Archived: The Meadows Nursing Home

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 requires improvement. At this assessment the rating remains requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders and staff did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. One relative told us they did not feel staff understood their family member’s needs and they had not been involved in any reviews of their care. At our last assessment in February 2024 the manager acknowledged they needed to update care records. At this assessment we found care records still needed updating, some records contained conflicting and inaccurate information despite them being regularly reviewed by staff. Feedback from people’s relatives about their involvement in reviews was mixed. One relative told us, “Staff have never discussed anything with regards to care needs with me. They [staff] do not call with any updates, if we want to know anything we have to call.” and “They [staff] do when I visit but not enough, I would like them to be more proactive”. Another relative said, “I have to sign something every year, they [staff] call me, and we go through it”.

Staff did not plan and deliver people’s care and treatment with them. Staff did not follow legislation and current evidence-based good practice and standards. One person had been assessed by the speech and language therapy team who identified a specialised diet due to the risk of them chocking, however their care records contained contradictory information. Whilst we saw no evidence of the wrong food being given to them, this placed them at increased risk harm. Where staff had assessed people at high risk of developing skin damage, measures in place to reduce this were not always effective, for example, one person’s mattress was incorrectly set despite daily checks being undertaken. This increased the risk of the person developing skin damage.

Staff and leaders did not always work well across teams and services to support people. There was a lack of effective oversight and poor leadership which meant people did not receive the expected standard of care. Some relatives felt communication could be improved. One relative told us, “They [staff] can be a bit hit and miss with communication”. Another said, “communication is getting better but still needs to improve”. However, staff felt the team worked well. One staff member told us, “We are a strong team and work well together, especially with [Staff member], the clinical lead, leading us, she is really good”.

Staff supported people were supported to access a range of appropriate healthcare services and support as needed, such as, GP and chiropodist. Some relatives told us they were kept up to date about the outcome of their family members health-related appointments.

Staff monitored people’s care and treatment however, we found inconsistencies. Managers did not always ensure staff kept care records up to date to reflect people’s current care needs. For example, 1 person’s care records had not been updated to reflect their wound had deteriorated. Guidance in care records contained conflicting information regarding the how often staff should support the person to reposition to prevent further deterioration.

Staff did not always work within the principles of the Mental Capacity Act (MCA). Where people lacked capacity to consent to restrictions placed on them, mental capacity assessments had been completed in relation to aspects of care and treatment. However, we found some were contradictory. For example, staff had recorded for 1 person that they lacked capacity. However, a mental capacity assessment recorded for the same person stated they were able to understand, retain and use information. Not all staff had completed MCA training, and some did not know which people had an authorised Deprivation of Liberty Safeguards (DoLS) in place. This meant staff may not always appropriately support people.