25 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 24 July 2018 and was announced. We gave the service 24 hours' notice of the inspection because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by one inspector.
Before the inspection, we reviewed the information available to us about the service, such as the notifications that they had sent us. A notification is information about important events which the provider is required to send us by law.
During the inspection, we spoke with one relative and sought feedback from five healthcare professionals, which we received from one. We also spoke with the director, the registered manager, the deputy manager and two support workers including a new staff member. We looked at two care records, as well as the Medicines Administration Records (MARs). We also looked at records relating to the management of the service, such as audits and rotas. We were not able to gain verbal feedback from people using the service, due to communication needs and some being being unavailable. When we were in the home we observed some interactions between staff and people.
25 August 2018
This inspection was announced 24 hours’ prior to our visit, as it is a small home and we wanted to ensure that someone would be available to speak with us. This was the first comprehensive inspection carried out of this service which was registered with the Care Quality Commission (CQC) in June 2017.
The Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care home accommodates up to 6 people in one adapted building. At the time of our inspection 3 people were living in the home.
The Meadows provided accommodation, care and rehabilitation to adults who have neurological difficulties such as acquired brain injury. The home had communal areas such as a kitchen and lounge, and people were accommodated in their own rooms, each with an en-suite shower or bathroom
There was a registered manager working in the service. 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.
People were supported by a suitable number of staff who understood how to keep them safe, and staff were recruited safely. Risks to people were assessed and mitigated, including those associated with the environment they lived in as well as their own health needs. Staff administered and supervised medicines safely, and people received these as prescribed. The home was clean and there were infection control processes in place.
People’s needs were thoroughly assessed prior to moving into the home. The staff continued to work effectively with other teams to ensure people received consistent care. Staff received training relevant to their roles, including the provider’s mandatory training as well as training specific to some people’s needs. They also received supervision from the management team. Staff supported people to drink enough and to eat a balanced diet, and to access healthcare from other professionals as needed.
People lived in a homely environment and garden which was adapted to their needs. Staff knew about people’s mental capacity and understood how to support people to make decisions. There were also appropriate healthcare professionals involved in making best interests decisions for some people.
There were caring and supportive relationships between staff and people. Staff adapted their communication according to people’s needs. Privacy and dignity was respected at all times, and people and relatives were involved in their care as much as possible.
Care records were in place for people living in the home, and these contained individualised guidance for staff about how to support people. People were able to go out into the local community if they wanted, and participate in activities, as well as do activities in the home with staff.
People and relatives felt they could raise any concerns with staff, and a complaints system was in place.
There was good leadership in place and staff felt happy in their roles. There were quality assurance systems in place which contributed to assessing, monitoring, and improving the service provided.