Meadowside Residential Home

People’s experience of using this service:

People had active and fulfilled lives and were part of the local community. Staff were highly motivated and enabled people to achieve their goals and dreams. People were empowered to make their own choices. The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance.

Without exception, people and their relatives told us staff were kind and caring. People told us “I’m very happy because everyone’s very kind to me” and “A home is not the building it’s also the people in it.”

People felt safe and comfortable when staff were with them. People were kept safe as potential risks had been assessed and managed.

People’s needs were met by staff who had received regular training and support. People were treated with respect and staff understood how to protect people’s rights.

People were involved in making decisions about their care and supported to maintain their independence. Care plans contained up-to-date information about each person’s needs and preferences. People received personalised care from staff who knew them well.

People were involved in the running of the service, expressed their views, and made decisions about areas such as meal choices, the environment, and activities.

There were systems in place to monitor the quality of the service.

The registered manager was committed to improving care where possible and had developed effective working relationships with other professionals and agencies. The service had been nominated for The Outstanding Care Awards for Devon and Cornwall 2019 in the categories of ‘care home manager of the year’ and ‘care home of the year’.

The service met the characteristics for a rating of “good” in four key questions we inspected and “outstanding” in one key question. Therefore, our overall rating for the service after this inspection was “good”.

More information is in the full report.

Rating at last inspection: Good (The report was published on 5 October 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about this service until we return to visit as part of our re-inspection programme. If we have any concerns, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service provides accommodation and support for up to eleven adults with a learning disability. At the time of the inspection the home was fully occupied. People had complex care and communication needs due to their learning disabilities and this meant we could not talk with everyone who lived at the home. We therefore used our observations of care and our conversations with staff and people’s relatives to help us understand their experiences.

The service had a registered manager. 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 told us how happy they were living at Meadowside. We saw they were relaxed and comfortable; smiling and responding warmly to care staff. This indicated they felt safe and secure within their home. One person said “I always feel safe when the staff are around”. Another said “Nice staff. We love them and they love us from the bottom of their hearts.” Relatives told us they were very happy with the care provided. One person’s relative said “I would recognise the signs if there was anything wrong. There is always a happy atmosphere in the home”. Staff received training in safeguarding adults and knew how to raise concerns if they were worried about anybody being harmed or neglected.

The culture of the home was person-centred, open and friendly. Staff treated people with great kindness and respect and offered people choice in all aspects of their care. For example in relation to meals, bedtimes, activities and how people liked to spend their day. Staff worked closely with people to ensure they understood their needs and preferences. People were involved in planning and reviewing their own care as fully as they were able.

Staff ensured people's privacy and dignity was respected at all times. They always checked with people before providing care or support and respected people’s decisions. Where people lacked the mental capacity to make certain decisions about their care and welfare the service knew how to protect people’s rights.

People’s relatives said they were always made very welcome and were encouraged to visit the home as often as they wished. They said the service was very good at keeping them informed and involving them in decisions about their relatives care.

People received care and support in line with their individual care plans. Records showed each person had comprehensive assessments of any potential risks to their health and welfare. Where risks were identified, care plans were in place that gave detailed guidance for staff about how to reduce risk. Staff knew peoples care needs very well. They were skilled at managing risks in relation to people’s complex needs.

There were enough care staff to meet people’s complex needs and to care for them safely. As well as assisting people with their physical care needs, staff had time to sit and chat to people and provide emotional reassurance and support if people became upset or anxious.

People were engaged in a variety of activities within the home and in the community and there were sufficient numbers of staff to support this. People were encouraged to maintain their independence and to be part of the local community. This helped ensure people experienced a good quality of life.

We observed medicines being administered and this was done safely and unhurriedly. Staff received regular training in medicines management and medicines audits were completed to ensure consistent safe practice. People were supported to maintain good health by a range of external health and social care professionals.

There were robust recruitment processes in place to ensure that suitable staff were employed. Staff were well supported by the registered manager through supervision and appraisal. High standards of care were encouraged through staff training and development. Staff participated in a wide range of training courses in topics relevant to people’s care needs, including diabetes, epilepsy, person-centred care and first aid.

People were supported to eat and drink enough to ensure they maintained good health. We spoke with people about their meals and observed the lunchtime meal and saw everyone enjoyed the meals provided and staff supported people appropriately.

People's needs were met by the adaptation, design and decoration of the service. There was an ongoing programme of maintenance at the home with plans to refurbish and replace a carpet and kitchen units that had become worn. It was decorated and furnished in a comfortable, homely way.

There was clear leadership from the registered manager and people and relatives had a high level of confidence in them. The service’s quality monitoring systems enabled the service to maintain high standards of care and to promote continuing service improvements.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found. The inspection was carried out by an adult social care inspector. The summary is based on our observations during the inspection, speaking with six people using the service, three staff supporting them and from looking at records. We also met and spoke with the Registered Manager.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

One person told us 'It's safe and friendly here; there is good food and staff explain what they are doing.'

People were treated with respect and dignity by the staff. During our inspection we spent time observing and talking to people in the dining room. We noted the interactions between staff and people were positive and showed staff respected people at the home. People told us they felt safe at the home and the people we met told us they were happy.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us they had not needed to submit any applications. Proper policies and procedures were in place and the manager had liaised with the local DoLS team. The manager and senior staff had been trained to understand when an application should be made, and how to submit one.

Recruitment practice was safe and thorough. Staff files showed us that the service had undertaken appropriate inductions, training and had regular one to one meetings with their manager. Equipment such as hoists, lifts, fire alarm systems, and heating systems were well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

People who lived in the home told us they were happy with the care they received. We spoke with staff who were able to tell us how they met people's care needs. We observed the care provided and spoke with the people who lived in the home. This gave us evidence that staff knew people well. People's health and care needs were assessed. Where people were not able to make certain choices and decisions we found evidence that relatives and representatives had been involved in the care planning process. Regular care plan reviews were carried out to ensure they reflected people's current needs.

We saw that people consented to the care and treatment they received. Where people were unable to make a decision related to their care, the home followed the correct local procedures for assessing mental capacity and undertook a meeting with health and social care professionals to discuss the best way forward for the person.

We saw good evidence that the home's equipment was well maintained to ensure it was safe and fit for purpose.

Staff told us they were supported in their work and we saw that appraisals and one to one meetings with staff were occurring. There were regular staff meetings held at the home to keep staff informed of relevant issues.

Is the service caring?

People were supported by kind and attentive staff. We observed that staff were patient and worked alongside people at their pace when assisting them with their mobility, food, and personal care needs. People's rooms were personalised to their own taste, people were involved in their care planning and were able to choose how they spent their time.

Staff understood people's diverse needs in respect of their age, disability, gender and beliefs. People told us they felt listened to by staff and we observed that people mattered. Staff knew people's preferences and their personal communication styles and responded promptly to meet their needs.

Is the service responsive?

People's needs had been assessed before they moved into the home. The manager visited people and carried out an assessment to ensure the service was able to meet their needs. People were able to visit the home and meet the current residents and decide whether they liked Meadowside. We saw that as far as possible the home involved people in their care planning and treatment.

People had access to activities that were important to them such as pottery to occupy them, provide structure to their days and reduce social isolation. There was a complaints policy and several people told us they felt able to speak to the staff if they were unhappy about something. They felt confident that the service would deal with any matters to their satisfaction.

Is the service well-led?

Staff told us the home was 'relaxed, supportive, everyone works as a team, lots of training.'

The culture we observed during our inspection was open, person-centred and inclusive. The service worked well with other agencies and services to make sure people received their care in a joined up way. Regular coffee mornings were held to encourage professionals to visit the home.

Staff told us they were clear about their roles and responsibilities. There was a clear set of vision and values the home encouraged. Staff told us they had regular meetings with the manager to support their development. Staff told us they felt supported by their colleagues and the manager. This helped to ensure that people received a good quality service at all times.

The home had a detailed Statement of Purpose which set out the philosophy and values of the home. There were monitoring procedures in place such as audits which drove improvement at Meadowside.

We observed people were able to make choices about their day to day lives. People we spoke with said 'I've only to ask to do something or go somewhere and they'll always explain why if I can't', 'I understand that my bedroom is my own personal space' and 'we can go to different places without support'. One person told us 'I like it here'.

All of the people we spoke with said they had a support plan and knew what they contained. One person said 'if you want to look at it you're entitled to and can ask'. They said they had been involved in drawing them up and that they reflected their needs. When asked what they could do if they were unhappy with their support plan one person said 'they'd talk about it with me'.

We observed positive interactions between staff and people who use the service and people we spoke with said 'staff here are wonderful' and 'I get on very well with staff'.

Care files we saw had up to date care plans that contained person centred information and detailed risk assessments. We saw these had been recently reviewed. One person we spoke with told us that 'it is a really nice place. We have a choice of lunch. I help around the house and do my ironing.'

One person showed us their room which had pictures of their family and lots of ornaments displayed. People are encouraged to help in the kitchen and also with their laundry. One person told us that 'I help prepare the vegetables for Sunday lunch.'

Staff told us that they felt well supported and were able to go to their team leader and/or manager if they had any concerns. These staff told us that they had regular supervision and training.

Staff told us that 'even if complaints are small we take them seriously'. One person told us that if they had any problems they would 'talk to the manager who is very kind.'