Archived: 80 Meridian Walk

About the service

80 Meridian Walk is a residential care home providing personal care to six people at the time of the inspection. The service can support up to six people.

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

Right Support

The service did not support people to have the maximum choice, control or to be as independent as they could be. While people’s bedrooms were highly personalised, the communal areas of the home were in a poor state of repair and were not homely. For long periods during the inspection people were left with minimal stimulation and engagement while music played and the television was on with a low volume. There was limited evidence that people were supported to explore their interests. People had been assessed as lacking capacity to consent to their care and treatment. Where specific decisions needed to be made, appropriate best interest decision making processes had been followed. People were supported by staff to take their medicines, but records contained conflicting information about what medicines people were prescribed.

Right Care

Staff knew about people’s cultural backgrounds, but there was a reliance on people’s families to meet cultural needs. Staff knew people and their needs but did not demonstrate compassion or respect in their interactions with people. Information about people’s communication needs and styles was limited and some information showed misunderstandings about different tools of communication. People’s care was not planned in line with best practice guidance; people were not supported to identify goals or ambitions. People were not receiving care as planned and were rarely supported with activities and were not active members of their community.

Right culture

Staff were not ambitious for the people they supported and did not show they understood how to engage people with all aspects of their own lives. The service had recently recruited additional staff but the use of agency staff to fill rotas remained high. The agency staff were well known to people but the way staff were deployed showed there was a task focussed approach to support. The provider had allowed a culture of low ambition and aspiration to flourish in this home.

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

Rating at last inspection

The last rating for this service was good (published 26 February 2018)

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right Support Right Care Right Culture.

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to Person Centred Care, Dignity and Respect, Safe Care and Treatment and Good Governance.

We served the provider and registered manager with Warning Notices which required them to meet the regulations by a specified date.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service was last inspected in October 2015 and was rated Good.

The inspection took place on 17 January 2018 and was announced. The provider was given 24 hours’ notice to ensure people were available to meet us during the inspection.

The service 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 2008 and associated Regulations about how the service is run . The acting manager had made their application to the Care Quality Commission to become the registered manager.

The service was safe and had practices in place to protect people from harm. Staff had training in safeguarding adults from abuse and knew what to do if they had any concerns and how to report them.

Risk assessments were personalised and robust to keep people safe from harm. Staff had the information they needed to mitigate risks.

Staffing levels were adequate to meet the needs of people who used the service and cover arrangements were in place if there were any absences.

Recruitment practices were safe to ensure staff were suitable for working in the caring profession.

Medicines were managed and stored safely. Support workers were only permitted to administer medicines after they had undertaken training and were assessed as competent to do so.

The service was clean and free of malodour. People were protected from the spread of infection due to a robust cleaning schedule.

The service documented incidents accurately and learned from them in order to put procedures in place to prevent them from reoccurring.

Training for care staff was provided on a regular basis. Staff spoke positively about the training they received.

Staff had a good understanding of the Mental Capacity Act (2005) and how to obtain consent on a daily basis.

People were supported to maintain a balanced diet and had a choice of food and beverages.

People were supported to have access to healthcare services and receive on-going support. The provider made referrals to healthcare professionals when necessary and advice from healthcare professionals was followed.

Staff demonstrated a caring and supportive approach towards people who used the service and we observed positive interactions and rapport between them.

The provider promoted the independence of the people who used the service and people felt respected and treated with dignity.

Care plans were reviewed every six months and any changes were documented accordingly.

Concerns and complaints were encouraged and listened to and records confirmed this. Relatives of people who used the service told us they knew how to make a complaint.

The acting manager had a positive relationship with staff and people who used the service. Staff spoke positively about the acting manager and their management style.

The provider had quality assurance methods in place and carried out regular audits to improve the service.

In order to gain an independent and external view on the quality of the service being provided at this service, we consulted two separate family members. One family member told us that the quality of the service was "quite good." This same person commented on concerns when regular staff were unavailable and temporary or agency staff had to be used.

Additional comments made to us by a relative related to lack of in-house activities.

People who used this service experienced effective, safe and appropriate care because their needs were assessed and their support was planned and delivered to ensure their welfare was protected and their needs were met.

People who used this service had their nutritional needs met and there was a range of variety and choices available to them.

Staff had received safeguarding of vulnerable adults training and knew how to report any concerns they had.

People who used this service were provided with equipment which had been properly assessed and for which staff had been trained to use when supporting them.

Staff were properly supported by the home when they were first inducted into their role and managers regularly and appropriately supervised staff.

People who used this service were supported in a home which took steps to continuously assess and monitor the quality of the service being provided.