Meadow View

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed positive interactions between people and staff. When people were unable to communicate their wishes and feelings verbally, staff used a variety of communication techniques and adapted their approach to meet the needs of each individual. One person told us, “It’s nice” when we asked them if they liked living at the service.

All of the relatives we spoke to were positive about the provider, telling us that they felt that their family members were safe and well care for. Relatives told us that they were kept updated about their family member’s health and wellbeing, and were able to raise any concerns that they had with leaders.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place where accidents, incidents and safeguarding concerns were analysed to look for themes and trends. These systems included identified learning and actions that needed to be put in place to prevent recurrence. This meant any incidents of concern were treated as learning events so measures could be put in place to ensure mistakes were not repeated.

Staff told us they felt comfortable in raising any concerns and leaders would listen to them. Leaders told us they looked at accidents and incidents as learning events to drive continuous improvement.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider worked closely with the GP and local NHS nursing teams to ensure people’s health and wellbeing was monitored and reviewed regularly. Staff maintained regular contact with the pharmacy to ensure medication orders were made promptly and instructions for the administration of medication were correct.

Systems were in place to ensure new admissions were supported to integrate and feel at home quickly. For example, leaders told us about a person who had come to live at the care home because they had found living in a supported living placement difficult due to their anxiety. The provider liaised with relatives and agencies involved in the person’s care and took steps to create a calm environment for the person which alleviated their anxiety but also ensured that they were still supported to be as independent as possible.

Each person had a thorough hospital passport in their care plan which meant if they had to go to hospital, staff would be able to provide person-centred support that was adapted to their needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The registered manager told us about a recent safeguarding concern which had been received by the service and how this was dealt with, including the processes involved. Staff and leaders demonstrated an awareness of safeguarding and how to raise concerns internally and externally.

During our visit we observed some confidential information relating to people in folders in communal areas. Leaders explained that staff were present at all times and would be able to prevent people from accessing the information. However, leaders agreed for best practice this information would not be kept in communal areas going forward.

Leaders demonstrated an understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) legislation, with all relevant paperwork in place. DoLS are required to protect individuals who lack mental capacity within care settings.

The provider used the least restrictive option to support people and keep them safe.

Relatives told us they felt that staff were open about any safeguarding concerns. One relative said, “There is a nice feeling there and they are not hiding anything so I am not worried.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff adapted their communication techniques to communicate effectively with each person. They understood each person’s needs and levels of independence. For example, one person was supported to mobilise in a safe way that met their preferences. Staff recognised, and records reflected, how to manage any associated risks. We observed another person trying to mobilise in a way which was unsafe – staff calmly intervened by explaining to the person why what they were doing was unsafe and supported them to move in a safe manner. Staff showed compassion and knowledge of how to communicate with the person to achieve the best outcome.

Care plans were written in a person-centred way, with relatives consulted and involved in each person’s care planning where appropriate.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

During our visit we observed some risks such as open cupboards which could have been accessed by people, a lack of window restrictors meaning that windows could open wide enough for people to climb in/out of, and some confidential paperwork in communal areas. The provider took immediate action to mitigate these risks and put risk assessments in place.

Bedrooms and bathrooms contained ceiling-mounted hoist trackers, allowing for the safe transfer of people with limited mobility. Each bungalow was equipped with a bathroom which had been recently refurbished. Corridors and indoor communal areas were spacious and allowed for the free movement of people in wheelchairs. Each bungalow had a spacious outdoor area with a summerhouse and raised flowerbeds. These areas were wheelchair accessible and fenced off so that the space was contained.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff received training to equip them with the skills to meet people’s needs, with a mix of online and in-person training sessions. The provider had processes in place which ensured staff training was kept up to date.

Leaders told us the provider has a large group of experienced permanent staff. Staff absences were covered by other permanent staff members as additional hours, so that there was rarely a requirement to use agency staff.

Training records showed there was a high level of compliance with staff training, with a considerable amount of training modules available covering a broad scope of subjects relevant to health and social care.

Staff met people’s needs in a timely way and anticipated the needs of people who were unable to communicate. We observed staff using equipment such as hoists and wheelchairs to support people to mobilise safely. Staff supported people to use safety equipment such as protective headgear.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were well presented and wearing clean clothes. All areas of the bungalows were clean and tidy. Staff were observed using the appropriate personal protective equipment when cooking and serving food to people.

The provider had cleaning rotas in place and regular audits to ensure cleaning tasks had been completed. There were dedicated housekeeping staff, and care staff also took responsibility for cleaning and washing laundry.

One relative said, “My relative is always clean and well looked after.” Another said, “We visited before Christmas and the place was clean and top notch.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Nursing staff demonstrated knowledge of the processes in place to manage medicines and the individual needs of people using the service. There were effective systems in place for administering and storing medication, with accurate records kept. We asked staff to carry out random stock checks of medication, which were all correct. Medication Administration Records (MAR) were up to date and clear to read and understand. There were protocols in place which identified when and how people may need to take “as and when required” medicine such as pain relief or anti-anxiety medicine.

Medicines were regularly reviewed by the GP. Nursing staff told us that they contacted the pharmacy if they had any concerns around the medicine and the pharmacy always provided assistance.

There were some minor medicine errors recorded in the care homes incident log – these had been audited and analysed, with actions and learning clearly recorded and communicated to staff to prevent reoccurrence.