The inspection took place on 12 December 2018 and was unannounced.

Maple Dene is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodated up to 40 older people. At the time of our inspection there were 37 people living in the home.

At our last inspection on 27 April 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall. There was no evidence or information from our inspection and ongoing monitoring which demonstrated serious 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.

People continued to receive a safe service. Medicine administration records were completed by staff safely. Risks associated with people’s needs had been assessed and measures were in place to reduce these. There were sufficient staff to meet people’s needs and safe recruitment procedures for staff were in place. Accidents and incidents were monitored to identify any trends and measures were put in place to reduce the likelihood of these happening again.

People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. 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. The principles of the Mental Capacity Act (MCA) were followed.

People received care from staff who were very kind and compassionate. Staff supported people on an individual basis and focused on them as a person. Feedback from people, relatives and healthcare professionals was extremely positive and complimentary. People’s rights to privacy were respected by the staff and their dignity was maintained and upheld at all times. People were supported to express their views and be actively involved in making decisions about their care and support needs by a provider who valued their input. People’s independence was encouraged and promoted.

People continued to receive a responsive service. Their needs were assessed and their support was planned with them and or their relative where required. Staff knew and understood people’s needs well. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaints procedure available if this was needed.

People continued to receive a well-led service. The monitoring of service provision was effective because shortfalls had been identified and resolved. There was an open and transparent and person-centred culture with adequate leadership. People were asked to share their feedback about the service.

Further information is in the detailed findings below.

We inspected this home on 27 and 28 April 2016. The home was last inspected in July 2014 and was meeting all the regulations. The home is registered to provide personal care and accommodation for up to 40 older people. At the time of our inspection 37 people were living at the home. We observed how care was provided to people and whether people were happy living at the home.

The registered manager was present during 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.

People felt safe living at the home and risks to their safety had been identified and managed in a way that did not restrict their freedom. Staff knew how to support people safely and had received training in how to safeguard people from abuse. People and staff told us there were sufficient staffing levels to meet people’s needs. People’s medicines were safely managed, stored and administered by staff who had received training and had been assessed as competent to administer medicines.

Staff received training to provide them with the level of skills and knowledge to deliver care effectively to meet people’s individual needs. Staff obtained people’s consent before proving them with care and support. People’s liberty was not restricted and the registered manager had followed the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) where people’s safety needed this. People told us they were offered meals which they enjoyed. People were supported to eat enough food and drink by staff who understood their nutritional needs. People’s health was supported by access to a variety of health professionals.

People told us that they were supported by staff who were kind, caring, attentive and compassionate. People were able to make decisions about how they wanted their care provided. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People told us that they played an active part and contributed to the planning and reviewing of the care they wished for. A variety of activities were provided to meet the interests of individual people. We saw people were engaged and were consulted about the activities programme. A complaints procedure was available and accessible to people and their relatives. People were confident complaints and concerns would be listened to and acted upon.

People described the management of the home as supportive, approachable and friendly. People told us they were encouraged to express their views and experiences about living at the home and that their views were valued. Systems for monitoring the quality and safety of the service were being undertaken to drive improvements within the service. We saw evidence to demonstrate that the registered manager was continually looking at how they could provide better care for people.

This inspection was completed by one inspector. On the day of our inspection we found that 37 people lived at Maple Dene. We spoke with eight people who used the service, three relatives, the registered manager, care manager and four care staff. Below is a summary of what we found. The summary describes what people told us, what we observed, the records we looked at and what staff told us. We used the evidence we collected during our inspection to answer five questions. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. One person told us, "I feel very safe here." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.

Staff respected people's choices and preferences in the way they received support. One person told us, "They (the staff) always ask us what we need and want. We choose what we do." We saw that staff gained people's consent before they supported them with their care needs. This ensured that people's rights were protected.

Staff knew about people's risk management plans and we saw they were supported in line with those plans. This meant people were cared for in a way that protected them from harm.

People were protected against the risks associated with the administration of medicines.

There were sufficient numbers of staff to ensure that people were cared for safely.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people.

Is the service effective?

People told us their care needs were assessed with them. We saw evidence that people were involved in their care planning and reviews. We saw care plans were regularly reviewed and updated. One person told us, "The staff always ask what I need."

People had their medicines at the dose, time and frequency they were prescribed to ensure medicines were effective. Staff monitored the effect of medicines and reported these to people's health care professionals.

Is the service caring?

People were supported by kind and caring staff. We saw staff were patient and encouraged people to be independent. One person told us, "The staff are excellent."

People’s preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

People had the opportunity to plan and engage in a range of different activities each day.

People were asked their views about the service and the provider acted on comments that people made.

Where care staff had noticed people's changing needs, their care plans were updated to reflect this. We found staff discussed people's care needs with them on a regular basis.

Is the service well led?

The registered manager ensured there were sufficient numbers of staff with the appropriate skills to care for people in the way they wanted and needed to be.

The provider had risk management systems in place. We found the provider checked that risks were managed effectively. We found the provider used the information they gathered from their checks to develop a service improvement plan.

The provider sought the views of people who used the service and staff. Records seen by us indicated that people were asked about all aspects of the service and their views were acted on.

Staff told us they were clear about their roles and responsibilities. Staff told us the service was well organised and they felt supported by their manager.

There were 39 people living at the home at time of our visit. During our visit we spoke with nine people who lived at the home and three of their relatives. We also spoke with a health professional, the registered manager and four members of staff.

People we spoke with were complimentary about the home and told us that they were happy with the care they received. One person told us, “I think the staff all look after me well, I’ve no complaints. It’s not a bad place at all.” Another person told us, “I would give it 95 out of a 100.” The relatives of two people at the home told us that overall, they were satisfied with the care.

We found that care and support was not always planned and delivered in a way that ensured people's safety and welfare.

People living at the home told us they felt safe and were able to raise any concerns they had.

Improvements were needed to ensure there were enough staff available at all times to meet people’s needs.

Arrangements were in place so that people were involved in monitoring the quality of service provided. This meant that they had opportunities to put forward any suggestions for improvements.

We visited Maple Dene unannounced and spoke to seven people who lived at the home about the care and support they received. People told us they were happy with the service they were receiving and how their needs were being met. One person told us ‘’The home is superb, I cannot fault them.’’ During our visit we spoke with a relative of a person who lived at the home. They told us they were satisfied with the care provided.

Throughout the inspection, we found that staff treated people with respect and supported them in a friendly, engaging manner. People living at the home confirmed their privacy was respected.

During our visit we spoke with two health care professionals. They told us they did not have any concerns about the care provided and told us that staff demonstrated a good understanding of people’s needs.

People who lived at the home told us they were satisfied with the meals on offer. One person told us ‘’The food is good.’’ Another person told us ‘’The food is okay here, you can choose what you want to eat.’’

Staff told us that they were well trained and felt they had been provided with the appropriate training in order to do their job effectively.

People living at the home told us they felt safe and were able to raise any concerns they had. A relative of a person living at the home told us they would feel able to raise any complaints directly with staff at the home.

People and a visiting relative spoke positively about the staff at the home.

People told us they had received enough information about the home before they moved there.

People told us that they are involved in making decisions about the care and support provided at the home.

People told us they were happy with the care they receive at Maple Dene. Comments from people included ''It's very comfortable here, I’m very grateful to be here. I live here very happily, I’m pleasantly looked after''.

''They look after you here. If you tell them you are poorly they check you are okay and get the doctor if needed''.

''I've been made very welcome, my needs were assessed, I filled in a form with staff, it covered all areas''.

'' I do not get bored, we have books and a computer for people to use but at the moment these have been put away whilst the decorators are here. At Christmas there was some carol singing which I enjoyed''.

A relative told us ''It’s a lovely home, I have no concerns. They look after people well, staff are aware of people’s needs. They look after people's personal care. When my relative is ill as far as I’m aware they get the healthcare they need''.

We spoke with people about the food they are served and again comments were generally positive. People told us that ''I'm happy with the food choices'', ''The chef has got better in the last 2 years. If you want something different you can ask in the kitchen and you get it'', and '' The food is fine, there are good choices''.

People told us that health care professionals regularly visit the home, for example the GP.

People and one relative told us that they were able to raise concerns.

People told us they are happy with the way they receive their medication.

People told us they are happy with the environment. One person said ''my bedroom is very nice, it's warm enough''.