Archived: Maitland House

At our last inspection in July 2018 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated any risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service continued to meet all the fundamental standards and had a registered manager as required. The registered manager was present and assisted us with the inspection.

People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. Medicines were handled correctly and safely.

People received effective care and support from staff who knew them well and were trained and supervised. We have made a recommendation related to reviewing the ongoing staff training at the service.

People received care and support which was personalised to meet their individual needs. They knew how to complain and staff knew the process to follow if they had concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's right to make their own decisions were protected.

People benefitted from a service which had an open and inclusive culture. Staff were happy working at the service and people benefitted from having staff who felt well managed and supported.

People were treated with care and kindness and their right to confidentiality was protected. People's diversity needs were identified and incorporated into their care plans where applicable. People were treated with respect and their dignity was upheld.

Further information is in the detailed findings in the full report.

Abbeyfield Reading Society Limited is a care home providing accommodation and personal care for up to 28 older people. At the time of the inspection the service was full and 28 people were in residence. There was a registered manager in post, a registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service benefitted from the stable management of the registered manager and the deputy manager who had both been in post for a number of years.

The registered manager monitored the quality of the service and sought regular feedback from people and other stakeholders. They encouraged an open and transparent culture and nurtured a good team working spirit.

People were safe at Abbeyfield Reading Society Limited. They enjoyed living in a calm and relaxed environment where interactions were seen to be friendly and caring. People were protected by staff who had the knowledge and skills to identify and report any safeguarding issues.

People were protected from being cared for by unsuitable staff as the provider completed thorough recruitment checks. We found there were sufficient numbers of staff to meet people’s needs. People received their medicines safely and when they required them. Medicines were ordered, stored and managed safely.

Risk assessments were completed and included those associated with individuals such as falls, skin integrity and nutrition as well as those related to the environment such as fire and legionella. When risks were identified guidance was provided to minimise the risk while still respecting people’s freedom and choice.

The service was well maintained, clean and provided a safe environment for people. The provider had an on-going development plan to maintain and improve the premises. We saw a recent project had resulted in a permanent gazebo and a sensory area in the garden which people were enjoying.

People had their right to make decisions protected. The registered manager understood their responsibilities with regard to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Although there were no DoLS authorisations in place at the time of the inspection, a need had been identified and an application was about to be made for one person.

Staff understood their responsibilities regarding gaining consent and offering choice to people. They helped people to be as independent as they wished to be.

Staff were supported through effective training which was refreshed regularly. They had individual meetings with their manager and attended team meetings. Their work was appraised during their one to one meetings.

People enjoyed nutritious, freshly prepared food. When required staff monitored people’s nutrition and referred them to specialist healthcare professionals for advice when necessary. People were able to see their GP or other health professionals in order to maintain their health and well-being.

People had their privacy and dignity respected. Staff interacted in a positive way with people and were polite and friendly in their approach. People appeared relaxed and we saw examples of humour being shared between them and staff members.

People’s care was reviewed regularly and care plans were updated promptly to reflect any changes. An activities co-ordinator managed a programme of activities which people could choose to take part in if they wished. Where people found it difficult to leave their rooms due to their condition, this was monitored and staff were encouraged to spend time with them to avoid social isolation.

The inspection team who carried out this inspection consisted of two inspectors. During the inspection, we worked together to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe and secure. The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place. We saw that the home was clean and well maintained.

Procedures for dealing with emergencies were in place and staff were able to describe the action they would take to ensure the safety of the people who use the service.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made the Manager was able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they had been fully involved in the assessment of their health and care needs and had contributed to developing their care plan. Assessments included needs for any equipment, mobility aids and specialist dietary requirements. One person told us: 'I have a walking frame they gave me and it gives me confidence.'

People had access to a range of health care professionals some of whom visited the home. For example: The Stroke specialist team and Speech and language therapist. This meant that people were sure that their individual care needs and wishes were known and planned for.

Is the service caring?

People were supported by kind and attentive staff who spoke politely to them. We saw that care workers showed patience and gave encouragement when supporting people, offering explanation when necessary. People commented: "They ask us if we like things; they're very good at explaining things."

Staff were aware of people's preferences, interests, aspirations and diverse needs. Our observations of care provided and discussions with people told us that individual wishes for care and support were accounted for and respected. Records we reviewed also confirmed this.

Is the service responsive?

People told us, that they were able to participate in a range of activities both in the home and in the local community. One person told us they were looking forward to going out for lunch with some other people on the day of our visit. The activities provided included ones people could enjoy as a group and others that met their individual interests.

People told us they were involved in reviewing their plans of care when their needs changed.

The home had a system to assure the quality of service they provided. The way the service was run had been regularly reviewed and action taken when necessary to address any shortfalls.Trends in accidents and incidents had been monitored, advice sought and action taken appropriately to prevent reoccurrence.

People's personal care records, and other records kept in the home, were accurate and complete.

Is the service well-led?

The service worked well with other agencies and professionals to make sure people received their care in a joined up way.

The service had a quality assurance system; we saw that any identified shortfalls were addressed promptly. Staff had a good knowledge of their roles and responsibilities and could seek advice from senior staff and managers.

Staff had a good understanding of the ethos of the home and the quality assurance processes in place. This helped to ensure that people received a good quality service at all times.

We observed care workers speaking to people politely and in a calm and friendly manner. Care was delivered in accordance with people's identified individual support needs and reflected people's preferences. Care plans were regularly updated. We saw care workers asking before assisting people.

We looked at three recruitment files which contained all the relevant information according to regulations.

We toured the building and were shown up to date records in respect of the home's suitability, including maintenance records and equipment servicing. We saw that the home was clean and had adequate procedures in place for infection control and cleanliness.

The home had policies and procedures for complaints and concerns and completed yearly residents' and family member's satisfaction surveys. We noted the home had no current complaints