We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looks at the overall quality of the service.
The Meadow provides care for up to 40 older people who may also have dementia care needs. There are two separate units where people are accommodated, one on the ground floor and one on the first floor. The ground floor unit provides care and support specifically for people with dementia care needs.
The last inspection of this service took place on 22 May 2013. During that inspection we found that the service was meeting regulations related to respecting and involving people, care and welfare, nutrition, staff recruitment and support, medicines and assessing and monitoring the quality of the service.
This inspection was an unannounced inspection. At the time of our inspection there was a registered manager in post. 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 and associated Regulations about how the service is run.
People were not kept safe at the service. Behaviour that challenged the service was not managed in a way that protected people from harm and staff were not clear about how to manage these risks. People’s needs had not been fully assessed prior to their admission to the service to ensure that staff could meet their needs.
People were not always asked about their likes, dislikes and preferences and care plans were not always updated to reflect changes in people’s needs. Records were not always kept up to date so there was a clear record of people’s wellbeing and any support they needed.
Staff recruitment checks were not robust and therefore did not ensure that all staff employed were suitable to work with vulnerable adults. Staff with the required experience and expertise were not always on shift and staff sometimes worked extra hours which may have meant they had not had enough rest to make sure they could carry out their duties effectively.
We found that the service did not fully consider people’s mental capacity and the impact of any restrictive practices to ensure that people’s rights were respected.
People told us that staff were caring and treated them with respect. Our observations confirmed this.
People told us they enjoyed the activities provided at the service and told us that staff listened to their views. We found that people knew how to make a complaint and felt comfortable raising any concerns. The manager responded to any complaints promptly and addressed any issues raised.
Systems were in place to monitor the service, however, we found that these were not always effective in ensuring that the service met the required regulations.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.