Meadow View

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Some further development was needed to the provider’s systems and processes, to ensure gaps in risk management were consistently identified as people’s needs changed.

People told us staff discussed what care they wanted before they moved into the home. One person said, “When I first came here, they asked me what support I needed.” Another person told us their care needs had been communicated to staff at the home by their previous carers before they moved in. One relative said, “We had discussed his care needs with the staff and we do feel involved.”

Staff were supported to provide the care people wanted from the point they moved into the home as key information was handed over to them from senior staff. One staff member explained this included details of people’s mobility, support requirements when eating and how to ensure people had enough to drink.

People said staff checked with them over time to make sure they were getting the care they wanted. One person said, “The staff talk to me about my needs and they always ask me how I’m doing.” People’s care plans were reviewed each month to ensure they remained effective and relevant. However, we found some instances where people’s reviews had not always identified gaps in risk management strategies when people’s needs had changed. The registered manager told us they would address this without delay.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were positive about the meals and drinks prepared for them. One person described the food as, “Excellent because of the variety. It is always cooked very well." Another person told us staff regularly offered them drinks and snacks, and said, “They make sure that I have water to drink in my room.” People were not rushed and were encouraged to choose what they wanted to eat and drink. This helped to ensure they had enough nutrition and fluids to remain well.

The provider used recognised assessment tools to assess and identify risks associated with malnutrition, falls and skin breakdown. However, one person’s increase in nutritional risk had not been accurately reflected in their risk assessment. Senior staff recognised this was an area of improvement and we were told further training was being arranged.

The provider followed the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. Information about the IDDSI standards was accessible to both care and kitchen staff. A member of kitchen staff told us they had received training in the IDDSI standards and were able to easily access guidance and support. Kitchen staff told us they were informed about people’s nutritional needs and updated if those needs changed. This included in relation to any modified diets, allergies or weight loss.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People told us staff worked well with other health and social care professions. One person described how information communicated from other health professionals continued to positively impact their health, as staff ensured they were supported to follow their advice. The person said, “The milk was recommended by the hospital, and it helps me. So, I have a mug of milk every morning.” People were confident if they wanted support from other health and social care professionals staff would arrange this. One person told us, “If I wasn’t well, they would get a doctor to see me.”

Staff were positive about the relationships built with other health professionals and outlined how people benefited from this. For example, prompt referral when people were anxious or needed support with their health. Other health and social care professionals told us staff made timely referrals and followed any treatment or advice they provided. One health and social care professional said, “[Registered manager] contacts me with any concerns they might have, or if they are reviewing someone’s care needs, she also keeps me updated on what’s going on.”

People told us staff now communicated information across teams appropriately. One person told us, “The staff worked very well together as a team. I couldn’t fault them.” Staff described effective processes to ensure information was shared. This included a handover between shifts, so staff had up to date information about people. One staff member said, “You have to know what has happened, or you wouldn’t have a clue, the communication is pretty good." Another staff member told us about changes in the staffing team and procedures and said, “Communication is easier, now we act as a team together.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were confident if they wanted support from other health and social care professionals to maintain their health staff would arrange this. One person told us, “If I wasn’t well, they would get a doctor to see me.” Another person said, “The optician comes in here to see me.” A further person told us they had been supported by staff to access the care they required to manage a health condition. The person said as because of this support, “I’ve been referred to the hospital in Worcester.”

A health and social care professional spoke positively of the home, saying there had been a reduction in hospital admissions because of the joint working undertaken with staff at the home.

People were weighed regularly and referred to other healthcare professionals such as the dietician and SALT team if they were not eating or drinking well. People were encouraged to make healthy meal choices based on their individual needs and those at risk of losing weight were given a diet with extra calories added. Referrals had also been made to mental health teams, if people were anxious, so their well-being needs would be met.

The provider did not always accurately monitor people’s care and treatment to continuously improve it, where this was required. However, staff worked with people and other professionals to help to ensure people experienced positive outcomes which met both clinical expectations and the expectations of people themselves.

One person was on regular repositioning to promote healing of damaged skin and to prevent further deterioration. Records did not evidence the person was regularly being supported to change their position, to effectively relieve pressure on different areas of their body. In addition, there were processes in place to identify if people were at risk of constipation, but these were not always completed accurately and also included monitoring of people’s constipation where people did not need support from staff to manage this. One health and social care professional told us, “Records are always available, but sometimes charts are not filled in fully, or are missing specific details.” We found no evidence of harm to people as a result of this.

However, most health and social care professionals told us monitoring systems ensured they had the information they needed when they reviewed people’s needs and some other systems to monitor risks to people’s health were working well. For example, people identified as being at risk of dehydration had fluid monitoring records in place. These demonstrated people were being offered regular drinks and encouraged to drink enough to remain hydrated.

One person said, “The staff do come in and ask me if I’m okay from time to time” and another person told us, “The staff understand my health needs and look after me.” A staff member told us, “Care has improved, there’s regular monitoring of [people’s] weights, food and fluids.” The staff member said this made clear how they were to care for people, and this was reflected during daily information sharing about people’s needs. The effectiveness of clinical advice was assessed by external healthcare professionals who regularly visited the home. Health and social care professionals told us staff knew people’s needs well and promptly took action to support them.

The provider did not always tell people about their rights around consent, but did respect t their rights when delivering care and treatment.

One person had their medicines administered covertly. This is where medicines are administered in a disguised format. Although we were confident these medicines were being given in the person’s best interests, records did not support this practice as a mental capacity assessment had not been completed to support this best interest decision.

Where capacity assessments had been partially completed, there was limited detail about how information had been shared with people to ensure they had been given every opportunity to participate in the decision-making process. On the second day of our inspection, we saw action had been taken to document the actions taken to support decision making.

Although records did not always demonstrate full understanding of the Mental Capacity Act 2005, staff worked in accordance with the principles of the Act in their everyday interactions with people. Staff offered people choice and understood people’s right to decline support in that moment. One staff member told us if a person declined support they would, “Jot it down on the system and go back 5 or 10 minutes later and try again. You need to jot it down that you have offered personal care and they are still refusing. You just have to keep trying."