Maidstone Care Centre

Updated 6 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Maidstone Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Maidstone Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for a week and planned to submit an application to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who use the service and 4 relatives about their experience of the care provided. We spoke with 11 members of staff including the manager, head of quality and governance, interim manager, the provider, associate practitioner, nursing staff, wellbeing staff and care staff including agency staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records including 9 people’s care records and multiple medicine administration records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, such as audits, meetings, monitoring, and training were reviewed. After the inspection we spoke with the local authority.

Updated 6 December 2023

About the service

Maidstone Care Centre is a residential care home providing personal and nursing care to up to 58 people. At the time of our inspection there were 52 people using the service. The service provides support to people who may be living with dementia who require support and nursing care. The service is arranged over 3 floors with lift access.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

There were not enough staff employed to meet people’s needs. The service employed large numbers of agency staff, these were not always regular agency staff. People were not consistently supported by staff who knew their needs. Potential risks to people’s health and welfare had been assessed but there was not always guidance in place for staff to mitigate all the risks.

Medicines were not always managed safely. Accidents and incidents had been recorded and some analysis had been completed but more detail was needed to reduce the risk of them happening again. The provider had organised bespoke dementia training for staff, however, very few staff had attended, and the recommendations had not been consistently deployed.

There had not been a consistent management team in place to drive improvement and the service continued to be in breach of regulations. Audits had been completed but action had not always been taken to rectify the shortfalls identified. A new manager had started the week of the inspection, they had already identified most of the shortfalls found at this inspection. Following the inspection, they supplied evidence of the improvements they had put in place.

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 policies and systems in the service supported this practice.

People were supported to remain as independent as possible, and their privacy was respected. People and relatives were invited to meeting to express their concerns and suggestions, the provider had responded to suggestions, including the employment of a receptionist at the weekend. Complaints had been investigated and apologies given when the complaint had been upheld.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 July 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had not been made and the provider continued to be in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

We received concerns in relation to risk management, staffing levels and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well -led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Maidstone Care Centre on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.