Meadow Court Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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 service did not always make sure people’s care and treatment was effective because they did not consistently check and discuss people’s health, care, wellbeing and communication needs with them or record these discussions.

However, we spoke with people and their relatives who felt they were involved in the planning and reviewing of their care. We received positive feedback from relatives and people regarding care provision. One relative said they were involved in their family member’s care stating, “We are invited in to discuss any issues, and we feel their needs are being met well here.”

However, needs were not fully assessed effectively. We reviewed care plans for people with specific needs and found their health, care, wellbeing and communication needs were not effectively assessed. For example, 1 person who was at nutritional risk did not have a repositioning chart or regular weight checks in place as identified in their care plan. People with specific additional or communication needs had little reference to this in their care plans and appropriate interventions required to support this need were not documented. The service immediately took action to rectify these issues following feedback.

The service did not always plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

We received mixed feedback from people regarding the food and drink provided. Some gave positive feedback; others were not happy with the food. When asked about the quality of the food, some people said, “Don’t’ ask” or “it’s alright… it isn’t the Ritz.” Other people told us the food was “delicious.”

People who required specialised diets, were not always provided them. For example, there was not always documentation to show that people had been given thickened fluids as per their care plan. Staff were aware that thickened fluids were required but this was not always documented in the daily records. We were not made aware there had been any incidents regarding choking because of this.

There was some signage evident within the service to help people living with dementia find their way around the environment such as, where bedrooms were within the building. However, signage on bedroom doors and within the communal areas need to be further improved to meet Department of Health: Dementia-Friendly Health and Social Care Environments guidance. There were people within the service who were visually impaired and the signage in place did not support them to navigate their environment. We identified 1 example where a resident had flash cards in place to support communication, however this was not consistent across the service. Appropriate alternative communication aids were not in place to support these individuals to meet Accessible Information Standards. The service gave assurances they would address these issues.

The service did not always work consistently well across teams and services to effectively support people.

Staff were aware of how to make referrals to health professionals, and we did not receive any negative feedback regarding this. We received positive feedback from the local GP practice regarding effective working. However, the service did not always make appropriate referrals to external agencies. For example, there were several people with either sensory or additional needs and we found appropriate referrals had not always been made for them to access appropriate support. Care records were not always accurate which meant there was a risk that information shared within the staff team was not accurate or fully complete.

The service did not always support people to manage their health and wellbeing, so people could maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People and their relatives did not raise any concerns about accessing health care support. However, care plans did not always maximise opportunities for people to reduce their future care and support needs. For example, 1 person was identified as having additional needs. The service had not provided staff with the specific training or interventions required to support this individual’s particular needs. The service put this in place following feedback.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

There were not effective processes in place to monitor people’s care and treatment. For example, we reviewed care plans for individuals who were at nutritional and hydrational risk. People’s outcomes were not effectively monitored and there was poor oversight of care records. Appropriate mitigation measures such as weight and food and fluid charts were not effectively used to monitor individual risk. Food and fluid intake was not completed contemporaneously. The service put measures in place to more effectively monitor and improve outcomes following feedback.

The service told people about their rights around consent and respected their rights when delivering care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

The service had a good system in place to demonstrate who had a DoLS authorisation in place. This supported the service to have oversight of individual risk to people and ensured they could evidence how any requirements of the DoLS, known as conditions, were being appropriately met. People and their relatives said they were involved in decisions pertaining to care and treatment.

Where people lacked capacity, the principles of the MCA were followed. Capacity assessments had been completed, and best interest assessments were in place for relevant areas.