Archived: Meadow Lodge Home Care Services LLP

About the service

Meadow Lodge Home Care Services LLP is a domiciliary care service. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger disabled adults and people living with dementia or mental health problems. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service is mainly provided to people living in the Selby area, as well as some parts of Wakefield and the outskirts of York. When we inspected there were approximately 180 people using the service.

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

People were positive about the quality of the service they received. Everyone told us their care workers were polite and said they were kind and respectful.

People told us they enjoyed positive relationships with their care workers and looked forward to them visiting. One person commented, “I feel safe with the carers without a doubt, they are kind and caring towards me and we have a joke with each other which is nice.”

There were effective systems to monitor that calls took place as planned. Effective management systems, policies and procedures were in place to protect people’s safety and welfare. We have made a recommendation about the management of some medicines to make sure that best practice guidance is followed.

The service was responsive to people’s changing needs and people felt well cared for and listened to. Care plans contained information regarding people’s care preferences; these were kept under review and updated as needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff felt the registered manager was supportive and they always had the appropriate support and training to fulfil their roles effectively. Managers undertook regular audits and checks on the quality of the service to identify themes and trends and monitor progress.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 February 2018).

Why we inspected

This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.

The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadow Lodge Home Care Services LLP on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and people living with dementia or mental health problems. Not everyone using the service receives a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service is provided mainly to people living in the Selby area, as well as some parts of Wakefield and the periphery of York. When we inspected the service had approximately 200 people who used the service.

At the last inspection in November 2016 we found there were breaches of Regulation12: Safe care and treatment and Regulation 17: Good Governance in relation to risk assessments and risk management, medicine management, mental capacity and consent to care, auditing and care planning. We asked the provider to complete an improvement plan to show what they would do and by when to improve the key questions Is the service safe? Is the service effective? and Is the service well-led? During this inspection we found sufficient improvements had been made within the service to enable the provider to meet the legal requirements of both regulations.

The provider is required to have a registered manager. 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. There was a manager in post who registered with CQC in March 2017.

Improvements had been made to medicine management practices. Documentation had been reviewed and updated, staff received training and support around medicine administration and people said they had no concerns about how they received their medicines.

Risk management and the assessment of risk had improved. The assessment and documentation of risk was clear and detailed to aid support workers to deliver safe care, and the management team audited and reviewed risk on a regular basis. People were involved in their care planning and were able to discuss risk taking as part of this process.

Care records had been reviewed, updated and rewritten as needed. Improvements had been made to ensure these were person centred and reflected people’s wishes, choices and decisions about their care and support.

The people using the service told us that they felt confident about their safety. We found that their support workers had a good knowledge of how to keep people safe from harm and the support workers had been employed following robust recruitment and selection processes.

People were supported to have maximum choice and control of their lives and support workers assisted them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were sufficient support workers employed to meet people’s individual needs. The support workers received induction, training and supervision from the management team and we saw they had the necessary skills and knowledge to meet people’s needs.

There was a complaints procedure in place and people told us that they would not hesitate to contact the agency office if they had a concern.

Where support workers prepared and cooked meals for people, people told us they enjoyed good food.

People were treated with respect and dignity by the support workers. People who spoke with us were positive about the service they received.

People and the support workers told us that the service was well managed. The registered manager monitored the quality of the service, supported the support workers and ensured that people who used the service were able to make suggestions and have input into the development of the service.

Further information is in the detailed findings below

At the last inspection on 14 May 2014 the service was meeting all of the regulations we assessed.

Meadow Lodge home care service provides personal care to people living in their own homes in the Sherburn-in-Elment, Tadcaster, Wakefield and Selby areas. The service currently provides support to approximately 200 people.

The service has a registered manager. 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.

At this inspection the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulation 12 Safe care and treatment and Regulation 17 Good Governance.

Risk assessments and risk management plans did not provide staff with clear guidance about how to safely manage known risks to people. They were not always up to date which meant they did not reflect people’s current needs.

Medicines were not safely managed. The registered provider did not have accurate recording systems in place for medicines which were administered to people from pre filled dosette boxes. This meant there was no clear record to say what medicines the person had received. In addition to this medicines risk assessments required improvement.

Care planning documentation was generic and task focused, although people told us they received good care and that staff knew them well the care plans we reviewed did not reflect this. Care records did not contain adequate information to provide staff with clear guidance about the care individuals required.

You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe. The service had clear systems in place to report and investigate abuse. Staff understood the types of abuse and were confident in raising concerns with the management team. Care calls were delivered by a consistent staff team and, in the main, people received their care calls on time.

Where people were unable to consent to care due to their mental health difficulties the service had not completed mental capacity assessments or recorded best interests decisions.

The service had safe and effective recruitment systems in place. Once recruited staff completed an in depth induction programme and were subject to a probationary period. The service offered ongoing training and support to their staff team and also carried out routine competency checks to ensure staff were delivering effective care.

There were strong working relationships with relevant health and social care professionals and the service was proactive in liaising with other agencies when they were concerned about people’s well-being.

People told us care staff were kind and compassionate and that they were provided with care which promoted their independence. The service had received a number of compliments about the care they provided for people at the end of their life.

The service had an up to date complaints policy and people told us they knew how to raise concerns. Complaints had been investigated and responded to in line with the policy.

Staff told us they felt well supported by the management team. There were regular staff meetings and changes to people’s needs were communicated to the team.

The service had clear management systems in place and staff understood their roles and responsibilities. The registered provider had been operating the service for 22 years and had made appropriate notifications to the CQC.

People’s views on the service were sought on a regular basis and this was used for ongoing improvements.

Below is a summary of what we found. The summary describes what people using the service told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:

Is the service safe?

People were treated with respect and dignity by the staff. People we spoke with told us they felt staff listened to them and acted on what they had said. Safeguarding procedures are in place and the provider and staff had reported safeguarding issues to the relevant Local Authority Safeguarding team for their consideration. The agency had policies and procedures in place in relation to The Mental Capacity Act. Staff had received training about safeguarding people from abuse. This had helped to protect people.

The provider had systems in place to check the quality of service provided. These systems were constantly being monitored to ensure people remained satisfied with the service they received.

Is the service effective?

People's health and care needs were assessed at a 'meet and greet' appointment. People were involved in stating what care and support they wished to receive. This information was included in care plans and risk assessments. This ensured that people's needs were known and could be met. A person we spoke with said 'The carers are always on time and they are friendly. They look after my needs. I am happy with my care.' Another said 'I am looked after by polite and professional staff. New staff take a bit of time to find out my needs. They need time to get to know me. They write down the care given before they leave. I am satisfied with the care and support I receive.' Staff at the agency had monitored when the care staff undertook their calls to people. This had helped to ensure that the service provided was effective.

Is the service caring?

We accompanied a senior member of staff to a person's home to observe a 'spot check' visit. This person spoke highly of the help and support they received from the staff. They told us staff understood their likes, dislikes and preferences. Comments made at this meeting were looked at, and it was noted that more care staff were to receive further training from a health care professional to enhance the care provided to this person.

We were told by the provider that they had always informed the care managers if people's needs changed and more help and support was required. We saw from the care records we looked at that the care staff recorded in detail all the care they provided to people. People we spoke with told us that the care staff were professional and kind.

Care staff we spoke with appeared to be passionate about their work. The staff told us that they loved working for this provider. A carer said 'It is fantastic here. I have more time to focus on what the client wants and needs. Some clients have very specific routines. Everyone cares here.'

Is the service responsive?

There was a complaints policy in place which people were made aware of. People we spoke with said they would raise issues with the provider or staff. A phone number was provided so that people receiving a service or staff could gain help and advice at any time. This helped all parties to feel supported and ensured that any issues could be acted upon in a timely way.

The provider told us how people were treated as individuals by the staff. We were informed that the staff had worked together to support each other and cover sickness or absence. The provider told us how the office staff were trained in care so they could carry out care calls if the need arose.

A person we spoke with told us that if they wished to have an extra call all they had to do was speak with the office staff and this would be accommodated even at short notice. The flexibility was valued by people who used the service.

Is the service well- led?

The provider had put systems in place to monitor the quality of the service. These systems were always being reviewed and developed. People were regularly asked for their views by phone, through staff visiting them or by reviewing people's care.

The service worked well with health care professionals and staff from the local authorities to ensure people received the care and support they required.

Staff told us there were clear roles and responsibilities in place. Staff told us that they valued working for this provider. A number of staff we spoke with had worked there for a long time. The staff worked as a team to address any issues, this included the office staff and providers.