2 June 2022
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 Health and Social Care Act 2008.
The inspection was carried out by one inspector and an Expert by Experience. 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. This service also provides care and support to people living in a number of ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 21 April 2022 and ended on 26 April 2022. We visited the location’s office/service on 21 April 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We spoke with two people who use the service about their experience of the care provided, three relatives, three staff members and the registered manager. We reviewed a range of records. This included three people’s care records and two medicine records. We looked at three staff files in relation to recruitment and specific training. A variety of records relating to the management of the service, quality assurance, maintenance and incidents/accidents, including policies and procedures were also reviewed.
2 June 2022
About the service
The Meadway is a domiciliary care agency providing personal care to people. The service provides support primarily to people living within a supported living service but also within people’s own homes. The service provides support to people who may have a physical disability, dementia or a learning disability. At the time of our inspection there were five people receiving personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided
People’s experience of using this service and what we found
The provider had not ensured systems were in place to oversee the service and ensure compliance with the fundamental standards.
We have made a recommendation about reviewing best practice in relation to medicine administration records.
People told us they felt safe. The provider ensured their safeguarding systems were operated effectively to investigate allegations of abuse, neglect or acts of omission. Individual risk assessments were in place meaning staff knew how to provide safe care to people.
There was positive feedback about how staff felt regarding the new registered manager and the support, accessibility, and the management of the service. Staff felt they could ask the management for help when needed. Staff felt the management was open and transparent with them.
The service had an open and transparent way of working to ensure the safety of the people living at the service. Staff knew people they supported well and cared about their wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 good (published 25 July 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Meadway on our website at www.cqc.org.uk.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.