Long Meadow

Updated 22 December 2023

Inspection team

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

The inspection was carried out by 1 inspector.

Service and service type

Long Meadow is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. 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 used all of this information to plan our inspection.

During the inspection

Inspection activity started on 3 October 2023 and ended on 13 October 2023. We visited the service location on 3 and 9 October 2023. We made phone calls to relatives on 12 October 2023.

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.

We spoke with 5 people who lived at the service, 3 relatives and 1 visiting healthcare professional.

We spoke with 13 staff including the manager, regional manager, 2 senior carers, 3 carers, 2 housekeepers, 2 kitchen staff, 1 activity and 1 maintenance staff member.

We reviewed the relevant parts of 13 people’s care plans and multiple medicines records. We looked at other records such as staff training records, recruitment files, policies and audits.

Updated 22 December 2023

About the service

Long Meadow is a residential care home providing personal care to up to 41 people. The service provides support to older people and younger adults. At the time of our inspection there were 34 people using the service

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

Systems to help protect people from abuse had not always been operated effectively. Not all relevant care plans and risk assessments required to help keep people safe were in place. Monitoring and assessment of people’s behaviours that challenged was not always consistent or effective. Equipment had not always been provided to ensure people received safe care. Accident and incident reporting and monitoring of behaviours that challenge were not always operated effectively.

Measures to prevent and control infection were not always effective as there was not always enough housekeeping staff to complete planned cleaning tasks. Staff had not always been deployed to ensure people received the care that was planned and needed. Not all agency staff had received appropriate support when they first started at the service. Other staff had completed training relevant to people’s healthcare needs.

Not all assurances were in place to show people received suitable food and people were not always offered meal choices.

Records were not always complete and accurate and the provider had not always followed their own safeguarding policy. Systems to help improve the safety and quality of services and reduce risks were not always effective. The provider had not always been able to provide a person-centred care care experience for people.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People’s healthcare assessments had been regularly updated. People saw other healthcare professionals when needed and had access to healthcare services. The home had been adapted to meet people’s needs and the provider had ongoing plans in place to refurbish parts of the home.

Policies were in place for the management of infections and outbreak such as Covid-19. Other actions had been taken since our last inspection to secure windows and ensure action plans were followed to ensure fire safety was maintained. Visitors were able to freely visit people living at Long Meadow. Recruitment processes were followed to help the provider recruit staff safely. Medicines were managed safely.

A new manager was in post and they intended to register with the CQC. Meetings were planned with staff and relatives to help keep them informed of relevant information and involve them in the running of the service. The provider understood and acted on their duty of candour to be open and honest when things had gone wrong.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 December 2022).

At our last inspection we found breaches of the regulations in relation to the systems used to ensure people received good quality care, are protected from abuse and receive safe care. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection, we found the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to people’s safe care, the use of equipment, staff competence, staffing levels and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report

You can see what action we have asked the provider to take at the end of this full report.

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

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 found breaches in relation to safe care, safeguarding, staffing and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 will re-inspect within six months of the date we published this report to check for significant improvements.

If the registered provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question, we will take action in line with our enforcement procedures. This usually means we will start processes that will prevent the provider from continuing to operate the service.

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

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.