Archived: Meadowside

This was an unannounced inspection that took place on 18 July 2017.

The home did not have 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 and associated Regulations about how the service is run. There had not been a registered manager at Meadowside for over a year. There was a new manager in post but they had not yet started their application to register as they were currently at Meadowside on a three-month secondment. Following our inspection we were told the new manager had been successful in securing the position as manager and had commenced with their application to register with CQC.

We carried out an inspection to this home in May 2016 where we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These relates to staff acting on risks to people, failure to follow procedures in relation to the Mental Capacity Act, a lack of person centred care and a failure for the registered manager to submit statutory notifications to CQC when required. Following that inspection the registered provider sent us an action plan telling us how they planned to address our concerns. We undertook this fully comprehensive inspection to check that the registered provider had completed actions in line with what they told us. We found improvements had been made.

Care records relating to people were not always fully comprehensive. Some useful guidance for staff was missing and records relating to medicines management were not completed in full. We have made recommendations that these areas be reviewed and improved.

Staff demonstrated a kind, caring attitude towards people and people were attended to promptly by staff when they needed support. However, we did notice during the afternoon that deployment of staff could have been better organised as some areas of the home were not as well staffed as others. We have made a recommendation for this to be improved. Staff knew people well and had good relationships with people.

The provider had appropriate recruitment processes in place and staff were knowledgeable on their role in relation to helping to ensure people did not suffer from poor care or abuse. People told us they felt safe living within the home and where risks had been identified for people staff had taken appropriate action to help reduce the possibility of reoccurrence.

People received the medicines they required and we found medicines were stored appropriately. Staff working with other health professionals to help ensure people received the most appropriate care. In the event of an emergency people’s care would continue with the least disruption possible.

Staff followed the legal requirements in relation to consent to ensure people’s views had been considered and they made their own decisions where they could. The staff was very knowledgeable on people’s individual dietary requirements. People were offered a choice of meals and could always ask for an alternative.

People were cared for by staff who were supported by management. They had been given access to relevant training to allow them to carry out their roles competently and they had regular opportunities to meet with their line manager to discuss their performance.

A range of activities took place within the home and people were encouraged to participate. Where people preferred some quiet time to undertake their own interests we saw staff respected this. People were seen to be independent and enabled to move around their individual units and the home unsupported. If people were unhappy about any aspect of their care they told us they felt confident they could speak to staff. We saw a complaints policy in place and complaints received had been responded to.

The new manager had made a positive impact on the home in the time they had been there. They knew the people who lived there and they demonstrated their support of staff as we received positive feedback from staff about them. People, relatives and staff were involved in the running of the home and feedback and suggestions were listened to. Quality assurance processes were in place to monitor the quality of care provided and actions identified were acted upon. We found notifications had been submitted to CQC when required.

During our inspection we made some recommendations to the registered provider.

This was an unannounced inspection that took place on 24 May 2016.

The home did not have 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 and associated Regulations about how the service is run. We were told a new registered manager had been recruited and was due to commence in post in July 2016. The deputy manager’s helped us during our inspection.

Although there were a sufficient number of staff on duty staff were not deployed appropriately to ensure people always received care in line with their care plan. Staff told us the increase in staffing levels had a positive impact on people and people said they did not have to wait for support.

Risks to people had been identified, however, some guidance for staff was missing. Although falls were monitored routinely by staff the same was not done for accidents and incidents. This meant action may not always be taken as promptly as it could be.

Although quality assurance processes were in place staff did not always follow up on actions identified. The provider had failed to ensure robust processes were in place for ensuring that all staff worked to a certain standard.

Medicines records were not always well maintained, however, staff held medicines securely and information in relation to other medicines, such as ‘as required’ and topical creams was in place.

Staff did not always comply with the Mental Capacity Act 2005 or Deprivation of Liberty Safeguards requirements. People’s care records were not always complete or contained sufficient information for staff which meant people might not always receive responsive care.

Staff helped to protect people because they were aware of their responsibilities in relation to safeguarding. Staff had received fire training which meant they would know what to do in the event of having to evacuate the building.

The provider had recruitment processes in place to help ensure they only employed staff suitable to work in the home. Staff felt supported by management and enjoyed working at Meadowside.

People were provided with a range of foods and enabled to make decisions about what they ate. People who had specific dietary needs were given food appropriate to these needs. People told us they enjoyed the food and could always ask for an alternative.

Staff enabled people to access health care services should they need it. Such as the GP, district nurse or optician. People were encouraged to make their own decisions and remain independent.

People were cared for by staff who treated them with kindness, respect and attention. Both people and relatives had only positive comments about the staff who worked at Meadowside. Relatives told us they were always made to feel welcome.

People had access to a range of activities and people with specific hobbies and interests were supported to maintain these. Should people feel the need to make a complaint there was information available to them in order to do this.

Everyone felt involved in the running of the home. They were encouraged to attend meetings as well as leave feedback and suggestions.

During the inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made a recommendation to the provider. You can see what action we told the provider to take at the back of the full version of the report.

All the people that we spoke with told us they received good care at the home. All people were complimentary about the staff and confirmed they were kind towards them. One person told us 'It's not my home but it's really nice here.' Another person told us 'I'm looked after well by the staff.'

During our observations and speaking with staff we saw that staff consulted with people who used the service. This was to ensure they gained consent prior to personal care or treatments being carried out.

Care plans and risk assessments had been updated regularly and reflected the care needs that had been identified.

Safeguarding training had taken place for staff and they had good knowledge of the procedures to be followed.

We found the home had enough staff to meet the needs of the people who used the service. The provider had identified the home needed more support at night and numbers had been increased prior to the inspection

The provider had systems in place which ensured complaints were listened to and taken seriou

In one dining room the people were very complimentary about the carer who was assisting them with lunch 'she's our angel' they told us. In another lounge we found one member of staff being very supportive and kind to one person who was demonstrating challenging behaviour during the lunch period. This particular person kept calling out for attention but the carer approached her regularly and reassured them that someone was in the room and they were there to help. The member of staff was supportive and spoke in a quiet voice to respect their privacy.

We spoke to some relatives that were visiting the home. We were told by one family member that their mother's health had improved since admission to the home and there had been no admissions to hospital. This had been a frequent occurrence when at home.

The home has not had the benefit of consistent management arrangements during this year and following this inspection has two compliance actions which can be viewed in the report. Training had not taken place for the staff and quality audits to ensure the health and safety of people using the service and staff had also not taken place.