3 November 2023
During an inspection looking at part of the service
Maple Cottage is a residential care home providing the regulated activity of accommodation and personal care to up to 5 people. The service provides support to people who have a learning disability and/or are autistic. At the time of our inspection there were 5 people using the service.
People’s experience of the service and what we found:
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the polices and systems in the service supported this practice. Staff did everything they could to avoid restraining people. People were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines to achieve the best possible health outcome.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Staff had training on how to recognise and report abuse and they knew how to apply this to their day-to-day work. The service had enough appropriately skilled staff to meet people’s needs and to keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People’s care, treatment and support plans reflected their range of needs and the risks posed.
Right Culture
Governance arrangements were effective at service level but not at provider level. The registered manager had the skills, knowledge, and experience to perform their role and a clear understanding of people’s needs but this oversight was lacking at provider level. The provider did not invest in staff by providing them with appropriate training to meet the needs of all people using the service. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity. The registered manager and team leader were visible in the service, approachable and took a genuine interest in what people, staff, family, and other professionals had to say. Staff felt respected, supported, and valued by the registered manager and team leader.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good [Published January 2018]
Why we inspected
The inspection was prompted in part due to concerns received about the use of unauthorised restraint at one of the provider’s ‘sister’ services. A decision was made for us to inspect and examine those risks.
We undertook a focused inspection to review the key questions of Safe, Effective and Well-Led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Maple Cottage on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to the management of risks, including those related to hot water outlets and the service’s fire arrangements, and the provider’s governance arrangements. We have made a recommendation about staff training.
Please see the action we have told the provider to take at the end of this report.
Follow Up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will also request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.