Meadway Court

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement.

At this assessment the rating has remained requires improvement.

This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff demonstrated a good understanding of people's individual needs and were able to describe the support required to meet these.

However, staffing pressures meant people did not always receive care and support in a timely manner.

People and their relatives told us there were occasions when they experienced delays in receiving support. For example, some people had to wait extended periods for staff to respond to call bells. One relative told us, “One time I visited my loved one during the nighttime and they needed help to change their continence aid and their clothes. When I asked staff to help, they said they needed to wait for the senior staff member to finish administering medicines.”

We found people who were cared for in bed and required support to reposition were not always assisted at the frequency specified within their care plans. This placed people at increased risk of avoidable harm and indicated care was not always delivered in line with assessed needs.

Staff did not consistently recognise when additional support from external healthcare professionals was required. Referrals to relevant services were not always made in a timely manner, which meant people did not always receive the specialist support they needed. For example, we identified one person who required a dressing change which had not been recognised by staff. Following our feedback, the district nursing team was contacted immediately, and arrangements were made for the person to receive appropriate care.

Care plans in place which were generally person-centred and reflected their individual needs and preferences. However, some records contained conflicting information, creating a risk that staff may not always have clear guidance about how to support people. In addition, care plans were not always followed in practice. This included areas such as monitoring people's weight, supporting adequate fluid intake, and providing appropriate support with continence care.

Daily care records were not always sufficiently detailed and often focused on tasks completed rather than the outcomes achieved for people or their lived experiences. This limited the provider's ability to demonstrate that care had been delivered consistently and in accordance with people's assessed needs. However, we saw evidence the registered manager had recognised these concerns and was working with staff to improve the quality of recording through ongoing guidance, supervision and support.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

For example, one person's care plan stated staff should monitor and support them with their continence care. However, person's daily records, showed they had not opened their bowels for a number of days and there was no evidence that staff had recognised this concern or taken appropriate action. This meant potential risks to the person's health and wellbeing were not always identified or managed promptly.

The provider worked with external healthcare professionals where required. However, advice and guidance were not always sought in a timely manner when people's needs changed or concerns were identified. In addition, when professional advice had been obtained, this was not always clearly documented within people's care records. This increased the risk of staff not having access to accurate and up-to-date information to guide their practice.

For example, one person required a modified diet to reduce the risk of choking. We found conflicting information within their care plan regarding the consistency of food they should be offered. The absence of clear and accurate records meant staff did not always have the information necessary to support the person safely.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider did not have specific policies or guidance in place to support people's communication needs. This meant there was not a clear framework to ensure people received information and support in a way that met their individual needs and preferences.

Staff generally demonstrated a good understanding of how people communicated and were able to describe the support individuals required. However, we observed occasions where staff did not appear to have the skills or confidence necessary to effectively support people who communicated through their behaviour. This meant opportunities to understand and respond to people's needs were not always maximised.

There was limited evidence to demonstrate that information was routinely provided to people in accessible formats tailored to their individual communication needs. Care records did not always clearly identify how people preferred to receive information or what reasonable adjustments were required to support their understanding.

Further work was needed to ensure the principles of accessible communication were fully embedded within the service and that people could access information in ways that were meaningful to them.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care or tell them what had changed as a result.

People and their relatives told us they felt able to raise concerns, make suggestions and speak openly with the registered manager. Feedback about the management of the service was generally positive. One person told us, “The manager seems very nice and if I had a problem I would go and talk to them.” A staff member said, “There was a lot of changes within the management but now I feel I can go and speak to the new manager when I need to.”

The registered manager operated an open-door policy and was visible within the service. People, relatives and staff told us they found the manager approachable and felt confident concerns would be listened to and acted upon.

The provider offered regular opportunities for people and their relatives to share their views about the service, including through residents' and relatives' meetings. These forums helped people express their opinions and contribute to discussions about the care and support provided.

However, systems to gather feedback were not always used effectively to drive continuous improvement. Records did not always consistently demonstrate how feedback received from people, relatives and staff had been analysed, reviewed or translated into actions to improve the quality of care and outcomes for people.

We told the registered manager about this, and they confirmed they would review the process going forward.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

The provider worked with a range of external stakeholders and healthcare professionals to support people’s health and wellbeing. This included engagement with services such as GPs, community nursing teams and other specialist professionals where required.

However, we found that support and advice from external professionals was not always sought in a timely manner when concerns about people's health were identified. This meant opportunities to obtain specialist input and prevent deterioration in people's health could be missed. For example, one person had a significantly low body weight, but a referral to a dietitian

was only made after we highlighted our concerns to the registered manager during the inspection.

Despite this, feedback received from stakeholders and partner organisations was positive. Professionals told us the service engaged appropriately with them, and staff were generally responsive when support was requested.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback from people and their relatives was sought on a regular basis. One relative told us, “The manager is easy to talk to. They [manager] ask if we have any questions. This gives us a piece of mind that our loved one is well looked after.” However, there was limited assurance that the provider gathered feedback from people who may have difficulty expressing their views, such as those lacking capacity or living with conditions that affect communication. This was fed back to the registered manger, and they confirmed they would review the existing processes to ensure that all people can actively share their feedback and participate in making decisions about their care.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s care plans contained information about their personal goals, future aspirations, and end-of-life wishes. While some care plans were more detailed than others, they provided relevant information overall to enable staff to support people in a meaningful way. Care plans reflected people’s preferences, including their cultural and religious needs, helping to ensure care was delivered in accordance with their wishes and values.