The Meadows

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.

The service is registered to accommodate up to 54 people and at the time of the inspection there were 54 people residing in the home. The registered manager has opened a waiting list of people who have enquired about a placement at The Meadows. The home is purpose built, and designed around the needs of older, infirm people some of who may have a degree of dementia. The home is run as ‘four separate houses’, three for 15 people and the fourth being for nine people. The four houses are on the ground and first floor with lifts and staircases available. An additional 30 beds on the second floor are block-contracted to Sirona Healthcare (a community health service provider) and do not come within the remit of the homes registration. Each of the house have their own lounge and dining room, and assisted bathroom. Each of the bedrooms are for single occupancy and have en-suite shower facilities.

There was 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 registered manager is also the registered provider.

This is the first inspection of the service since it was registered by the Care Quality Commission in January 2018.

Why have we rated the service as Good?

People received a safe service. Staff received safeguarding vulnerable adults training and would know what to do if there were concerns raised regarding a person’s health and welfare. Staff also received moving and handling training and therefore assisted people safely. Any other risks to people’s health were assessed and management plans were in place to mitigate those risks. The premises were well maintained and safe for people to live in.

People were provided with an effective service. Feedback received from people who live in The Meadows, their relatives and health and social care professionals, was overwhelmingly positive. The staff team were well supported and trained to deliver exceptional care. The premises and facilities at The Meadows were spacious and designed to the promote well-being of people. The service was specifically designed for people living with dementia.

People received a service that was caring and supportive, not only to people who lived there but also to their family. The registered manager ensured each staff member delivered care which was exceptionally compassionate and kind, in a homely ‘family’ environment. Feedback we received included, “A very innovative and caring provider, who has put together a staff team of such high calibre. People are really well looked after”.

The Meadows provided a responsive service which took account of each person’s individual care and support needs. People were provided with ‘holistic’ person centred care which included their recreational needs. The care team spent time finding out what people had done in the past and accommodated this in the activities they helped them follow. The service participated in inter-generational activities and toddlers from a local nursery, and children from the primary school visited The Meadows.

The service was consistently managed and well-led. The management team, led by the registered manager (registered provider), had created a culture to ensure people were provided with high quality, person centred care. Feedback received from people who live in The Meadows, their relatives and health and social care professionals was positive. The service had clear and effective governance arrangements in place to monitor the quality and safety of the service.

We will continue to monitor intelligence we receive about the service until the next inspection. If any concerning information is received we may inspect sooner.