The Meadows Care Home

Updated 9 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Meadows care home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Meadows care home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider had not been sent a provider information return (PIR) prior to this inspection. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We discussed this information with the registered manager as part of this inspection.

During the inspection

We spoke with 8 people and 1 person's relative to gain their views about the service. We also spoke with 10 staff including the registered manager, deputy manager, a nurse, an administrator and care staff. We reviewed care plans and records for 5 people and undertook a sampled review of people's medicines. We reviewed 3 staff recruitment files, staff training records and other records relating to the day to day management and governance of the service.

Updated 9 August 2023

About the service

The Meadows Care Home is a care home providing nursing and personal care for up to a maximum of 34 people. The service provides support to older people and people with physical disabilities in an adapted building, over 2 floors. At the time of our inspection, there were 32 people using the service.

People's experience of using this service and what we found

Risks to people had not always been mitigated. Care records did not always evidence staff were following people's care plans in providing effective and timely intervention to manage known risks. Records did not demonstrate what, if any, interventions staff were providing when people became distressed, prior to administering anti-psychotic medicines. Medicine administration systems were not always effective in demonstrating people had received their medicines as prescribed.

There were systems to monitor and improve the quality of the service provided but these were not always effective. Audits and checks had not identified the concerns we found during this inspection around care records, staff interventions and medicines.

Overall, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation that the provider reviews people's mental capacity assessments to ensure these are sufficiently detailed and support specific decision making.

People's care plans included information about people's life histories, wishes and preferences that support staff to provide personalised care. People were able to participate in a range of activities. People and relatives felt able to raise concerns if they needed to. We have made a recommendation that people's care plans record that opportunities have been provided for them to discuss their end of life wishes.

People were supported to maintain their well being and stay healthy. Staff worked with a range of health and social care professionals. Staff received the training, supervision and support they needed to understand and meet people's needs.

People told us they felt safe living at the home and with the staff who supported them. Staff had been trained to recognise and report signs of abuse. There were sufficient staff to meet people's needs and help keep them safe. The provider's staff recruitment procedures helped to protect people from harm. The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19.

People and their relatives were consulted about their care and support and engaged in the development of the service. Staff supported people to be a part of their local community and worked with external agencies to enable people to maintain their health and well being.

The registered manager was open and transparent throughout the inspection. Updated records and new procedures were implemented immediately after the inspection. However, these required time to become embedded into practice to reduce risks.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating under the previous provider was good (published 12 October 2019). This is the first inspection under this new provider.

Why we inspected

We received concerns in relation to infection prevention and control and oversight. Whilst we did not found any concerns around the management of infections, we made a decision to inspect all key questions for this new provider based on the evidence we found.

You can read the report from our last comprehensive inspection under the previous provider, by selecting the 'all reports' link for The Meadow Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk management and management oversight at this inspection. You can see the action we have told the provider to take at the end of this report.

We have made a recommendation that the provider reviews mental capacity assessments to ensure they meet the requirements of the Mental Capacity Act 2005.

We have made a recommendation that the registered manager ensure opportunities to discuss end of life are recorded in people's care plans and include their wish to decline to discuss this if relevant.

Follow up

We have requested an action plan from the provider. We will continue to monitor information we receive about the service, which will help inform when we next inspect.