Meade Close

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication needs with them.

A thorough assessment of people’s needs was carried out before agreeing to provide their care and support. As people were not able to verbally communicate their needs and wishes, information was gathered from family members and professionals involved with the person. The relatives of one person told us, “They asked [relative] and social worker for details when care planning for [person].” Information gathered was used to develop personalised care plans and risk assessments, which were kept under review.

The provider did not always effectively plan and deliver people’s care and treatment in line with legislation and current evidence-based good practice and standards.

Suitable and safe arrangements had not been established with regards to the delegated task of administering people’s diet and prescribed medicines through a feeding tube. These tasks are nursing clinical tasks, which in appropriate circumstances can be delegated to social care staff by a nurse or other acceptable health care professional. We found there was no designated health care professional identified to provide clinical oversight of the task and assess staff skills in carrying out the task. Immediate action was required to ensure arrangements were in place.

Care plans outlined people’s physical and healthcare needs. Appropriate referrals were made where further advice and support was needed to help meet people’s specific care needs. However, guidance provided was not accurately reflected in people’s care plans.

Training in line with best practice had been provided in relation to International Dysphagia Diet Standardisation Initiative (IDDSI), for people with swallowing difficulties and React to Red, whichhelps staff recognise increased risk of pressure. Staff also used the Malnutrition Universal Screening Tool (MUST) which helped identify people at risk of malnutrition.

The dietician team and speech and language therapists provided additional advice and support. A healthcare professional told us, “Meade Close are very good at requesting training for new starters, or refresher training if they feel it is required for any members of staff. They are always happy to have any training that is offered."

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked with a range of health and social care professionals in supporting people to meet their individual needs. People were registered with a local GP and were supported by health care professionals, where appropriate. A healthcare professional told us, “Most staff have very good relationships with all clients, and I always get good communication if I have any questions regarding any of the individuals” and “Staff are proactive in seeking advice or support when they have any queries or concerns.”

Staff supported people to access healthcare and attend medical appointments. A hospital passport was used to help effectively communicate people’s individual needs when moving between services.

The provider did not always support people so they 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’s plans outlined their preferred activities, interests and routines. Additional 1-2-1 hours were allocated so opportunities could be provided. From our observations and feedback from staff we found this was not always flexible due to the level of care and support required across the service. Following our visits the provider had introduced further staffing so better flexibility in support could be provided.

A number of people were supported with a percutaneous endoscopic gastrostomy (PEG). This is a feeding tube which is placed through the abdomen directly into the stomach to provide liquid nutrition, hydration, and medication. Following recent safeguarding concerns in relation to people’s dietary needs, additional training had been provided by the speech and language therapists needs.

Systems were in place for the recording and monitoring of any accidents or incidents helping to identify areas for improvement. Records were kept under review and action identified where necessary. Learning was shared with staff through team meetings or individual discussions. A new management team had recently been appointed. Individual role and responsibilities were to be established providing additional monitoring and support for the team so that learning can be consistently embedded.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People living at Meade Close had been assessed as lacking capacity to make decisions about their care and treatment. Lawful authorisations were in place to deprive people of their liberty.Where additional restrictions were in place, decisions were made jointly with relevant parties to ensure these were in the person’s best interests.

Staff were aware of seeking people’s consent. They understood that not everyone could verbally express consent and took care to observe non-verbal cues and behaviours that might indicate a person’s wishes.