We inspected Meadow Sands Care Home 08 August 2015. This was an unannounced inspection. Our last inspection took place on 04 February 2014. The service provides care and support for up to 26 people. When we undertook our inspection there were 21 people living at the home.
People living at the home were older people. Some people required more assistance either because of physical illnesses or because they were experiencing memory loss. The home also provides end of life care.
There was no registered manager in post. The post had been vacant since May 2015. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run. The current manager had submitted their registered application to CQC and were awaiting an interview.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of our inspection there was no one subject to such a restriction. Staff had not implemented the MCA guidance correctly and had not recorded how decisions had been reached.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the lack of information on how decisions had been reached for people who could not make decisions for themselves. You can see what action we told the provider to take at the back of the full report.
We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period by observations and talking with people who used the service and staff. There was no formal recording of how decisions had been reached.
We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.
People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.
People had a choice of meals, snacks and drinks. And meals could be taken in a dining room, sitting room or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.
The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse, but had not received any formal training, except on induction. They knew the action to take if they were concerned about the welfare of an individual.
People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements. However, there was no analysis of audits or feedback forms so the provider did not know whether suitable actions had been taken by staff.