Maidstone Care Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We found that the service continued to Require Improvement in relation to the Responsive domain. We identified a breach of the legal regulation in relation to person-centred care. People were not always receiving personalised care. People were not always listened to or involved in all aspects of their care and the service delivery. Some people were made more vulnerable because they were not always supported to have equity in access, experience, and outcomes in relation to their care and treatment from the service.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always receive person-centred care. People gave some examples of how they did not receive support in line with their wishes and preferences. For example, some people told us when they requested food during the night staff did not provide any. A relative told us their loved one always liked to wear a piece of jewellery and told us they had to remind staff to put this on for the person. The relative said, “It’s something very simple but they just can’t seem to get it right.” Another relative said, “If [staff are] looking after someone and don’t care who they were, how does that make us feel as a family.” Some people and relatives felt there was not enough meaningful engagement. A person said, “They used to put on shows here, I looked forward to them, then they stopped...There used to be a Daily Sparkle Newsletter that the home produced, then that stopped. However today we have one again.” Relatives said, “When [loved one] was a bit more active when [they] first went in,[they] use to join in the entertainment, but [loved one] does not get so involved now – It doesn’t seem that there is as much going on as they did before” and “They have a [team to carry out activities] but a number of them have left and there is only one person left on that team – I asked them to take [loved one] in the garden when the weather was good, but it never happened.”

Staff told us they communicated with people and read people’s care plans so that they were guided to provide person-centred care. However, not all care plans we reviewed contained people’s personal preferences for all aspects of their care. Staff told us to support people’s social and emotional well-being, they encouraged people to engage together. A staff member told us, “I feel like activities need to be increased more as there isn’t as many as there used to be.” Leaders told us they were trying to improve the programme of activities for people to make them person-centred.

People did not always receive person centred care. We observed people were not always given choice over all aspects of their care. We observed staff making choices for people on the day of assessment about what people would drink based off of the staff members own preferences. We observed that some staff while supporting some people to eat their meals were not engaged with people. They supported people to eat with no verbal communication to indicate what food was being given or support a pleasant mealtime experience. We observed some care records contained some personalised details for example, 1 person liked to be called a shortened version of their name. However, we observed throughout their care records this was not respected. Records demonstrated people did not always received their care as outlined in their care plans. For example, people’s oral care was not recorded as routinely given. We reviewed the last survey for people living at the service. Half of the people who responded disagree they were able to live their preferred daily life and half disagreed they were able to enjoy social engagement and activity.

People told us they knew the staff. A person said, “I know most of the staff, they are familiar to me.” Relatives told us that there had been a turnover in staff and the service had used agency staff. Relatives felt this meant their loved ones had not always received good continuity in care. However, the provider had recently begun to address this. Relative comments included, “Quite often when I go it’s the weekend and there are temporary staff around” and “They get really good staff, but the turnover is really high.”

Staff told us the service had recently increased staffing. Staff said they felt this was beginning to improve care provision and continuity for people. A staff member told us, “We work on the same floors often, so we know their routine and they also tell us.” Staff told us that when required regular agency staff were used to provide continuity of care for people. Comments included, “We get on well with agency staff. We know the agency staff members quite well as they are usually the same staff members, and they know the residents and us” and “I feel very comfortable with agency staff. Most of the staff know everything and they have had good training. If new agency staff come, they give a proper induction.”

Feedback from partners was mixed in relation to the services care provision. Examples were given of times when the care provision had not been sufficient to fully meet people’s needs, and the service had not integrated well with other relevant professionals to address this in a timely manner. For example, people needing to be admitted to other services where the service had not been meeting people’s needs effectively. Some positive examples were shared by another professional of where the service had been responsive to people’s needs and ensured correct care provision and integrated with other relevant services.

The provider had been working to improve the continuity of care for people, staff recruitment had taken place and there were many newly recruited staff members at the service. The provider aimed to use regular agency staff to ensure continuity of carers for people where possible. However, due to care records not containing detailed guidance, clear indication of preferences and full and up to date records there was a risk that people might not receive the correct care provision from new or agency staff. Staff skill mix had recently been reviewed and changes made to the deployment of staff to better support the care provision.

People fed back that they were not always supported to have all information relevant to their care. For example, people were not aware of their risk assessments or care plans and the majority of people did not know the manager of the service. Some people and relatives commented they did not have access to aids to support them to receive information such as glasses and hearing aids. However, another person told us they had access to their glasses as needed and we observed people with their aids for their sight and hearing during our assessment.

Staff told us they provided information to people in ways they could understand for example using gestures and help people understand information. A staff member gave an example of a suggestion they had recently made for a person who was new to the service who spoke another language. They suggested using a language translator to help provide information to the person.

There were systems and processes in place to support staff to provide information to people in ways that were meaningful to them. People had communication care plans in place which described how to verbally and non-verbally support people to receive and understand information. People’s daily care records showed there were checks in place to support people to use their glasses and hearing aids.

People did not always feel involved in aspects of their care or the service. Some people and relatives told us, “The staff listen to me” and “I have been to a residents meeting.” Whereas other people and relatives did not know about meetings that took place where they could express their views and be involved in the service. Some people and relatives told us although they could raise concerns with the service, they did not always feel these were responded to appropriately. A person said, “I have complained, but nothing happened.” The last survey results for the service also indicated people did not always feel involved or listened to. For example, all respondents said they did not feel involved in decisions about changes to the environment. We discussed this with the manager who told us people who were able to feedback on the personalisation of their rooms were able to contribute. But those who were not able to, staff made decisions for them based on what they knew about the person. No other ways of supporting people to be involved had been discussed such as showing people samples to choose from.

Staff told us they listened to people and would raise concerns or complaints on their behalf when required.

There were systems and processes in place to enable people to share their feedback and to be involved in decisions relating to their care and their home such as the service’s ‘resident of the day’ which provided opportunity to get people and their loved ones feedback. However, we found that these systems had not been operated effectively and this was reflected in the feedback received by people. Where people lacked mental capacity for some decision making about particular aspects of their care or where people’s first language was not English it was not always clear that systems and processes in place had been effectively operated. Records did not always demonstrate how people had been supported to ensure they had full meaningful participation in decisions about their care. It was not always recorded whether people received support from relevant others where required to enable their involvement.

People did not always experience equal access in relation to their care and support needs. Some people who required aids such as glasses or hearing aids did not always have access to these. A person said, “I am not sure where I go for my glasses.” Another said, “My ears are a bit of a problem. I used to have hearing aids.” Other people felt they had access to equipment they needed to be able to go about their daily lives for example, a person said, “I can get myself up and about with the walker.”

Staff told us they knew people well and were able to support them to access the care they required. A staff member gave an example of how a person had used actions to demonstrate they needed a drink, and staff supported them with this. Another staff member said, “We have a few who are non-verbal…we know what they like and what they don’t like. If we don’t know them, we check the care plan and see what they like to drink and if they have any allergies.” Staff and leaders told us they made referrals when required to ensure people had equal access to care and treatment they required.

Professionals who worked with the service gave mixed feedback about how the home supported people to have equal access. A professional described how the service had not consistently supported an individual to have equal access to other services. For example, the person had not received required support to enable them to leave the service in time to go to another service. Another professional felt that the staff had supported people to access their services without any barriers.

There were processes in place which allowed the provider to identify any potential barriers to people receiving equal access to care. Although these systems were in place they had not been operated effectively by staff to ensure people received equal access in their care and treatment. There were no visiting restrictions within the service, which meant people could be supported by those important to them in line with their preferences.

Feedback we received from people and their relatives throughout the assessment indicated that not all people felt they had equity in experience and outcomes. A person told us “I just sit around all day” but they were supported by a relative to access things they liked to do.

Staff told us they treated people respectfully and were mindful of their protected characteristics for example, people’s gender, race, and disability.

The provider ensured people had equipment which supported them to have equity in their experiences. For example, the service utilised mobility equipment and adaptive eating equipment to maximise people’s engagement in their daily living activities such as moving around their home eating their meals as independently as possible with the help of assessed equipment. There was some signage around the service to support people to orientate to the function of rooms. However, where people lacked capacity, the provider did not always support people to have equity in experience and outcomes in relation to their rights. We found issues with people’s mental capacity assessments which had not been completed in line with the principles of the mental capacity act.

People and relatives did not provide feedback about whether the service helped them to plan or achieve things important to them.

Staff told us they supported people in line with their planned care to maintain their needs and comfort. However, feedback from a professional was that Maidstone Care Centre had at times failed to plan effectively to have sufficient resources to meet people’s identified needs. In addition, the professional fed back that they had provided opportunities for the service to enhance staff skills to meet people’s needs, offering planned training, and this had not been accepted.

There were systems in place to allow staff to maintain oversight of people’s future plans and to record these. However, the feedback from a professional shows these systems were not always operated effectively to ensure people’s needs were met. Care plans contained goals for people and actions on how to achieve those goals. People’s care plans around death and dying showed whether there were any particular treatment plans, who to involve and how to manage people’s care to maintain their comfort.