Meadow Lodge

We found the following examples of good practice.

Meadow Lodge ensured current government guidelines in relation to COVID-19 were being followed by staff and visitors to reduce the risk of infection to people living at the home. This included comprehensive checks for visitors and staff on arrival to the home.

People living at Meadow Lodge and staff were supported to receive COVID-19 vaccinations and boosters at the care home. Detailed information on vaccinations was made available to people who lived there and staff which included easy read information.

Meadow Lodge felt well supported by stakeholders and had good links with their GP practice staff.

Meadow Lodge supported people who lived there to remain connected with friends and relatives through visits, video calls, phone calls and letters.

Meadow Lodge is a residential care home providing personal care to 16 people aged 65 and over at the time of the inspection. The service can support up to 25 people.

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

People felt safe living at Meadow Lodge and felt safe with the staff who supported them. Risks associated with people’s care and support had been assessed and these were being monitored regularly. People’s medicines were stored and managed safely. Suitable numbers of appropriately recruited staff were available to support the people using the service and the providers infection control policy was being followed. The registered manager ensured lessons were learned when things went wrong to continually improve the service.

Whenever possible, people’s needs had been assessed prior to them moving into the service. From this assessment, plans of care had been developed. These provided staff with the information they needed to meet people’s individual care and support needs. The staff team had received appropriate training, guidance and support and they ensured they gained people’s consent to their care. People’s nutritional needs were being met and they were supported to access healthcare services when needed. Improvements had been made to the environment and people were provided with a comfortable place to live.

The staff team were kind, caring and compassionate and treated people in a dignified and respectful way. 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. People were involved in making decisions about their care.

A formal complaints process was displayed explaining what people should do, should they have a concern of any kind. People’s end of life wishes were being explored and included in people’s plans of care. People's likes and dislikes were observed, and activities of choice were offered.

People, their relatives and staff were involved in how the service was run through meetings, the use of surveys and day to day conversations with the registered manager and the staff team. The staff team felt supported by the registered manager and the registered manager worked in partnership with others to make sure people received safe care and support. Systems were in place to regularly monitor the service being provided.

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 6 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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 provider is registered to provide accommodation for up to 25 older people living with or without dementia in the home over two floors. There were 19 people using the service at the time of our inspection.

At our last inspection on 9 February 2016, we asked the provider to take action to make improvements in the area of medicines. We received an action plan setting out when the provider would be compliant with the regulations. At this inspection we found that the concerns in the area of medicines had been addressed.

A registered manager was in post and was available throughout the inspection. 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.

Staff knew how to keep people safe and understood their duty to protect people from the risk of abuse. Risks were managed so that people were protected from avoidable harm and not unnecessarily restricted.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Safe medicines and infection control practices were followed by staff.

Staff received induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005.

People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate and adaptations had been made to the design of the home to support people living with dementia.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people. People received care that respected their privacy and dignity and promoted their independence.

People received personalised care that was responsive to their needs. Care records contained information to support staff to meet people’s individual needs, though activities could be further improved so that more people could access activities outside the home. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and that appropriate action would be taken.

The provider was meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.

Accommodation for up to 25 people is provided in the home over two floors. The service is designed to meet the needs of older people. There were 22 people using the service at the time of our inspection.

At the previous inspection on 10 and 11 February 2015, we asked the provider to take action to make improvements to the area of good governance. We received an action plan in which the provider told us the actions they had taken to meet the relevant legal requirements. At this inspection we found that improvements had been made in this area but more work was required.

There is a registered manager and she was available during the inspection. 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.

Safe medicines practices were not always followed. People felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. The premises were managed to keep people safe. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Safe infection control practices were followed.

Staff received appropriate induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate. People’s needs were met by the adaptation, design and decoration of the service.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received personalised care that was responsive to their needs. People were supported to follow their interests and take part in social activities. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

There were systems in place to monitor and improve the quality of the service provided, however, they were not fully effective. The provider was not fully meeting their regulatory responsibilities as they had not sent a statutory notification to the CQC when required to do so.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the registered manager and that they would take action.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.

We spoke with four people about their care and the support they received. All of them told us that staff were polite and respectful. One person said, 'The staff are very nice.' Another person said, 'The staff are nice enough, they are always respectful.'

We spoke with four people using the service about their experiences of the care they received. They all told us they were happy and settled living at the home. One person said, 'The staff are very nice and helpful.' Another person said, 'The staff are lovely, they help me. I really like it here.'

We found that the recruitment procedures did not fully protect people from the risk of unsuitable staff being employed.

We found the provider did not have a fully effective quality monitoring system in place to ensure that relevant systems and processes were fully managed.

We spoke with three people about their care and the support they received. All of them told us staff were polite and respectful to them.

We saw that staff were generally attentive to people's needs. However, the quality of interactions between people who used the service and staff was not always person centred.

Although staff felt they maintained people's dignity it was apparent that staff did not fully understand the concept of dignity.

Although improvements had continued in respect of care planning we found people's needs were still not always fully assessed and care and support was not always planned and delivered in line with their individual requirements or in a way that met their needs.

People we spoke with told us they were happy and settled living at the home. One person said, 'The staff are very good, you can't fault them, they help me when needed. Another person said, 'The staff are nice and they help me as needed.'

We found the improvements in respect of the environment had been maintained and further work had taken place.

People we spoke with told us they thought the home was clean. One person said, 'The staff keep everywhere clean and tidy.'

One person told us that although there were no concerns in respect of the environment that if anything needed to be repaired that this would take place quickly.

Although there had been continued improvements in respect of records and record keeping further improvements were still needed.

We spoke with three people using the service and one relative. They all told us they thought the home was clean. One person said, 'They (staff) keep my room clean, I thing the place is clean enough.'

We observed positive interactions between staff and people using the service. There was a relaxed atmosphere and we saw that people using the service looked comfortable talking to staff. We spoke with three staff and they told us they thought there were enough staff to meet the needs of the people using the service.

We found there had been many improvements to the service since we last visited.