Background to this inspection
Updated
30 August 2019
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.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Mead Lodge is a care home for older people, the majority of whom were living with dementia. People in care homes receive accommodation and nursing or personal care. 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 they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided in line with the Health and Social Care Act 2008 and associated Regulations.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications the service had made, and the details of concerns raised with us about the service. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the registered manager, deputy manager, nominated individual, a director of the company and care staff. Service's are required to register a nominated individual. A nominated individual is a senior person with authority to speak on behalf of the organisation. They carry responsibility for supervising the management of the carrying on of the regulated activity
We reviewed a range of records. This included nine people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
Updated
30 August 2019
About the service
Mead Lodge is a care home registered to provide accommodation and personal care to a maximum of 24 older people. At the time of the inspection there were 20 people living in the service.
People’s experience of using this service and what we found
We carried out this inspection in response to concerns about the safety and welfare of people using the service.
People didn’t always receive support from staff at the time they required it. Staff did not respond to people’s requests for support in a timely way and this compromised people’s safety, welfare and dignity.
People’s medicines were not always managed and administered safely. This led to some people not receiving medicines prescribed for them.
Risks to people had not always been identified and planned for. This meant staff did not always have access to information which could guide them on how to reduce risks.
The service did not have an adequate system in place to analyse accidents and incidents for trends. This meant they had not identified trends which they could have acted on to protect people from harm.
The support people needed to reach and maintain a healthy weight was not always documented.
The quality assurance system in place had not identified the shortfalls we identified during our inspection. The company directors did not have a quality assurance system in place to assess the quality and safety of the service at provider level. This meant they did not have adequate oversight of the service.
We were not assured that staff always received appropriate training for the role. Training records demonstrated staff had not always received training in subjects relevant to their role.
Improvements were required to ensure that people’s views about their care were reflected in care planning. Care plans were not always personalised to include information about people’s preferences and life history.
Improvements were required to ensure that people’s capacity to make decisions was consistently assessed under the Mental Capacity Act 2005 and that formal best interests’ processes were followed where appropriate.
Despite the concerns we identified, people told us they felt safe. Recruitment procedures were safe.
People told us care staff were kind and caring towards them.
You can see what action we have asked the provider to take at the end of this full report.
Rating at last inspection: The last rating for this service was good (published 1 February 2019).
Why we inspected
This inspection was carried out in response to concerns about people’s health, safety and welfare.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.