The Care Quality Commission
  • Care Home
  • Care home

Archived: Meadowside

Overall: Good read more about inspection ratings

60 Holden Road, Finchley, London, N12 7DY (020) 8492 6500

Provided and run by:
The Fremantle Trust

All Inspections

23 November 2017

During a routine inspection

This inspection took place on 23 November 2017 and was unannounced. At our last inspection in October 2015 the service was rated as good.

Meadowside is a care home for older people. The home has 68 beds split into six flats on three floors; each floor has its own dining area and lounge. On the day we inspected there were 65 people living in the home. People in care homes receive accommodation and nursing or personal care as 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 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.

People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.

Staff treated people with respect and as individuals with different needs and preferences. Relatives we spoke with said they felt welcome at any time in the home. They felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained information about how to provide support, what the person liked, disliked and their preferences and interests.

The staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences.

Staff understood the provider’s safeguarding procedures and could explain how they would protect people and who to contact if they had any concerns.

Risk assessments were in place for a number of areas and were regularly updated, and staff had a good knowledge and understanding of many health conditions.

There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people living at the home.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Medicines were managed safely. Staff had received relevant training and regular medicine audits were taking place.

People were satisfied with the food provided at the home and the support they received in relation to nutrition and hydration.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff told us they really enjoyed working for the organisation and spoke very positively about the culture and management of the service. Staff told us that they were encouraged to openly discuss any issues.

People, relatives, staff and health and social care professionals spoke highly of the registered manager; they found her to be dedicated, approachable and supportive. The registered manager understood their responsibilities and ensured people, relatives and staff felt able to contribute to the development of the service. Staff were supported to be valued members of the organisation. The continued development of the skills and performance of the staff was integral to the success of the service.

The provider’s governance framework ensured quality performance, risks and regulatory requirements were understood and managed. There was good use of online monitoring tools in support of this.

6 October 2015

During a routine inspection

This inspection took place on 6 October 2015 and was unannounced. At our last inspection in September 2013 the service was meeting all of the regulations we looked at.

Meadowside is a care home for people with learning difficulties, dementia and physical frailty. The home has 68 beds split into six flats on three floors; each floor has its own dining area and lounge. On the day we inspected there were 65 people living in the home.

There was a new manager in post and she had not yet gone through the process of being registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with CQC 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 and associated Regulations about how the service is run.

People were positive about the service and the staff who supported them. People told us they liked the staff that supported them and that they were treated with dignity and kindness.

Staff treated people with respect and as individuals with different needs and preferences. Staff understood that people’s diversity was important and something that needed to be upheld and valued. Relatives we spoke with said they felt welcome at any time in the home; they felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained detailed information about how to provide support, what the person liked, disliked and their preferences. People who used the service along with families and friends had completed a life history with information about what was important to people. The staff we spoke with told us this information helped them to understand the person.

The care staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home. Some staff told us that during busy periods they did not have as much time to spend with people.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Medicines were managed safely. Staff had detailed guidance to follow when administering medicines. Staff completed extensive training to ensure that the care provided to people was safe and effective.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. A complaints book, policy and procedure were in place. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and reports on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The manager had knowledge of the MCA 2005 and DoLS legislation and appropriate referrals for DoLS authorisation had been made so that people’s rights would be protected.

The management team provided good leadership and people using the service, relatives and staff told us they were approachable, visible and supportive. We saw that regular audits were carried out by the provider’s head office to monitor the quality of care.

The provider employed a leisure and lifestyle lead who organised a large range of activities that provided entertainment and stimulation for people living in the home.

24 September 2013

During a routine inspection

We spoke with four people who were using the service. They told us that they had no complaints, they enjoyed the food provided and the staff looked after them very well. Comments included "I have a very comfortable bed", "I love going into the garden" and, "I like to join in with the quizzes."

We spoke with the relative of one person who was overall very happy with the care given to her relative. She did, however, feel that there were not always enough staff for the lunchtime period. She was fully aware of the complaints procedure but said that she would not need to use it as "the managers always listen."

We saw that staff helped people in a friendly and professional way, offering assistance where required and also supporting choice and independence. We observed an engaging conversation with one person who was remembering his work in Africa. One staff member said she would come and talk to him later, to talk more about this subject and the person was thrilled.

We saw that the home was clean and tidy, with all bedrooms having an en-suite facility. We saw that there was a good atmosphere in the home and that people enjoyed taking part in the activities held on the day of the inspection.

26 July and 6 September 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live in this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) Inspector joined by an Expert by Experience; people who have experience of using services and who can provide that perspective. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.

People said that they were given choices of food, if they didn't like their first choice they were given a second one. People gave examples of how their food preferences were met on a daily basis.

People and their relatives told us that staff were always polite and they did not feel rushed. Staff knocked on doors before entering people's rooms and they were treated with dignity and respect. One person said "they are all pleasant when I am receiving personal care and they speak to me with respect." People told us that they felt safe at the home and felt able to speak to the manager about any concerns they had and knew they would be dealt with.

12 July 2011

During an inspection in response to concerns

A person told us that it 'seemed nice here'. One person said that they 'used to be so shy' and didn't mix a lot but this had changed and they were now joining in activities. There were a number of activities taking place during our visit, even though the activities coordinator was on leave. We saw carers playing music and encouraging people to sing along and to dance to the music, a game of soft ball was being played and a recognition game was taking place. Not everyone enjoyed music being played in the lounge areas.

People were involved in the day to day running of the home by giving feedback on applicants wishing to work in the home and in decisions about the care and support they received. Members of staff talked to people using the service and explained what they wanted to do before providing care and people gave their consent by saying 'alright' or 'yes'. People were unaware of their care or support plan. However, they were generally satisfied with the care received. They told us 'I get help here' and one person who said 'I like to go to bed reasonably early' confirmed that their wishes were met.

We asked people who use the service whether they were satisfied with the meals served in the home. Comments included 'you can choose the meals sometimes' and

'the food is good. There is enough. I like chicken and fish'. At the end of the meal a person who finished their meal said 'lunch was nice'. People told us that they felt safe and comfortable with members of staff supporting them and with the other people that they lived with. We were told that it was very nice in the home and that the people were 'very nice'. Another person said 'I am treated well'.

We asked people who use the service if there were enough members of staff on duty to provide the service needed. Comments included 'I've never really noticed staffing levels' and 'on the whole it's not bad'. When we asked people about the quality of care and about the people providing support comments included

'the staff are alright. I like them very much', 'nice carers' and 'some are very nice and some push you about. '. This was in reference to having incontinence pads changed in the early hours. However, they said that when they woke up the staff came quickly to help them. A family member told us that staffing levels were 'not enough' although members of staff were 'kind and caring'. When we asked about the quality of the service provided a person said 'you can't fault it'.

20 January 2011

During a routine inspection

When people who use the service commented on Meadowside as a care home we were told that they had read an article about what makes a good care home and 'Meadowside ticks all the boxes: you feel you belong, the staff are good, which is important'.

'When you walk in the front door, when you first come in, they greeted me wonderfully well'.

People who use the service confirmed that members of staff listened to them when people said what they wanted. They told us that members of staff "understood". They said that they didn't just have to accept things but could make their own minds up. People spoke about maintaining their independence by regaining skills and by keeping a good level of mobility.

People that visited the home prior to their admission told us that they were "happy to come back" and that "they liked it here". People were able to choose to spend time in their rooms, as they wished or join in the activities taking place. They told us that when assistance was given with personal care the carers respected their privacy and dignity.

"You can join in the activities. We cooked garlic bread".

"A lady comes to take people down. They were making cards".

When we discussed whether staff talked to people using the service and explained what they wanted to do before providing care i.e. seeking consent they told us

"They do explain first what they are doing, if not I would ask".

Most people were often unaware of their care or support plan and did not have a copy of the plan. A person that was aware of their plan told us

"I'm not sure how it's put into practice".

However, people were satisfied with the assistance given to enable people to maintain a healthy lifestyle. They valued having support to regain their independence. Comments included

"I came from hospital after problems with my leg. Immediately they helped to get me walking, using a frame. At first I had to be helped into bed and now I can dress and wash."

People said that the menu offers alternatives and that the food was very good. They said that portions were good and that they could choose whether to eat in the dining room or in their own room.

"They ask you the night before what you want".

"You don't have to accept what's on the menu".

"I enjoy all my meals".

People said that they felt safe living in the home and safe with the people supporting them. Names were given of who they would speak to if they were worried about anything or if they were upset and these included the names of members of staff working on their unit or the manager. People commented

"I feel safe here".

"I've no worries. Everything is taken care of".

People living in the home said that the home was kept clean and they were satisfied with the overall standard of hygiene. Praise was given when talking about the domestics.

"It's always clean, it's a compliment to the staff".

"The cleaners are excellent and obliging".

People said that they were satisfied with the assistance given to them with medication. They confirmed that medication was given as often as it should be and at the correct times of the day.

"It makes it safer" - Person was referring to the storage and administration of medication by the home.

"They bring it to me regularly".

People were pleased with their surroundings and appreciated having personal accommodation that included ensuite facilities. they said that everything was in good working order. Comments included

"It's a home from home".

"First appearance is very important'..can't fault anything".

People said that members of staff were knowledgeable about their needs and there was a good rapport between members of staff and people using the service, with some good natured banter. They agreed that there were enough staff on duty to support them but that members of staff were very busy. They told us that

"I have a problem with names but I can recognise understanding and people who are suited to the job".

"You can have a laugh. They are approachable".

They agreed that the members of staff providing care were kind and helpful and although there were enough staff on duty to support them, the members of staff were very busy.

"Good staff but they have to rush around".

"Staff are able to talk with me sometimes".

People were aware of who the managers were in the home and were confident that they could talk with them to tell them about any concerns, problems or complaints. Regular residents' meetings were held and people using the service were asked for their views and suggestions for improvements.

"We have residents' meetings but no one speaks up, they are too ill".

Overall people who use the service were satisfied with the service received and with the quality of care and said that there had not been any need to make a complaint.

"I've no complaints about how the home is run. The care is excellent".

"If I'm not happy I would go straight down to the manager".