The Meadows

Updated 8 January 2021

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 Care Act 2014.

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

The inspection team consisted of one inspector, a member of the medicines team 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 is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with four staff during the first inspection day. We looked at two staff recruitment files, daily records for people, staff meeting and resident meeting minutes and staff rotas. We spoke with a visiting consultant who provided support to people. During the second day of inspection we reviewed in detail four people’s medicine administration records and associated care plans. We checked policies and procedures, medicines audits and records and spoke with two members of staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

Following the inspection visit and in order to minimise the time spent on site due to the pandemic, we interviewed six further staff and spoke with six people using the service. These meetings were conducted via video calls. We also spoke with one other healthcare professional.

Updated 8 January 2021

About the service

The Meadows is a residential care home providing personal care and support care to 10 people who have a learning disability and or mental health conditions. The service can support up to 14 people. The Meadows accommodates people in one adapted building. Accommodation is set over two floors with a lift to access the first floor. Communal space is on the ground floor. The home is set back off the road with easy access to the local village.

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

People said they enjoyed living at The Meadows and felt safe. One person said, “I feel safe here as the staff are approachable even the agency staff, feels like a family even more so since the lockdowns.” Another said, “The staff here are a lovely team, some residents say they hate living here but they don’t, they just like to moan.” Two people said they would like to move on. One person told us “I want to move on to somewhere else as I have been here long enough, it’s not that I am unsafe, but I would like to live in Taunton.” One person said they were unhappy with the restrictions placed on them and would like to move. They were being supported with an independent advocate and restrictions were part of their agreed plan and Deprivation of Liberty safeguard process.

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 this practice. Some people had previously lived in more secure settings and through careful person-centred planning were being enabling to lead less restrictive lives.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they are working towards meeting the underpinning principles of Right support, right care, right culture. Although the service is larger than recommended, the use of positive support plans and individualised activities meant people were enabled to follow their interests’ hobbies and passions as far as possible. This had been curtailed by the pandemic and lockdown restrictions. Future planning was taking place to look at development of move on flats on site and developing more communal space so people could choose to be in smaller groups. In addition, people’s needs were being reviewed and two people had moved on to other settings as a result of this. Compatibility of people living together was being reviewed as was the skill mix of staff supporting them. Staff training had been enhanced since the last inspection to enable staff to consider a more person-centred approach for each individual living at The Meadows. Investment in enhancing the environment was ongoing and people were being enabled to influence choice of decoration and how they wished to develop their garden space.

Since the last inspection we found medicines were being managed safely. Risks were being clearly identified, assessed and monitored in a more timely way.

Staff reported there had been a lot more training support and guidance available to them. The team felt positive about the new management team and the direction they were working towards to enable people to live fulfilling lives. Most staff said there had been a definite improvement in staff numbers on shift, in skills and in staff morale.

Work had commenced on improving the environment. For example the entrance hall had been refurbished and people who live at the service had chosen a calming Forrest décor. Some of this work had unfortunately been delayed due to the pandemic and lockdown, but it was clear investment and plans to improve the building and grounds were taking place.

We made one good practice recommendation in respect of medicines.

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

Rating at last inspection and update

The last rating for this service was requires improvement (report published 7 May 2020)

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned focussed inspection based on the previous rating. We looked at the key areas where breaches had been identified.

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 coronavirus and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 11 March 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Meadows on our website at www.cqc.org.uk.