The Meadows Nursing Home

Updated 25 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. 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.

Inspection team

The inspection was carried out by one inspector. An Expert by Experience joined the inspection on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback professionals who work with the service including the local authority and the local clinical commissioning group who may fund the care provided to some people. We also sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection-

We spoke with five people who used the service and twelve relatives about their experience of the care provided while on the inspection. We spoke with a further three relatives on the telephone between the two inspection visits. In addition, the registered provider supplied us with information we requested in relation to aspects of the management of the service.

We spoke with ten members of staff and attended a daily meeting and brief training refresher. Staff spoken with included the registered manager, the clinical lead, five care staff, a maintenance employee and the activities coordinator. We spoke with the nominated individual who attended the location during the first two days of the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We spoke with one healthcare professional and one social care professional.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. We also reviewed a variety of other records relating to the management of the service.

Updated 25 March 2020

About the service

The Meadows Nursing Home is a care home providing personal and nursing care to 32 people aged 65 and over at the time of the inspection. The service can support up to 36 people.

The Meadows Nursing Home is an adapted and extended building on two floors. Communal facilities were provided on each floor. The ground floor accommodated people with nursing care needs while people on the first-floor required care and support as a result of them living with dementia.

People’s experience of using this service and what we found

Improvements were needed to ensure safe medicine practices and procedures were acted upon to ensure people were safe from risk. Environmental and infection control risks were not always identified and actioned to ensure people’s safety.

People’s care was not always seen to be person-centred. People’s personal care needs to maintain individual’s appearance was not always upheld. Care plans and care records did not always detail the care required to provide the care and support people needed.

Sufficient staff were on duty to care for people who were seen to be kind and caring. People felt safe from abuse and harm and staff knew what to do to safeguard people. Recruitment processes were in place although some improvement to application forms was needed.

People were not always supported to have maximum choice and control of their lives. Staff were aware of the need to support people in the least restrictive way possible.

People’s needs were assessed prior to moving into the home and healthcare needs were met by visiting professionals. Staff were knowledgeable although some areas of training needed to take place. People were pleased with the food provided. The provider planned to make improvements to the environmental standards of the home.

People were complimentary about the registered manager and felt able to make a complaint if needed. Improvements were needed to ensure governance arrangements were fully effective to provide high quality and person-centred care.

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

Rating at last inspection.

The last rating for this service was Requires Improvement (published 01 March 2019).

The provider was found to be in breach of registration regulation 18 for not informing the Care Quality Commission about the authorising of Deprivation of Liberty. 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 improvement had been made and the provider was no longer in breach of this regulation. However, we identified other shortfalls.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led sections of this full report.

Enforcement

We have identified breaches in relation to ensuring people received person centred care and support and in the governance of the service provided.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.