Maria Residential Home

The assessment was planned to follow up on our previous inspection in 2019 and to check whether improvements had been made. At the last inspection, we identified a breach of regulation in respect of good governance. At this assessment, we found continued concerns about good governance and found the provider remained in breach of Regulation. In addition, we found the provider was in breach of the legal regulation relating to safe care and treatment.

People were not always protected from avoidable harm. Staffing arrangements did not consistently reflect people’s assessed needs. There were periods when only 1 member of staff was rostered to work at the home, although 2 people required support from 2 trained staff for transfers and repositioning.

Records did not provide assurance people had always received planned support with repositioning, hydration or other care in accordance with their care plans.

Staff training and competency arrangements were not effective. Most staff had not completed moving and positioning training within the provider’s required timescales, practical training had not been completed, and documented competency assessments were unavailable.

Risks relating to medicines, emollient products, infection prevention and control, fire safety and the care environment had not always been adequately assessed or managed.

Care plans were personalised but were not always reviewed within the provider’s expected timescales. Records relating to best-interests decisions were incomplete, and relatives were not always aware of care plans or changes to people’s support. People’s feedback and concerns did not always result in timely action.

Governance and quality assurance systems remained ineffective. Audits had not consistently identified or addressed shortfalls in staffing, training, medicines management, risk assessment, care records and policy implementation. The provider and registered managers had not acted promptly on feedback from external partners, and continued breaches of legal regulations demonstrated learning from the previous inspection had not been embedded or sustained.

The provider was introducing an electronic care-record system, however, this remained under development and had not yet resulted in demonstrable improvements.

Relatives described the home as friendly, with a family atmosphere and a consistent staff team who knew people well. People were supported to make choices, maintain their independence and take part in activities and routines which were meaningful to them. The provider and registered managers worked with healthcare professionals to support people’s health needs and continuity of care.

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