Maidstone Care Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found that the service continued to Require Improvement in relation to the Well-led domain. We identified a continued breach of the legal regulation in relation to good governance, the service had not effectively embedded all of the actions they told us they would take and had not made sufficient improvements since the last assessment. A new manager was in post but was not registered with CQC. Their application needed review before resubmitting. There had been changes to the leadership team for the service to help to drive improvements and create a shared direction.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders were eager to improve the service. Leaders were aware that there were many areas of the service which still needed to improve, and plans had recently been updated to help formulate the direction of the service and share the vision with staff, people, and their relatives.

The recent changes to the service’s management had been discussed and shared with some people, relatives, and staff during meetings they attended. Areas of good practice were highlighted as well as areas where the leadership were aiming to improve. There were updates on new systems and processes being implemented. The leadership team told us they were working on new surveys to get up to date feedback about the service. Although changes were being made, these were not yet fully embedded and reflected in staff practices and the culture of the service.

The leaders at the service told us they were aware of areas for improvement within the service and felt the service would be where they wanted it to be in 6 months. Staff felt the current manager of the service was capable, compassionate, and inclusive. Comments included, “They care about the residents and make sure that everything is up to date” and “Present manager is very good, is very supportive and encouraging. [Manager] does monthly meetings. [Manager] goes around every floor checking in with residents, is very organised, and listens to us. I really like [Manager].”

There was a new management team that had been in place for 4 months to oversee the quality of the service in order to drive improvements. The new management team had recently formulated an updated action plan to try to address areas of improvement. Most people we spoke with were not aware of who the manager of the service was . Some relatives fed back that they had “Lost faith in the home.” They commented on the amount of change there had been within the management team in the past which made them sceptical that changes would be sustained. At our last assessment we were confident the then new management team at that time would improve the service. However, since then there had been further changes to the management team in place. At this assessment we found actions were still outstanding from the last inspection and the action plan that the provider had submitted following the previous inspection. This meant we could not be assured that the new changes would be sustained.

Staff told us they felt able to voice their concerns openly. They told us suggestions were listened to.

There were processes in place to support staff to speak up. This was an area the service had worked to improve following survey results from staff.

Staff told us they had a good understanding of equality diversity and human rights. They told us they respected one another to promote a good work culture and were accepting of differences.

There were systems and processes in place to support workforce equality, diversity, and inclusion. This started during the services recruitment processes and there were systems in place to enable staff and support their protected characteristics.

The leadership team at Maidstone Care Centre told us they were in the process of reviewing the service’s whole governance system. The new leadership team had identified that existing governance processes and audits had not always been effective in identifying issues and driving improvements within the service.

There were various systems and processes in place to support the management of the service including a suite of audits for various aspects of care delivery and service management. However, we found that these systems and processes had continued to not always be effectively operated. For example, care plan reviews were not always effective at identifying gaps in risk assessments or care plans, they failed to ensure enough details were recorded to guide staff and failed to ensure information was up to date. Supplementary charts continued to be ineffectively recorded, and actions implemented to address this, such as daily reviews of charts, were not consistently taking place. Although some of the provider’s audits had found some of the issues we identified, some issues we raised with the provider had not identified such as the concerns with the gates in people’s bedroom doorways. Accurate and completed records were not always kept which negatively impacted on the providers ability to maintain and demonstrate effective oversight of the service. For example, a recording error had resulted in the provider not identifying some notifications had not been submitted to CQC. We reviewed a tracker for Deprivation of Liberty Safeguarding applications which recorded when applications had been made and approved and whether these had been notified. Many had been marked as notified however we had only received one. We raised this with the manager who could not find records to support the notifications had been sent and sent them retrospectively. The service had continued to have issues with the oversight and management of the care delivered and not enough improvement had been made since we last visited the service.

People told us they received input from other healthcare professionals where required. People and relatives told us a hairdresser visited the service as well as a chiropodist to help people to maintain their appearances. We observed external entertainers singing for people during our visit.

Staff told us they worked in partnership with other professionals and other services owned by the provider to try to meet people’s needs as well as learn and improve aspects of the service.

Feedback from partners about their partnership working with Maidstone Care Centre was mixed. A professional fed back that, ‘Communication and information sharing is generally poor.’ Whereas another professional felt their partnership working with the staff at Maidstone Care Centre was effectively meeting people’s needs.

There were systems and processes in place to enable partnership working. For example, referrals were made between services, and we observed various other professionals at Maidstone Care Centre during our visit supporting people with a range of health and social care needs.

The leadership team told us that they had been reviewing the systems and processes for the management of the service and identified issues and updates required to the current processes. These were in the process of being created to better support the service to effectively learn and improve. Staff told us they felt the service was improving. A staff member said, “It has been a rough couple of years with many changes of managers and staffing shortages but much better now, we are improving all the time.”

The service had recently updated their action plan with systems and processes to address the previous issues from the last inspection. However, the systems and processes within the service had not been sufficient since our last visit to effectively identify all of the issues we found at this assessment. Some issues found have been continued issues since 2020. Areas for improvement had not always been acted on to drive improvement across the service. The service has been in breach of legal regulations in relation to safe care and treatment and good governance for the last four consecutive assessments and therefore we were not assured the systems and processes in place were robust to identify learning and drive improvement.