Archived: Meadowbank Care

At our last comprehensive inspection of 18 April 2013 we found the service was not meeting the requirements of the regulations in place at the time in respect of safe staff recruitment. We followed this up at an inspection on the 31 July 2013 and found there were still issues outstanding with staff recruitment practice. We took compliance action and the provider submitted an action plan to address this in September 2013. We carried out a further inspection in February 2014 to check if appropriate action had been taken. We found the provider had made the necessary improvements and that the service met the requirements of the regulations in respect of staff recruitment.

Meadowbank Care is registered to provide care for up to twenty two older people, some of whom may live with dementia. Eighteen people were being cared for at the time of our visit.

The service had 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 2008 and associated regulations about how the service is run.

We received consistently positive feedback about the service. “The standard of care is excellent” and “Absolutely excellent” were some of the comments made to us by people who lived in Meadowbank or their relatives. The only issues of concern expressed were in respect of the timing of the evening meal and bed time which were thought to be too early for some people and the frequency of activities outside of the home.

There were safeguarding procedures in place and staff received training on safeguarding vulnerable people. This meant staff had the skills and knowledge to recognise and respond to safeguarding concerns.

Risks to people were identified and managed well at the service so that people could be as independent as possible. A range of detailed risk assessments were in place to reduce the likelihood of injury or harm to people during the provision of their care.

We found set staffing levels were adequate to meet people’s needs effectively. The commitment and team work of staff meant people were kept safe and ensured their needs were met appropriately.

Staff had been subject to a robust recruitment process. This made sure people were supported by staff that were suitable to work with them.

Staff received appropriate support through structured induction and supervision. Although formal supervision was only approximately two to three monthly, all the staff we spoke with said they felt able to speak with the registered manager or senior staff at any time they needed to. There were also regular team meetings held to discuss issues and to support staff.

We looked at records of training for all staff. We found there was an on-going training programme to ensure staff gained and maintained the skills they required to ensure safe ways of working.

Care plans were in place to document people's needs and their preferences for how they wished to be supported. These were up to date and subject to review to take account of changes in people's needs over time.

Medicines were administered in line with safe practice. Staff who assisted people with their medicines received appropriate training to enable them to do so safely.

The service was managed effectively. The provider regularly checked quality of care at the service through audits and by giving people the opportunity to comment the service they received and/or observed.

We did not speak to people who use the service at this inspection. This was because our inspection was to follow up changes the provider was required to make, to attain compliance with the requirements relating to workers regulation.

We found the provider had improved their recruitment and selection processes to ensure a robust system of employment for new staff. This included changing their interview mechanisms, the type of information they collected before workers started and ensuring that the information required by Schedule 3 was in personnel files.

We spoke with the nominated individual and business partner about what changes the provider had made following our previous inspections. The provider had made some changes to their recruitment practices such as reviewing their recruitment tools so that they recorded more information about new workers.

However, the provider failed to undertake appropriate checks prior to new care workers taking up employment, to ensure that people who use the service were not placed at risk.

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. Refurbishment of the older part of the premises had occurred to increase the safety of people who use the service.

Appropriate checks were not always undertaken before new staff began work. The four personnel files we looked at were all missing some of the documentation required by the regulations.

Records were kept securely and could be located promptly when needed. Since our last visit, people's care records had been moved form a filing cabinet in a communal dining area to a locked staff office. We spoke to the registered manager about this and they told us the change was to improve the confidentiality of people's records.

We spoke with three people who use the service and one relative. All of the people we spoke with told us they were enabled to make decisions for themselves and the staff respected their decisions. For example, one person we spoke with told us, "If I wanted to eat a particular dish, I could ask for it and it would be considered".

Care plans were written in from the perspective of the people who use the service. The care plans contained guidance for staff about the way each person wished to be supported and cared for.

We looked at six staff recruitment files. We found key pre-employment documents missing from all of the staff recruitment files we reviewed. This meant the provider was placing people who use the service at risk of being cared for by staff who did not have appropriate knowledge, skills or experience.

We spoke to three people about the complaints system at the home. People told us they would feel comfortable making a complaint if they had one All of the people we spoke with were satisfied with the care home and did not have any complaints to make.