Maple House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Maple House accommodates up to five people. At the time of our inspection there were five people living at the service. Maple House is a detached bungalow in a cul-de-sac in Colchester which forms part of a group of similar properties owned by the same provider. Each property is a distinct service, though there are some shared facilities and joint social events.

This unannounced comprehensive inspection took place on the 5 and 12 June 2018.

At the last inspection in April 2017, the service was rated as requires improvement. We had concerns people were not always safe as staff did not have correct advice about how to safeguard people from abuse and there were gaps in the recording of some medication. We also found staff did not always keep people’s information confidential. At this inspection we found the provider had addressed our concerns and we rated the service as good.

At the time of our inspection there was 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service could live as ordinary a life as any citizen.

The registered manager was an effective leader and ran the service in an organised manner. There was a well-established and committed staff team well together n the registered manager’s absence. There were structured systems in place to check on the quality of the care being provided. When these checks found there were gaps or mistakes, senior staff ensured these were resolved. There was an open culture where the whole service learnt lessons and drove improvements.

Staff minimised the risks to people’s safety and knew what to do if they were concerned a person was at risk of abuse. Measures to reduce the spread of infection were extremely effective. There was enough safely recruited staff to meet people’s needs. People received their medicines safely and as prescribed.

Staff had the necessary skills to meet the complex needs of people at the service. The staff team felt well supported and communicated effectively to ensure support to people was consistent. People’s physical and mental wellbeing was promoted and they received support to access health and social care professionals when required.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. We found the registered manager and staff met their responsibility under the MCA. Where people were being restricted of their freedom, decisions were made in their best interest.

Staff were caring and treated people with dignity. They communicated with people in a variety of ways to ensure their views were central to the care provided. People lived full lives and were supported by staff to develop their independence. Care plans were extremely person centred and provided staff with the necessary information to meet people’s needs and keep them safe. People and families were able to provide feedback and know they would be listened to and a

Maple House is a residential care home that provides personal care and support for up to five people who have a learning disability and/or autistic spectrum disorder. On the day of our inspection there were five people living at the service.

The service 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. The manager is registered for this service and one other service other local, nearby care service and is also one of the organisation’s directors.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Risks to people’s health, welfare and safety had been assessed and guidance provided for staff with recorded action they should take to mitigate these risks.

People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff.

There were systems in place to ensure that staff were trained and people received their medicines as prescribed. However, gaps in medication administration records for the application of creams and lotions did not assure us that people always received these medicines as prescribed.

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. However the current practice of holding staff handover meetings in people’s communal lounge did not fully protect the confidentiality of their information and consider their rights to have their communal space protected without intrusion.

Staff were provided with training in Safeguarding Adults from abuse. However, policies which guided staff in how to report poor practice had not been reviewed since 2009 and safeguarding people from abuse policy since 2011. These policies contained out of date information and did not provide up to date, relevant guidance in line with local safeguarding protocols and current regulatory requirements.

Staff were provided with training in understanding their roles and responsibilities with regards to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People’s capacity to make decisions about their everyday lives had been assessed and their consent was considered in the planning and provision of their care and support

Staff were able to demonstrate that they knew people well and we observed treated people with dignity and respect. However, we recommend that the current practice of holding staff handover meetings in people’s communal lounge be reconsidered as this did not fully protect the confidentiality of their information and consider their rights to have their communal space protected without intrusion.

People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including GPs and dentists.

People were provided with the opportunity to participate in personalised, meaningful activities according to their assessed needs, wishes and preferences. People were encouraged to develop as much independence as possible and learn new life skills. People had access to annual holidays and opportunities to be integrated into the local community.

The provider had a system in place to respond to suggestions, concerns and complaints. The service had a number of ways of gathering people’s views including; one to one monthly meetings and satisfaction surveys. The provider and registered manager carried out a number of quality monitoring audit

Maple House is a residential care home that provides personal care and support for up to five people who have a learning disability and/or autistic spectrum disorder. There were four people living in the service when we inspected on 31 March 2015.

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 atmosphere in the service was friendly and welcoming. People received care that was personalised to them and met their needs and wishes.

People were safe and treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner. Staff had developed enabling relationships with people which respected their diverse needs. Staff understood each person’s way of communicating their needs and anxieties and how best to respond. Staff knew each person’s individual care and support needs well.

Staff listened to people and acted on what they said. Staff knew how to recognise and respond to abuse correctly. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff understood how to minimise risks and provide people with safe care. Care and support was individual and based on the assessed needs of each person. Appropriate arrangements were in place to provide people with their medicines safely.

Robust systems for recruitment and selection were in place to ensure that staff were suitable to work with people who used the service. There were enough staff with the knowledge and skills to meet people’s needs.

Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to attend appointments with other healthcare professionals to maintain their health and well-being. People knew how to make a complaint and any concerns were acted on promptly and appropriately

People were supported by the manager and staff to make decisions about how they led their lives and wanted to be supported. People were encouraged to follow their interests and take part in social activities and where appropriate attend college. People had their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests.

People were provided with a variety of meals and supported to eat and drink sufficiently. People enjoyed the food and were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities. The manager and provider planned, assessed and monitored the quality of care consistently. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.

During our inspection we used different methods to help us understand the experiences of people who used the service. Where people were unable to tell us about their experiences, we used observation and noted people’s responses to staff. We saw that people appeared calm and relaxed in the presence of staff.

We saw that care plans and risk assessments were regularly reviewed with people who used the service or relatives if they were unable to fully participate.

We saw that staff were knowledgeable about people’s needs and promoted their independence. During our discussions with staff we found that they had a good understanding and awareness of people’s care needs and preferences. One person who used the service told us: “I like living here, the staff talk to me and take me to play football."

There were policies and procedures, records and monitoring systems in place for the protection of people who used the service. Staff told us about the training they had received to enable them to carry out their roles in supporting people. Staff told us they felt supported by the manager.

We saw that there was a complaints policy and procedure in place which was in an easy read format. The staff were able to explain the complaints procedure. People who used the service told us they were aware of how and who to complain to.

When we visited Maple House on 28 January 2013, we used different methods, including observation, to help us understand the experiences of the four people living at the home. This was because some people had complex needs which meant they were not able to communicate verbally with us.

We spoke with two people who told us they liked living at Maple House and liked the staff who cared for them. One person said, "It is all very good here." Another person said, "The staff know what I need if I am anxious about things."

The people we observed during our visit were relaxed in the company of the staff and were able to pursue interests of their choice within the home. There was sufficient space within the home for people to go to an area away from others if they felt they needed privacy. We saw one person playing computer games with staff in his bedroom and another in the communal area watching the TV. Another person was out in the community, supported by a member of the staff team, at an educational establishment.

We saw that people's care records contained detailed information to show how they were to be cared for. The people using the service were familiar with these records and had signed them to confirm their agreement with the proposed care and support.