Maple Lodge

Updated 29 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 team consisted of 2 inspectors and 1 Regulatory co-ordinator

Service and service type

Maple Lodge 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. Maple Lodge is a care home without 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 31 October 2023 and ended 22 November 2023. We visited the location’s office and the service on 31 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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

Where people were unable to talk with us, we observed people’s interactions with staff. We contacted 5 relatives and received feedback from 1. We spoke with the registered manager, the team leader and 2 members of staff. We spoke with 2 professionals visiting the service. We reviewed 5 people’s care files and 2 staff personnel files relating to their recruitment. We looked at the provider’s arrangements for managing risk and medicines management, staff training and supervision data. We also looked at the service’s quality assurance arrangements, including the service’s auditing arrangements and the provider’s oversight of the service.

Updated 29 December 2023

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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Maple Lodge is a residential care home providing personal care to people who have a learning disability and/or autistic spectrum disorder. The service can support up to 5 people. Maple Lodge is a detached bungalow located in a residential cul-de-sac in Colchester and is 1 of a group of 5 similar properties in the same cul-de-sac and owned by the same provider. At the time of the inspection 5 people lived at the service.

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

Right Support: People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider failed to ensure people had the right support. The care records guiding staff as to the support people required were not effective as staff had not received adequate training to support people safely and this included in the use of physical and chemical restraint. A refurbishment programme was in the process of starting prior to the inspection, but this had not been completed and some areas of the home, still required urgent attention and renewal to promote cleaning to an acceptable standard. Infection prevention and control measures were not robust, and some areas of the service was visibly unkempt, not well maintained and unhygienic.

Right Care: Staff cared about the people they supported but were frustrated by their inability to deliver person centred care because of the provider's failings. Requests for training to the provider from the registered manager were not followed up or listened to. Systems and processes were not always effective in ensuring people were protected from the risk of avoidable harm.

Right Culture: The provider failed to ensure the service was being provided in a way which was compliant with the CQC's Right Support, Right Care, Right Culture guidance, or other national best practice guidelines to meet people's needs in this type of specialist setting. People experienced or were at risk of harm because of a lack of protection, they experienced or were at risk of abusive incidents, including unnecessary restraint. The governance systems used by the provider were not effective and did not identify concerns related to quality and safety, restraint, medicine administration, infection control or risk.

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 20 September 2018)

Why we inspected

The inspection was prompted in part due to concerns received about the use of unauthorised restraint used 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 question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

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

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding, and governance.

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 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.

The overall rating for this service is ‘Inadequate’ and the service is in ‘special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.