Background to this inspection
Updated
3 August 2023
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection visit was completed by 2 inspectors and an Expert by Experience. An Expert by Experience is someone who has experience of this type of service.
Service and service type
Meadow View is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Meadow View is a care home without nursing care. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection visit was unannounced.
Inspection activity started on 28 June 2023 and ended on 29 June 2023. Two inspectors visited the location on 28 June 2023. On 29 June 2023, an Expert by Experience made telephone calls to relatives to get their feedback about the quality of care provided.
What we did before inspection
We reviewed the information we held about the service, such as feedback from people and their relatives, statutory notifications, as well as any information shared with us by the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us 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 2 people who received a service to get their experiences about the quality of care received and 5 relatives. We spoke with 5 members of care staff and a maintenance person. We spoke with the registered manager, a regional manager and a director of elder services.
We reviewed a range of records. This included examples of 4 people’s care records, samples of medicine records and associated records of people’s care. We looked at records that related to the management and quality assurance of the service and risk management. We reviewed 2 staff recruitment files.
Updated
3 August 2023
About the service
Meadow View is registered to provide accommodation and personal care for up to 42 people, including people living with dementia. At the time of our inspection visit there were 32 people living at the home. The home is split into a large main building which provides care to people on a permanent basis. There is a separate building known as ‘The Poppies’ which provides respite care. Respite care is planned or emergency temporary care. Some people living at the home were living with dementia. People have use of a communal lounge and dining area, as well as occasional seating throughout corridors. People’s bedrooms are ensuite and there are further communal bathroom facilities located around the home. People can access outside spaces.
People's experience of using this service and what we found
At our last inspection, we found significant improvements were required around managing people’s risks and risks within the environment, medicines management, quality of record keeping and quality assurance processes. At this inspection, some improvements in medicines management an understanding people’s risks had improved. We found some improvements to the provider’s quality assurance systems.
However, we found the provider's systems and processes to monitor the quality of the whole service people received, continued to require improvements to embed those systems into everyday practice. We found some actions identified as improved, had not been improved consistently. We found the provider remained in breach of a regulation.
People received their medicines from trained staff. Medicines were stored safely and securely. People were assessed and protocols were in place for medication prescribed to be taken on an 'as required basis.’ Time critical medicines were administered in line with their prescribed instructions. However, some medicines such as topical creams and pain patch medicines required better recording to ensure staff administered these medicines safely.
Infection, prevention and control practices had improved. People’s bedrooms, communal hallways and lounge areas were clean and uncluttered.
The provider had sufficiently trained and suitable staff on shift to meet people’s needs. The registered manager was not required to cover kitchen duties as this had been recruited to. Vacancies were still advertised however regular staff picked up shifts were required. Agency staff were utilised but this had reduced since our last visit. Staff told us they worked well as a team.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Relatives were pleased with the support and care their family member received. Relatives were complementary of the staff, how their met their family members needs and wishes and they were also complementary of the management of the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 19 May 2023).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made but these had not become embedded into everyday practice. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. The providers action plan told us what they would do and by when to improve. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadow View on our website at www.cqc.org.uk.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We have identified a repeated breach in relation to regulation 17 (good governance) at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.