Archived: Little Meadows

Updated 17 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection site visit was carried out by one inspector on the first day and two inspectors on the second day.

Service and service type

Little Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. Although there was a manager in place, they had not completed their application to register with us. The previous registered manager had only recently left so the new managers application with us was still in progress. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced. Inspection site visit activity started on 20 November 2019 and was ended on 22 November 2019.

What we did

We looked at information we held about the service including notifications they had made to us about important events. A notification is information about events that by law the registered persons should tell us about. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection, we spoke with four people, one relative, two care staff, the manager and the previous registered manager who was supporting the service part time and the main partner who owned the care home. We also spoke with one visiting health professional. We reviewed four people's care records some of which included medicine records and daily notes. We looked at policies and procedures and records relating to the management of the service, including audits, meeting minutes and surveys and two staff recruitment files.

After the inspection, we requested additional evidence that could not be supplied on the day of our visits, such as evidence of building safety checks and the outcomes of complaints.

Updated 17 March 2020

About the service

Little Meadows is a small residential care home providing accommodation and personal care to 12 people at the time of the inspection who may have dementia, mental health needs or physical disabilities. The service can support up to 20 people.

People’s experience of using this service

People’s health and safety had been put at risk due to the poor oversight of the quality of care and safety of the building. Risks were not always assessed and planned for, so people were put at risk. People were not always supported or monitored in relation to their health conditions and health professional advice was not always sought. People were not always protected from the risk of infection. We could not be sure people were having their medicines as prescribed. Lessons were not always learned when things went wrong as there was not always oversight of these.

There were sufficient staffing numbers, however as the manager was having to work care shifts, this was impacting upon their time to manage and have oversight of the service. Staff had received some training although there were concerns relating to supporting people in relation to their health conditions and medicines. There were no training records available to confirm staff had received up to date training.

Staff understood their safeguarding responsibilities but as there was a lack of oversight for some incidents, we could not be confident that every incident was investigated.

People were not always supported to partake in meaningful activities of their choice. People were not always supported to plan for their end of life wishes, although no one was receiving palliative care at the time of the inspection.

People were supported to have enough to eat and drink, although there were concerns regarding the storage and management of food.

People were not always treated well due to the concerns we found in the service. Despite this, people were supported to remain independent. People were involved in decisions about their care.

People and relatives were able to complain and these were investigated and responded to. People were supported to access information in a way that suited them.

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

Rating at last inspection

The service was rated good overall. It was requires improvement in the well-led key question (published 24 June 2017). There had been multiple manager changes since the last inspection and the provider had no quality assurance oversight of the home so the rating has now deteriorated to inadequate overall.

Why we inspected

This was a planned inspection based on the rating at the last inspection. We found significant concerns during this inspection in relation to all key questions, resulting in an overall rating of inadequate.

Enforcement

We have identified breaches in relation to keeping people safe and managing risk, and the oversight of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.