On the day of our inspection there were 68 people living at The Meadows. We spoke with seven people who used the service, one person's relative and carried out a short observation framework (SOFI). A SOFI is used to capture the experiences of people who use the service who may not be able to express this for themselves.The home offered residential, nursing and dementia care. The home is part of The Order of St John Community Trust.
A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
People were cared for safely. Risk assessments were in place and regularly reviewed. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. One person told us 'everyone always asks for my consent even the cleaners ask if it's ok to come in and clean'.
There was enough appropriately qualified, skilled and experienced staff to meet the needs of the people who lived at this home at the time of our inspection. People living on Primrose and Bluebell unit told us that although care workers seemed busy at times they had time to meet their needs. The provider may find it useful to note that people on Poppy unit told us they felt there were not enough care workers on duty. One person said, 'there are never enough staff; the girls [care workers] are lovely but they are run off their feet. Another said 'they [care workers] look after me well but always seem really busy, I think they need more staff'. We saw that call bells were mostly answered promptly. We observed care on all three units and saw that care workers did not rush people during care tasks. We noted that although care workers were busy there was a calm and pleasant atmosphere throughout the home.
There were arrangements in place to deal with foreseeable emergencies. There was emergency lighting and plans for managing the person's needs in the event of a power failure. Each person had an emergency evacuation plan for use in the event of a fire.
We found that medicines were handled safely and securely. Appropriate arrangements were in place for obtaining and disposing of medicines safely and suitable records were kept regarding medication administration.
Systems were in place to make sure that managers and care workers learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service to continually improve.
The provider understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager had made three DoLS applications where it was in a person's best interest to do so.
Is the service effective?
The service was effective. People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with care workers that they understood people's care and support needs and that they knew them well. One person told us. "they [care workers] know me and what I need them to do'. Care workers had received training to meet the needs of the people living at the home.
Is the service caring?
The home was caring. People we spoke with were complementary about the home. One person said, 'they [care workers] look after you. I can't fault it'. Another said, 'staff are smashing, they can't do enough for you'. A relative told us 'I think they are brilliant and [the person] is being well looked after'. During the SOFI observation we saw that people were given choices, supported to make decisions and care workers took time to understand people where they had communication difficulties. Throughout our inspection the atmosphere was pleasant and we observed many interactions between care workers and people that were caring, relaxed and friendly.
Is the service responsive?
The service was responsive. People's needs had been assessed before they moved into the home, regularly reviewed and reflected in the care plans. We saw evidence that care workers recognised when a person's condition changed or their health had deteriorated and sought the help and advice of other professionals. We spoke with visiting health professionals who told us they found staff to be 'very helpful' and 'make a real effort to follow any recommendations'. One professional told us that people's 'changing needs are identified and alerted to us quickly'.
Is the service well-led?
The service was well led. There was a registered manager in post who was visible and available for people and staff to raise any concerns. We saw that the provider took account of complaints, comments and feedback to improve the service. During our inspection we looked at the quality assurance systems that were in place. The information reviewed demonstrated that the service was monitored on a consistent basis to ensure that people experienced safe and appropriate support, care and treatment.