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Meadow House Residential Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 November 2018

The inspection took place on 17 and 21 September 2018 and was unannounced.

Meadow House Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Meadow House Residential Home provides accommodation for up to 24 people, including people living with dementia care needs. At the time of our inspection, there were 24 people living in the home.

There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

When we completed our previous inspection of the service in September 2017, we found concerns relating to; people being treated with dignity and respect, gaining people’s consent in line with the Mental Capacity Act 2005, and a lack of effective quality assurance processes. At this inspection, we found the provider had taken action to make some improvements in these areas, however we identified they continued to lack effective systems and processes to assess, monitor and improve the quality and safety of the service.

Although most areas of the service were clean, we identified certain areas which posed a risk of infection and contamination due to ineffective cleaning in damaged areas.

People’s medicines were stored securely; however, they were not always stored at the right temperature. Medicine administrated records were not always completed effectively to ensure that people received their medicines safely.

Actions had not been taken to ensure that there were adequate fire safety arrangements within the home.

There were quality assurance systems in place based on a range of audits. However, we found these were not always effective and had not identified the concerns raised during the inspection.

People felt safe living at Meadow House. Staff knew how to identify, prevent and report abuse.

Recruitment procedures were in place to ensure that suitable staff were employed by the service.

People received care and support from staff who were suitably qualified, skilled and knowledgeable to carry out their roles effectively.

New staff completed a comprehensive induction programme and all staff were suitably supported in their roles.

People praised the standard of care delivered and the quality of the meals. Dietary needs were met and people received appropriate support to eat and drink.

People were supported to access healthcare services when needed and to attend hospital appointments.

People were cared for with dignity and respect and were treated in a kind and caring way by staff. Staff knew people well and encouraged people to remain as independent as possible.

Staff protected people's privacy and responded promptly when people's needs or preferences changed.

They involved people in the care planning process and kept family members up to date with any changes to their relative's needs.

Staff interacted with people in a polite and positive way. They spoke about people warmly and demonstrated a detailed knowledge of them as individuals and what was important to them.

People received personalised care and support that met their needs. Care plans provided staff with detailed information about how they should support people in an individualised way.

Where people’s need changed, staff were responsive to ensuring they received effective care.

People had the opportunity to access to a range of suitable activities. There was an appropriate complaints procedure in place and people knew how to make a complaint.

There was an open and transparent culture in the home. Relatives could visit at any time and were made welcome.

Staff were happy in their work and felt supported by management of the service.

Inspection areas

Safe

Requires improvement

Updated 13 November 2018

The service was not always safe.

A number of areas of the service could not be cleaned effectively because the building had not been properly maintained. This posed a risk of infection.

Medicines were not always stored safely and medicine administration records were not always completed effectively.

Actions had not been taken promptly to ensure adequate fire safety.

People felt safe and staff knew how to identify, report and prevent abuse.

There were sufficient staff to meet people’s needs and there were robust staff recruitment procedures in place.

Effective

Good

Updated 13 November 2018

The service was effective.

People were supported by staff who were knowledgeable, skilled and experienced to carry out their role effectively.

People had enough to eat and drink and were offered a choice at meal times.

The environment was designed to be supportive of people who lived there.

People were supported to access healthcare services when they required them.

Staff followed legislation designed to protect people rights in line with the Mental Capacity Act 2005.

Caring

Good

Updated 13 November 2018

The service was caring.

People were treated with dignity at all times and staff respected their privacy.

Staff had built positive relationship with people and knew what was important to them.

Staff encouraged people to stay as independent as possible in all areas of their care.

Staff supported people to meet their cultural and religious needs.

Staff knew how to communicate with people on an individual basis depending on their needs.

Responsive

Good

Updated 13 November 2018

The service was responsive.

Care plans contained information to support staff to provide care

in a personalised way.

Care and support was planned in partnership with people, their families and healthcare professionals where appropriate.

Staff responded promptly when people's needs or preferences changed. Staff were kept up to date on people's changing needs.

People received appropriate mental and physical stimulation and had access to activities they enjoyed.

The provider had arrangements in place to deal with complaints.

Well-led

Requires improvement

Updated 13 November 2018

The service was not always well-led.

We identified a lack of provider engagement and actions were not always followed up in a timely manner by the provider.

A quality assurance process was in place; however, this had not identified all the areas of concerns we found during this inspection.

There was an open culture within the service and staff told us they felt able to raise concerns.

Staff were organised, motivated and worked well as a team. They felt fully supported and valued by the registered manager.

The service had developed positive links with the community. Health and social care professionals spoke positively about the leadership of the service.