The Meadows

Updated 20 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Meadows is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Meadows is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included CQC notifications. Notifications describe events that happen in the service that the provider is legally required to tell us about. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 10 relatives about their experience of the care provided. We spoke with 14 care staff including the senior carers, the operations manager, the deputy manager, the nominated individual, the registered manager, the chef, laundry assistant and care staff. We received feedback from two professionals. We reviewed a range of records. This included 7 people's care records and multiple medication records for the service. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 20 October 2023

About the service

The Meadows is a residential care home providing the regulated activity of personal care to up to 54 people. At the time of our inspection there were 53 people using the service.

The home is purpose built and designed around the needs of older people, some who may be living with dementia. It is located within a community setting. The home is run as 'four separate houses', three for 15 people and the fourth being for 9 people. The 4 houses are on the ground and first floor with lifts and staircases available. An additional 30 beds on the second floor are contracted to a community provider and do not come within the remit of the home’s registration. A small, enclosed garden was situated within the grounds.

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

People's care and support needs were assessed. However, risk assessments were not always regularly reviewed and in some cases lacked guidance for staff. This was rectified during the inspection and the provider added an additional measure on their IT systems to ensure risk assessments were reviewed in a timely and consistent manner.

Staff did not always follow infection prevention and control guidance to minimise risks related to the spread of infection. We observed some staff with painted and gel nails. We raised this with the management team. Infection control procedures were in place and staff used personal protective equipment (PPE) effectively.

Although people’s mental capacity had been assessed for their ability to consent to aspects of their care, assessments did not always record decisions made in line with guidance. Staff knowledge around mental capacity was inconsistent. Staff told us they had mental capacity act training and the management team confirmed this. The management team informed us they would be providing refresher training for all staff.

Staff and relatives were positive about the culture and ethos of the service. The senior team led by example and were respected by staff. Staff understood how to safeguard people and when to raise concerns. People received their medicines safely and recruitment practices were in line with government guidance.

There was an established staff team that was motivated and well trained to carry out their roles effectively. There were enough staff to support people. The service was accessible and had been adapted to meet people's needs.

Records had been kept of all food and drink taken by those assessed as at risk nutritionally. The staff and kitchen were clear about who needed modified/enriched diets and ensured they received this and recorded it. People were supported to maintain their nutritional needs and referred to appropriate health professionals when needed

People were supported to have maximum choice and control of their lives and staff did always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. These concerns were highlighted to the management team who resolved the concerns during the inspection process.

The systems for quality assurance and monitoring were not always effective and had not identified the shortfalls we encountered during the inspection. Records in relation to people’s consent to care, did not always record information sought in line with guidance. Mental capacity assessments for people were in place but did not always record who was involved in the decision making process. We discussed our concerns with the deputy manager and the management team during the inspection. The management team informed us, they had rectified their systems and processes to ensure the shortfalls were addressed

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 11 May 2019)

Why we inspected

This was a planned inspection due to the age of the rating. You can see what action we have asked the provider to take at the end of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.