Archived: Maudes Meadow

We found the following examples of good practice.

Staff and people living in the home followed good practice around social distancing. The registered manager had ensured clear information about maintaining social distancing was in place to guide staff and visitors. They had rearranged communal areas in the home to support social distancing.

Staff were trained in infection prevention and control and using Personal Protective Equipment (PPE) safely. We saw staff used the appropriate levels of PPE in communal areas and when supporting people with their care.

The provider had ensured sufficient quantities of PPE were available.

The registered manager had followed government guidance about visiting. They had suspended indoor visits during the COVID-19 outbreak, except if people were at the end of life. The had supported alternative, safe window visits.

The registered manager followed good practice around safe admissions when people moved into the home.

The registered manager had arranged for regular COVID-19 testing for staff and people who lived in the home. They had also arranged for people who lived in the home and care staff to receive the COVID-19 vaccine.

The staff team kept the home clean and hygienic. Frequently touched surfaces were cleaned regularly throughout the day to reduce the risk of infection.

The registered manager had reviewed staffing arrangements. Staff were allocated to consistently work in specific areas of the home to reduce the transmission of infection.

The registered manager had followed advice from external specialists to further improve the infection prevention and control measures in the home.

Maudes Meadow provides accommodation and care for up to 28 older people some of who may be living with dementia. At the time of the inspection there were 12 people living there.

Accommodation is provided over two floors accessed by a lift. On the ground floor there is a designated unit for people living with dementia that has an open plan communal area for dining and socialising. There is another large communal area on the ground floor predominately used by others living in the home.

People’s experience of using this service and what we found

Safeguarding systems were in place to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. The provider had recruited staff safely. The registered manager made sure sufficient numbers of staff were on duty throughout the day and night to make sure people received the support as they needed. People received their medicines safely and as their doctor had prescribed.

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. People and their families had been fully involved, where relevant, in planning and reviewing the care and support provided. People received good nutrition and hydration in line with their personal choices.

People were treated with respect and their dignity and privacy were actively promoted by the staff supporting them. People were fully supported to maintain their independence. The provider planned people's care to meet their needs and take account of their choices. People could see their families and friends as they wished. People knew how they could raise concerns about the service provided.

The provider and registered manager monitored the quality of the service and identified areas which could be improved. Governance and quality assurance were well-embedded within the service. Staff said they felt valued and respected. Staff spoke very positively about the new management of the home. The leadership of the service promoted a positive, open culture. The registered manager and staff team worked closely with other agencies and healthcare professionals to make sure people had good care.

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 19 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Maudes Meadow is a residential care home that can accommodate up to 28 older people at the time of this inspection there were 14 people living at the home. The property is a two-storey building and accommodation is provided over two floors the upper being accessed by a passenger lift. There are two separate communal and dining areas on the ground floor and one is designated for people who are living with dementia. It is close to the town centre of Kendal.

There was a registered manager in post at the time of the inspection who had been appointed after the last inspection. A registered manager is a person who has registered with the (CQC) 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.

There were sufficient numbers of suitably qualified staff to meet people’s needs and promote people’s safety.

Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities and we could see records of the actions taken by the home to protect people.

When employing fit and proper persons the recruitment procedures of the provider had not always been followed. We saw for one person recently employed that one of the checks the provider usually completed had not been done in line with the company’s procedures.

The storage and records for medications had improved since the last inspection in December 2015. We saw medicines were being administered and recorded appropriately and were being kept safely. However two people’s medicines had not been reordered in a timely manner.

We have made a recommendation that systems in place were reviewed for the management of reordering medications.

People’s rights were protected. The staff team were knowledgeable about their responsibilities under the Mental Capacity Act 2005. People were only deprived of their liberty if this had been authorised by the appropriate body and was required to maintain their safety and welfare.

Staff had completed training that enabled them to improve their knowledge in order to deliver care and support safely.

People were supported to maintain good health and appropriate referrals to healthcare professionals were made.

There was a clear management structure in place and staff were happy with the level of support they received.

People living in the home were supported to access activities of their choice.

Since the last inspection in December 2015 more formal audits and quality monitoring systems had been implemented that were effective in monitoring the safety and quality of the home.

Maudes Meadow is a residential care home that can accommodate up to 28 older people. It is close to the town centre of Kendal. The property is a two-storey building and accommodation is provided over two floors the upper being accessed by a passenger lift. There are two separate communal and dining areas on the ground floor one is designated for people who live with dementia.

There was no registered manager in post at the time of the inspection. A registered manager is a person who has registered with the (CQC) 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. The provider had made arrangements for the home to be supported by a manager that was registered with CQC from another of their homes pending registration of a new manager.

During this inspection we found breaches of Regulation 12 Safe care and treatment and of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Some maintenance of the environment had not been acted upon. Two of the baths in the home required repair or replacement and another was found to be dirty.

The storage arrangements for some medicines in the home were not always in line with current national guidance. Some records for peoples as required medications were not always clear about their needs.

We found that there had been inconsistencies with the numbers of staff on shifts and that there was no process in place to determine the numbers of staff required to meet people’s individual needs. The level of staffing observed on the day of the inspection ensured that people had their needs met in a timely manner.

Information held about people’s care and support was routinely recorded in four different types of records. The information recorded was not always consistent or accurate within these four types of records. The reviews of care plans and records made were not always accurate about the changing needs of people’s health and support required.

People living in the home spoke highly of the staff and were happy with their care and support.

The recruitment procedures demonstrated that the provider operated a safe recruitment procedure to ensure that fit and proper persons had been employed.

Staff told us they had received regular training and supervision to support them in their roles. However records provided relating to staff training indicated that some staff required elements of training to be updated to refresh their skills and knowledge

Where safeguarding concerns or incidents had occurred these had been reported to the appropriate authorities and we saw records of the actions taken by the home to protect people.

We have made a recommendation that the provider review their best interest decision making process to ensure it follows guidance outlined in the Mental Capacity Act 2005.

We have made a recommendation that records relating to care are consistent to provide accurate information.

We have made a recommendation that all staff are refreshed and updated in their skills and knowledge in some specific topics.

‘You can see what action we told the provider to take at the back of the full version of the report.’