Maitland Park Care Home is registered to provide accommodation and nursing care to 60 older people, some of whom were living with dementia. There were 56 people living at the home when we carried out our inspection.

We carried out an unannounced, comprehensive inspection of this service on 11 and 13 July 2017. After that inspection we received concerns in relation to tissue viability care provided at the home. As a result, we undertook a focused inspection to look into those concerns. This report covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk”

We did not identify risks, concerns or areas for significant improvement with regards to the remaining key questions. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

The home had a registered manager in post at the time of our inspection. 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 current registered manager had registered with the Commission in August 2017. The registered manager was supported by the deputy manager who was also a clinical lead at the home, the provider’s senior management team and a team of nurses, team leaders, support workers and other support staff.

Prior to our inspection we received information of concern that related to tissue viability care provided at the home and increased number of falls amongst people who used the service. Therefore, as part of this inspection we looked in detail at arrangements around skin viability care and falls prevention. We found that risks to health and wellbeing of people who used the service had been appropriately assessed. Records showed that staff were provided with guidelines on how to support people safely. These included various assessments related to skin care and the prevention of falls.

However, during this inspection we found issues around some aspects of the safety and leadership at the home. These were related to sharing important information about the care provided to people, staff knowledge of all the home’s policies and procedures and the lack of established procedures when transferring people between units within the home.

We found that information provided by the home to external monitoring bodies, such as, the local authority and the CQC, was not always fully transparent and complete.

We found the home’s representatives had not always made appropriate and prompt safeguarding referrals to respective monitoring bodies. This meant the home had not always worked closely with these monitoring bodies to fully identify and prevent, further potential harm or abuse that people could be subjected to.

The provider had a range of policies and procedures available to staff to guide them of their roles and responsibilities when providing care. However, we found that staff were not always aware of these polices. This could also lead to the lack of a unified approach in providing care across the service.

We found some issues related to the storage of controlled drugs (CDs) and discrepancies in the numbers of medicines administered and stock levels on the day of our inspection. These were addressed and rectified during and shortly after our inspection. We concluded that people received their medicines safely, however, improvements were needed in respect of how the home checked and audited medicines stock to ensure they tallied at all times.

Staff were generally content with the support they received from their line managers and their contribution to the service had been recogn

We inspected Maitland Park Care Home on July 11 & 13 2017. This was an unannounced inspection. Maitland Park Care Home provided accommodation and nursing care to 60 older people, some whom were living with dementia. There were 59 people living at the home when we visited. At the last inspection on December 2014 the service was rated as Good.

The service did not have a registered manager at the time of our inspection. The service had a manager who had been in place since June 2017. They had started the process of applying to become the registered manager of the service. 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.

People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and plans in place to monitor and reduce risks. People had access to relevant health professionals when they needed them. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. Medicines were stored and administered safely.

Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests. We saw people were able to choose what they ate and drank.

People’s needs were met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.

Staff told us the service had an open and inclusive atmosphere and the manager was approachable and open. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and relative meetings.

This inspection took place on 2 December 2014 and was unannounced. When we last visited the home on the 18 March 2014 we found the service was meeting all the regulations we looked at.

Maitland Park Care Home is located near Chalk Farm in Camden, North London. It provides accommodation and care to 60 older people, some whom were living with dementia.

The home had a registered manager. 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.

People were kept safe. Medicines were being managed safely. Risks to people were identified and action taken to reduce the risks. Staff were available and had the necessary training to meet people's needs. Staff responded to people’s needs promptly.

People were provided with a choice of food, and were supported to eat when this was needed. People were supported effectively with their health needs.

Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences. Staff understood people’s preferences, likes and dislikes regarding their care and support needs.

People were involved in decisions about their care and how their needs would be met. Staff knew what to do if people could not make decisions about their care needs in line with the Mental Capacity Act 2005.

People were treated with dignity and respect. There was an accessible complaints policy which the registered manager followed when complaints were made to ensure they were investigated and responded to appropriately.

People using the service, relatives and staff said the registered manager was approachable and supportive. Systems were in place to monitor the quality of the service and people and their relatives felt confident to express any concerns, so these could be addressed.

This inspection was a follow up to our visits made on the 27 and 29 November 2013. The home had opened earlier in the summer, replacing two homes run by another organisation. Some staff from the two closed homes had been taken on by the provider to work at Maitland Park. Other staff had been employed previously by the provider and a few had been appointed since the home opened.

At our last visit, it was apparent that there problems with workplace relations at the home. Some of the staff members who had transferred were finding it difficult to adjust to changes associated with working for a new employer. There was little effective communication and staff morale was generally low.

The provider did not effectively support staff to carry out their responsibilities. We could find no records of staff receiving 1-to-1 supervision, allowing them to formally raise concerns and discuss issues relating to their employment. Seven members of staff told us they had not received supervision. Although some staff members were positive in their comments to us, others had said they planned to leave.

We had found that the provider was failing to comply with the requirements of Regulation 23 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Following our inspection, the provider sent us a plan of the actions it intended to take to meet the requirements of the regulation. We carried out this visit to check that the actions had been implemented.

At this visit, we found that staff had received at least one supervision session since the last inspection. The provider told us that annual appraisals were due to commence shortly. We saw evidence that regular staff meetings had taken place and staff members we spoke with were much more positive about their experience of working at the home.

We found that the actions taken by the provider were sufficient to comply with the requirements of the regulation.

At the last inspection, we were informed that the local authority was working closely with the provider during the transition. During this visit, were we told that the local authority was continuing to provide support and guidance.

Maitland Park Care Home opened in June 2013. It replaced two homes run by another provider, with most of the staff transferring to Shaw Healthcare (Group) Ltd. The home shares a site with Gospel Oak Court, which is an extra care service, with a separate registration, run by another company within the provider's group of companies. This inspection related only to the care home.

We inspected the home on the 27 and 29 November 2013. We spoke with the scheme manager, who had recently been appointed to have overall responsibility for both the care home and the extra care service. The manager of the care home was on leave. In their absence, we spoke with the provider’s project manager who was helping to set up the service. We also spoke with a number of the staff who had transferred, as well as existing employees of the provider.

People using the service commented, “It’s very nice here” and “I like it. It’s much better than the old place.” A healthcare professional told us “There were a few initial problems, but that’s to be expected. Things are settling down now.”

We saw from the results of a recent residents’ survey that some people had concerns over activities at the home and access to the community, whist others were unhappy with the meals provided. But we noted that books recording people’s views of meals also contained numerous compliments.

The provider recognised that communications between management and staff needed to be improved and was working closely with the local authority to address identified issues of concern.