were supported by a stable staff team that had worked at the service for a number of years.” from the report
Improvement since the last inspection
The home had acted on the previous inspection findings. The earlier breaches had been met and the report describes a more inclusive culture focused on person-centred support.
“We found improvements had been made in the areas we rated as requires improvement following our previous inspection in March 2017.” from the report
Best-interest decisions were not fully recorded
needs fixingSome care plans did not clearly record the reasons for decisions made in people's best interests, including decisions about healthcare monitoring. Staff could explain the reasons, but the records did not show them clearly.
“Records were not in place to support all of the best interests decisions made for people to clearly reflect the rationale for the decisions made for people.” from the report
Some care guidance was missing
needs fixingThere was no written guidance at the inspection about how some medicines should be given or where creams should be applied. The manager said body maps were introduced after the visit.
“Records were not in place to guide staff on how to support people who had their medicines in a specific way.” from the report
Damage to some walls
minorInspectors saw areas of the home where walls needed remedial work. The issue had been identified and raised with the provider, but the report does not say that the work was complete.
“There were areas of the home that required remedial work to be undertaken due to damage to certain walls in the home.” from the report
- 01How do you now record the reasons for each best-interest decision, especially decisions about healthcare monitoring?
- 02What written guidance is now in place for people who need medicines given in a specific way?
- 03Are body maps completed and checked for everyone who needs creams, and how do you make sure they stay up to date?
- 04Has the remedial work to the damaged walls been completed, and how was it checked?
- 05How do you involve relatives and the people living here when reviewing care and making decisions?
This was an unannounced inspection that looked at all five CQC questions and both the premises and the care provided. This explanation was written from the published report of 2 March 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, June 2017
Rated Requires Improvement; inspectors found serious shortfalls in safety, dignity, choice, care planning and management.
The inspection was unannounced and took place on 15 and 16 March 2017. One inspector and an expert-by-experience observed care, reviewed records and spoke with relatives, staff, a healthcare professional and the registered manager.
The home supported five people with learning disabilities or autism. Inspectors found enough staff and suitable recruitment checks. Staff knew people well and received relevant training. However, care was not consistently safe, respectful, person-centred or based on up-to-date plans.
People were not always protected from harm, involved in decisions or supported to communicate their wishes. Inspectors also found problems with privacy, medicines practice, healthcare follow-up, records and quality checks. The home was rated Requires Improvement in all five areas and overall.
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks were completed before staff started work.
“We saw that there were enough staff deployed at the home and people received support from the correct number of staff as planned.” from the report
Staff knew people well
Many staff had worked at the home for several years. Inspectors found they were familiar with people's support needs.
“Many staff members had worked at the home for several years and told us that they were familiar with the support needs of people living at the home.” from the report
Training and handovers
Staff received relevant training and handovers included information about changes and people's support needs.
“We observed that staff received clear information through handovers as to changes at the home and people's support needs.” from the report
Community activities
People were supported to attend activities in the community and pursue some personal interests.
“People were encouraged to engage in activities in the community and records we sampled showed that staff had considered ways to help people explore and pursue interests.” from the report
Risks were not managed consistently
seriousSome risk plans were outdated or overly restrictive, while planned actions were not followed for another person. Inspectors observed that a person was able to cause further harm through self-injury.
“We observed that the person was therefore able to cause further harm through injury during our visit.” from the report
Choice and consent
seriousPeople were sometimes moved or supported with tasks without staff explaining what was happening or seeking consent. Locked areas and other restrictions had not been properly reviewed as less restrictive options.
“People were subject to additional restrictions beyond these authorisations which did not adhere to the principles of the MCA.” from the report
Dignity and privacy
seriousInspectors saw disrespectful language, discussions about people's care in communal areas and private care records left where others could access them.
“We observed that staff routinely discussed people's support needs in communal areas and in the presence of the person and others living at the home.” from the report
Weak records and checks
seriousCare records did not always give accurate, complete and current guidance. Quality checks had identified some issues but had not ensured that improvements were completed and maintained.
“Systems in place to assess, monitor and improve the quality and safety of the service were not effective.” from the report
- 01What has changed in the risk assessments and staff guidance for people at risk of self-injury?
- 02How do staff now record and show that people are supported to give consent and make everyday choices?
- 03Which bedrooms and communal areas are locked now, and how have less restrictive options been considered?
- 04How are care plans kept accurate and up to date, including people's communication, nutrition and healthcare needs?
- 05How do managers check that improvements are completed, records are secure and staff consistently protect dignity and privacy?
This was an unannounced inspection covering all five CQC questions, with observations, records checks and discussions with relatives, staff, a healthcare professional and the registered manager. This explanation was written from the published report of 20 June 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 Maycroft
3 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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.
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