Meadow View Residential Care Home

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.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people’s needs were not always met.

This service scored 54 (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, to decide how to respond to any relevant changes in people’s needs.

Care plans had been regularly reviewed, however they were not always up to date with people’s care needs, likes and dislikes. Care plans included some person-centred information, however this information was not always used by staff to support people, such as them helping to wipe tables during meal times where people expressed they would like to be involved in this.

Staff interactions were sometimes task-based and around nutrition and hydration. Staff told us they did not have the time they wanted and needed to support individuals with social or emotional interactions. Staff told us, ‘I think at times there are lots of staff and other times it's not enough - it needs to be more consistent.’

Information was shared with staff during handover regarding any changes to people’s health or care needs.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff had not always acted on concerns raised, or raised this with professionals when needed, which caused unnecessary delays to care. For example, on the first day of our inspection, we raised with staff that one person had shown an inspector sores, which they told us were painful. This information was shared with staff, however, it was not documented within the person’s care plan to ensure consistent care including pain relief and support from healthcare professionals was sought. When we raised this with the registered manager, they took action to address this.

However, to improve continuity of care we were told the service was moving towards staff working across the home to ensure flexibility when cover is needed. A relative told us, “It’s good quality care, I wouldn’t want her to go anywhere [else].”

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

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers.

When asked, staff told us that information was not produced in other formats, for example, large print, other languages, braille. Doors to people’s rooms were the same colour and some had a framed picture beside them. As an orientation aid these pictures were small and difficult to see until standing close. However, dementia friendly signage was observed as way marking on bathrooms and toilets.

Meetings for residents and their relatives or friends were held every other month to improve information sharing. There was a board in reception with staff photos on their team board. However, this was located in an area where only visitors could access it. This meant people could not access it.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider ran regular resident’s meetings every other month for people and their relatives and representatives. The registered manager introduced relative’s support meetings. These covered topics such as dementia to promote understanding of their relative’s condition. Relatives told us they felt kept informed. A relative told us, “We would go to [staff], we see her when we’re there and she’s very helpful with any updates.” Another told us that they were pleased with the openness of the registered manager. They said, “Last year they went into special measures, no one told us what they were marked down against. They made a lot of staff changes, the new manager introduced himself and made the effort.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People were not always supported to access care and treatment when needed, or in a way that worked best for them. For example, when one person reported being in pain, although this was passed over to staff, immediate action to make the person comfortable and seek medical support for them was not sought. Once this was raised with the registered manager, action was taken to address this.

However, the premises were accessible to people with reduced mobility and included a lift between floors. Staff told us that equipment was always available as needed to support people with their mobility. Call bells were answered in a timely manner with reasonable wait times.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Staff told us that there were people at the service, who would enjoy leaving the service with the support of staff, to have a walk or purchase a newspaper. Staff told us this was not possible due to staffing levels. Some people who required more support, who preferred to remain in their room, or were cared for in bed had restricted access to enrichment activities that would provide a good quality of life. This meant some people were not supported to develop or maintain relationships to avoid social isolation or provided with activities that were of interest or socially and culturally relevant to them.

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.

Not all care plans we reviewed included people’s end of life wishes. Staff told us this was discussed when people moved into the service, however the documentation of this, or re-visiting of this subject was not clear with all care plans reviewed. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. Training records for staff showed that only 5 staff members had completed any training in end of life care. The provider could not be assured that staff had the skills to support people at the end of their lives.