Meadow View Residential and Community Care Centre

Meadow View Residential and Community Care Centre is a care home that provides personal care for up to 32 people. The ground level is long term care for 16 people living with dementia. The other provision supports people on a short-term basis with rehabilitation goals. All rooms have en-suite facilities, there are communal areas and accessible gardens.

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

People received their medicines as prescribed and the risks associated with medicines were managed effectively. People received safe care and there were effective infection control systems to keep them safe. There were enough staff available to meet people’s needs safely and in a timely manner. Staff were recruited safely to ensure they did not pose a risk to people. People were protected from the risk of harm and lessons were learnt when mistakes happened.

The systems in place to monitor and improve the service were effective in achieving good outcomes for people. Staff were aware of their responsibilities and were encouraged to raise concerns and report mistakes to create a learning culture. Under current restrictions the service had implemented strict infection control measures but were innovative in maintaining contact with other professionals and stakeholders virtually.

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 requires improvement (published 20 June 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 19 March 2019. Breaches of legal requirements were found and a Warning Notice was issued. We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadow View Residential and Community Care Centre on our website at www.cqc.org.uk.

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.

About the service:

Meadow View Care Centre is a care home that provides personal care for up to 32 people. The accommodation is across four levels. The ground level is a dementia specific unit for 16 people. On the second floor there is a day unit, meeting spaces and therapy rooms and a café. CQC does not regulate these. On the third floor there is an intermediate unit for eight people, this is to support people to return to their home after a period of ill health. On the top floor there is a respite unit which can accommodate eight people. This enables people to have a short break to support family carers or receive support during a period of changing health needs. Each unit has their own communal spaces and bathing facilities. At the time of the inspection there were 27 people using the service.

People’s experience of using this service:

Medicine was not always managed safely and risk assessments completed to reduce the risk to people. Lessons were learnt in some areas, however in others the lessons had not been reviewed to ensure they had been embedded into new practice.

Audits had been completed, however these had not always identified areas of concern to address any risks or drive improvement. Some notifications had not been completed or sent to us as required to inform us of events or concerns.

The provider had not always supported the registered manager with the processes needed to manage the service in all areas. Care plans were not always detailed to ensure staff had all the information to provide safe care. Information about people’s methods of communication or equality needs were not reflected.

People were supported by sufficient staff and this support was flexible when people’s needs changed. When staff were recruited, the appropriate checks had been completed, including references and a police check.

People’s behaviours had been managed by staff who had received the training and who followed detailed guidance. When people received care, this was done with dignity and respect. People could choose how to spend their day. There were activities on offer and external entertainers visited weekly.

There was a choice of meals and people’s preferences had been considered. When people’s health needs changed they were supported with health care professionals who provided guidance.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were able to raise any concerns they had and they were responded to with a formal response. There was an opportunity for people to reflect and comment on their care they received. This was used to reflect on changes to the meals or activities, in addition to the quality of the care provided.

Staff felt supported by the registered manager and there was a homely atmosphere to the environment. Partnerships had been developed with health and social care professionals and this had enhanced how they worked together to develop new processes.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

Rating at last inspection: Requires Improvement (Published April 2018)

Why we inspected: This was a planned inspection based on the rating at the last inspection which was ‘Requires improvement.’ At this inspection we found the service continued to be ‘Requires Improvement.’

Enforcement : Action we told the provider to take. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals are added to reports after representations and appeals have been concluded.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We inspected this home on 13 February 2018. This was the service’s first inspection since their registration with us in June 2016. The inspection was unannounced. Meadow View Residential and Community Care Centre did not have a registered manager in post. 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. The provider had recruited a manager and we saw they had commenced their register with us.

Meadow view Residential and Community Care Centre provides a range of support. The care home accommodates 32 people across three separate units, each of which had separate adapted facilities. One of the units specialises in providing care to people living with dementia. On the day of our inspection 27 people were using the service. Other aspects of the service included a community café, space and a day service, we do not regulate these areas and therefore our inspection did not include these areas.

The dementia unit is a care home. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This home supported people living with Dementia. This accommodates 16 people, at the time of our inspection there were 16 people using the service. The second unit provided residential care with a facility to offer short term care for people. The third unit was linked to support from health care professionals to provide people with rehabilitation following an injury or to prevent a hospital admission by providing support within this setting. All the units were independent and had their own facilities and deputy managers.

There was a new manager in post who had audited a range of areas to establish an action plan to drive improvement. Many of the areas noted on the action plan were areas we also identified during our inspection.

People did not always receive the level of staff support they required for their needs. When people expressed behaviours which could harm themselves or others these had not been managed in a consistent way. Medicines were not always managed in line with their prescription.

Staff had not always received training to support their role and provide the correct information to reduce the risk of infection. Staff had not always received support with their role, however we saw meetings with the new manager had taken place to reflect on the practice moving forward.

When people received their meal, they were not always provided with the correct level of support to make the experience an enjoyable one. Refreshments and snacks to support people’s hydration and nutrition were not always available and this had an impact on people maintaining a consistent weight.

Staff felt that information could be improved and this was reflected in the confusion when recording details for people’s changing needs. Individual’s dignity was not always maintained and people had limited choices about how to spend their day. This was reflected in the lack of stimulation on offer and activities to distract people when they became anxious.

When people required support with their health care needs this was not always provided in a timely way. When guidance was provided this was not always followed to ensure the person received the correct level of care.

People had been supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. When staff were recruited we saw the relevant checks had been competed to ensure they were suitable to work with people. The manager had sent us notifications relating to events at the home. Risk assessments had been completed to consider when equipment was required or in relation to a person being at risk of falling.

Relatives felt welcome and had been included in the development of the care plans and ongoing reviews. Meetings had been held with relatives to obtain feedback and used to develop improvements. A complaints policy was in place and any complaints had been reviewed and investigated in line with the policy.

People could personalise their space and the home had won an award for its design in relation to dementia care.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.