CQC takes action to protect people at Bexleyheath care home

The Care Quality Commission (CQC) has dropped the rating for the Maples Care Home from good to inadequate following an inspection in July and August.

The Maples Care Home provides nursing and dementia care for up to 75 older people. This inspection was carried out to follow up concerns around accurate record-keeping, which CQC told the provider to improve following the home's previous inspection.

Following this inspection, the home's rating has dropped from good to inadequate, as has its rating for safe. The home's rating for well-led has dropped from requires improvement to inadequate. Its rating for effective, caring, and responsive have dropped from good to requires improvement.

To support its improvement and to ensure people's safety, CQC has placed the home in special measures. This means it is being closely monitored and will be inspected again to assess whether it has addressed the issues inspectors identified. 

Antoinette Smith, CQC deputy director of operations in London, said:

"When we inspected the Maples Care Home, we were disappointed to find staff didn't always know how to meet people's needs safely, and leaders lacked the oversight needed to identify these problems or support improvements.

"We found that not all staff had been trained in key areas such as managing people's medications and caring for people with specific conditions such as dementia, epilepsy or diabetes. This was also reflected in what people's relatives told us.

"Additionally, we saw people's care plans weren't always detailed enough to guide staff on managing people's individual risks safely. Because of this, staff didn't always recognise unsafe care. For example, inspectors found staff attempting to support someone to eat while they were falling asleep, which wasn't dignified and put them at risk of choking.

"We didn't see evidence that the service was always monitoring and learning from incidents effectively. Where they'd identified issues, such as the gaps in staff training, they had no records of action they'd taken to fix this.

"We've told the provider exactly where improvements are needed, and they've sent us an action plan detailing how they aim to do this. We'll be monitoring the service closely, including through further inspections, to ensure these improvements are made. We won't hesitate to take further action if we're not assured people are receiving safe care."

Inspectors also found:

• The service didn't always consult people's relatives on end-of-life care needs. Two people's relatives told inspectors they'd found their loved ones had do-not-resuscitate orders in their care plan without staff having discussed this with them. This put people's lives in danger
• There weren't always enough staff in the home to meet people's needs, and relatives told inspectors they had to search for staff if people needed support
• People weren't always supported to take part in meaningful activities. This was particularly severe for people with dementia. Inspectors saw many people were sat in front of televisions in lounges for long periods of the day, with most falling asleep
• Some people's care plans were inaccurate or contradictory, risking their needs not being met. For example, one person who needed mobility aids had a care plan which said staff should encourage them to stand without these
• People's medicines weren't always managed safely
• While inspectors saw some staff were kind and respectful, others were task-focused only and didn't always speak to the people they were caring for. Inspectors saw some examples of staff treating people in an undignified way, such as by shouting across a communal dining room about someone's diet
• People and their loved ones told inspectors the service didn't always take effective action in response to complaints. Leaders weren't formally logging any complaints, meaning they couldn't identify themes or learning from them.

The report will be published on CQC's website in the coming days.

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