The Meadway

The Meadway is a domiciliary care agency providing personal care to people. The service provides support primarily to people living within a supported living service but also within people’s own homes. The service provides support to people who may have a physical disability, dementia or a learning disability. At the time of our inspection there were five people receiving personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided

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

The provider had not ensured systems were in place to oversee the service and ensure compliance with the fundamental standards.

We have made a recommendation about reviewing best practice in relation to medicine administration records.

People told us they felt safe. The provider ensured their safeguarding systems were operated effectively to investigate allegations of abuse, neglect or acts of omission. Individual risk assessments were in place meaning staff knew how to provide safe care to people.

There was positive feedback about how staff felt regarding the new registered manager and the support, accessibility, and the management of the service. Staff felt they could ask the management for help when needed. Staff felt the management was open and transparent with them.

The service had an open and transparent way of working to ensure the safety of the people living at the service. Staff knew people they supported well and cared about their wellbeing. 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 supported this practice.

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 25 July 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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 good to requires improvement based on the findings of this inspection. 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 The Meadway on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Tonna Care Services Limited is a domiciliary care agency predominantly providing a supported living service to people. A range of support is provided to people living in their own homes, some of whom share accommodation with others. The service supports mainly people with a learning disability and associated needs. At the time of the inspection the service was providing personal care to approximately 74 people.

There was a registered manager for the service. 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 and their relatives told us that they felt safe with staff and would be confident to raise any concerns they had. The provider’s recruitment procedures were robust, medicines were managed safely and there were sufficient staff to provide safe, effective care.

There were procedures in place to manage risks to people and staff. Staff were made aware of how to deal with emergency situations and knew how to keep people safe by reporting concerns promptly through processes that they understood well.

New staff received an induction and spent time working with experienced members of staff prior to working alone with people. Staff were supported to receive the training and development they needed to care for and support people’s individual needs.

People and their relatives said they felt listened to and the majority were happy with the service provided. They told us that staff treated them with kindness and respected and involved them in decisions about their care.

People’s needs were reviewed and updated regularly. Individual care plans were in place which provided information about people’s care needs and they were specifically designed to promote person-centred care. Up to date information was communicated to staff to ensure they provided appropriate care. People were supported to contact healthcare professionals in a timely manner if there were concerns about their wellbeing.

People and their relatives told us they had been asked for their views on the service and were able to raise concerns and complaints if they needed to. They felt confident that staff and members of the management team would take action if necessary.

The provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care. Feedback was sought from people, their relatives and health and social care professionals and care records were audited. Complaints were addressed and action was taken according to the provider’s policy.

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.

People were supported and encouraged to make as many decisions for themselves whenever they were able. Access to community facilities and spontaneous outings were possible due to the nature and size of the supported living service.