CQC report explained · a residential care home
What the CQC found at Maylands
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed or recorded safely. Risk guidance was not always up to date or detailed enough, and accident and incident checks did not look properly for patterns.
- Effective?
- Good
- Staff had training and understood people's needs. People were supported with food, drink, healthcare and changing needs.
- Caring?
- Good
- Inspectors saw kind and respectful care. People were supported to make choices, keep their independence and have their privacy protected.
- Responsive?
- Good
- Care was personalised and staff understood people's communication styles and preferences. People were supported with activities, relationships, complaints and end of life care.
- Well-led?
- Requires improvement
- Care plans and risk information were not always current. Audits did not reliably identify problems with care plans or medicines.
What inspectors found, December 2021
Rated Requires Improvement; inspectors found kind, personalised care but medicines, risk records and management checks were not reliable enough.
Inspectors visited without notice on 11 and 13 October 2021. They spoke with people, relatives, staff and health professionals. They reviewed care plans, medicines records, staff files and management records.
People and relatives said they felt happy and safe. Staff were kind, respectful and supported people's choices and independence. The home also supported people with food, healthcare, activities and family contact.
There were important safety problems. Medicines were not always recorded or managed safely. Some care plans did not give staff enough up-to-date guidance about risks such as choking and constipation. Accident records and management audits did not reliably identify patterns or poor practice.
The overall rating was Requires Improvement. Effective, caring and responsive were rated Good. Safe and well-led were rated Requires Improvement. Compared with the last inspection in 2017, the overall rating fell from Outstanding, and caring and responsive fell from Outstanding to Good.
Kind and respectful care
Inspectors saw many positive interactions. People appeared happy with staff, and relatives said people were treated kindly.
“We observed countless positive interactions between people and staff.” from the report
Choice and independence
Staff supported people to make everyday and important decisions. The home made changes to help people do more for themselves.
“People were supported to as independent as possible.” from the report
Personalised support
Staff knew people's communication styles and preferences. Activities and support were adapted to people's needs, including during the pandemic.
“We observed staff change their approach from person to person.” from the report
Staffing and infection control
Inspectors saw enough staff to meet people's needs. They were assured that infection prevention measures, including PPE, testing and visiting arrangements, were in place.
“We observed there to be sufficient staff to meet people's needs and keep them safe.” from the report
Medicines records
seriousNight-time medicines were not always signed for because staff could not access all the required records. Patch positions and some required double signatures were also not recorded properly.
“There was a risk people would not receive their medicines as prescribed or receive the wrong medicine.” from the report
Risk guidance
seriousSome care plans did not explain clearly enough what staff should do if a person choked or became constipated. Guidance did not always reflect people's current needs.
“When people were at risk of choking, there was no guidance for staff to follow should the person choke.” from the report
Learning from incidents
needs fixingThe home recorded accidents and incidents but did not properly review them for trends, such as whether they happened at similar times.
“There was no oversight of accidents and incidents, to review for trends and patterns” from the report
Management checks
seriousCare plan and medicines audits did not identify important problems. This meant management systems did not give enough assurance that safety was being managed effectively.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
- 01What changes have you made to ensure night-time medicines are always available, administered as prescribed and signed for correctly?
- 02How are you now recording and checking the position of pain relief patches and medicines needing double signatures?
- 03Have all care plans been updated with clear instructions for choking, constipation and other changing risks?
- 04How do you now review accidents and incidents for patterns and make sure lessons are acted on?
- 05What evidence can you show that your medicines and care plan audits now identify problems promptly?
This inspection looked at the care home and the personal care provided through the supported living service; only one supported living person was receiving personal care, and CQC did not inspect supported living premises. This explanation was written from the published report of 1 December 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.
What inspectors found, March 2017
Rated Outstanding; inspectors found exceptionally caring, personalised support, with safe and effective care and good leadership.
The inspection was unannounced and took place on 18 January 2017. One inspector and an expert by experience observed care, spoke with people, staff, relatives and professionals, and reviewed care files, medicines records, staffing information and quality checks.
The home was rated Outstanding overall. Caring and Responsive were Outstanding. Safe, Effective and Well-led were Good. Inspectors found enough trained staff, safe medicines practices, suitable support with health needs and detailed care plans.
People were treated as individuals and supported to make choices, stay in touch with family and take part in activities they enjoyed. Inspectors also found strong support for people nearing the end of their lives and for people developing greater independence.
The previous inspection was in May 2013 and found no concerns. This report does not identify any breaches or enforcement action.
Personalised care
Care plans gave staff detailed information about each person's communication, preferences, routines, health and support needs. Bedrooms were personalised to individual tastes.
“Care plans gave staff an in-depth understanding of the person and were personalised to help staff to support the person in the way that they liked.” from the report
Kind and respectful staff
Inspectors saw warm relationships between staff and people. Staff adapted their communication and gave people time, privacy and dignity.
“Staff knew people well, were kind, caring and compassionate and had developed positive relationships with people and their family members.” from the report
Activities and family contact
People were supported to take part in activities and social events based on their interests. The home also worked hard to help people keep in touch with family and friends.
“People were supported to take part in a wide range of activities and an array of social events both within the home and in the community.” from the report
Developing independence
The home supported people to build confidence and independence, including travelling, personal care and moving on to more independent living where appropriate.
“Meaning their independence had been nurtured to achieve a positive outcome.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are currently on duty on each shift, and how do you cover sickness or short-notice absences?
- 02How are activities planned around each person's current interests, health and communication needs?
- 03How do you check that each person's care plan is up to date and reflects their current wishes?
- 04Which people currently have DoLS authorisations or applications in progress, and how are restrictions reviewed?
- 05How would you support my relative's end-of-life wishes and keep the family involved?
This was an unannounced inspection covering all five CQC questions; the previous inspection was in May 2013 and found no concerns. This explanation was written from the published report of 31 March 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 Maylands
2 rated inspections over 5 years: the service has slipped, from Outstanding to Requires improvement.
- December 2021Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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39 live-in carers within about an hour of Kent
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. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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.