Meadowview Neurological Centre Inspire Neurocare (Basingstoke) Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 did not always make sure people were at the centre of their care and treatment choices, and they did not always work in partnership with people.

Care plans did not consistently inform staff about people’s choices and preferences for how they wanted to be supported. For example, some people’s personal care plans did not inform staff if people preferred male or female staff, their preferred times to get up and go to bed, or how they liked to dress. Oral care plans were not in place in all the plans we looked at. Some plans contained conflicting information and other plans were not an accurate reflection of people’s needs. For example, in one person’s plan it was documented they preferred to be left alone when using the bathroom, but staff told us this was not the case and the person felt safer when they were not left alone.

Some people told us they did not feel staff knew their choices and preferences for how they liked to receive their care and support. They explained this was because of the high use of agency staff. For example, a person said, “It’s annoying to have to keep explaining how to put my sling on, how I like to be showered, how I like to be fed all the time.” A health professional told us, “I feel that staff are providing good care, however the individual care needs require staff who know [people] well and the service has high level of agency.”

Despite this, staff we spoke with, did demonstrate a good knowledge about people’s needs and were able to tell us how they supported people.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People had regular health checks. Regular multi-disciplinary (MDT) meetings took place. A health professional told us the service had requested additional specialist training. They said, “The team [at Meadowview] have proactively asked our team for support, with the aim of upskilling so that they can troubleshoot some [medical device] issues themselves and avoid preventable and unnecessary admissions to hospital for their patients.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Although people’s communication needs had been assessed, some staff told us they did not feel trained to meet those needs. This meant there was a risk some people’s communication needs were not always being met as fully as possible. Staff told us they would like to have specific training such as British Sign Language (BSL) or Makaton. We saw there were posters on display with basic Makaton information for staff, but staff told us they wanted more. A member of staff told us, “We don’t get training for Makaton, or sign language, and no training on [augmentative and alternative communication devices] either. The activities and wellbeing lead is BSL trained, but [they] are only here 3 days a week. Basic signs to communicate with people isn’t good enough.”

A person’s relative told us, “There are no BSL users there. Staff manage to communicate by using a wipe board and by pointing. It seems to be working.” We fed this back to the management team who advised they would speak with staff and source appropriate training.

We saw mixed communication in practise. Whilst we observed some positive interactions between people and staff, we also saw episodes where staff did not interact with people in any meaningful way. We fed this back to the management team who advised they would review how staff met people’s communication needs.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The service did not run any formal resident or relative meetings. The registered manager told us this was because they were conscious of the different communication needs of people living at the service and were considering how to make any meeting beneficial and participatory for all. They told us they were considering ‘ambassadors’ and the possibility of asking people what they wanted to discuss so that each meeting could focus on a specific topic. However, at the time of the inspection, this was not in place. People told us they would attend meetings if they were arranged so that they could give feedback. People told us there was no other way for them to provide feedback, other than directly to a member of staff. People told us they were not aware of any suggestion boxes being available.

People and their relatives told us they knew how to raise concerns. A person’s relative said, “I would speak to [registered manager] or [clinical lead]. They know everything about my [relative]. They are so helpful. I’m confident they would sort any issues I had.”

We reviewed the complaints log and saw that complaints had been logged and investigated and responded to. We saw thank you cards from people and relatives on display.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People’s needs were assessed before they moved to the service. When people’s needs changed, records showed staff referred people for specialist support and advice.

The environment was accessible, with large bedrooms, wide doorways and corridors fitted with handrails and adapted toilets and bathrooms. All areas within the service and the garden were wheelchair accessible.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes.

People’s communication needs were inconsistently met, and there were no opportunities for people to give formal feedback during meetings or care plan reviews.

Staff received training in equity, diversity and human rights to help them understand equality and address discrimination. Staff used this information to provide care that was fair and personalised and people told us this happened in practise. Records showed staff supported people to have any spiritual needs met.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Advanced care plans lacked information for staff about people’s choices for their end-of-life care. This meant there was a risk of things that were important to people, such as cultural or spiritual needs, might not be respected at end of life, because staff were not aware of them. We discussed this with the management team who told us this was an area for improvement they were aware of.