Meadow View Care Home

Updated 17 November 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

The inspection was carried out by 2 inspectors, a specialist advisor nurse 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

Meadow View Care Home 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. [Care home name] is a care home [with/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 not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 6th April 2023 and ended on 27th April 2023. We visited the location’s service on 6th and 12th April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people using the service and 5 family members. We spoke with the regional director, deputy manager, an agency nurse, 2 care assistants, maintenance lead, a housekeeper and chef.

We reviewed a range of records. This included 6 people's care records and multiple medicines records. We looked at 3 staff files in relation to recruitment and a variety of records relating to the management of the service, which included quality monitoring and auditing, minutes of meetings, policies and procedures.

Updated 17 November 2023

About the service

Meadow View Care Home is a residential care home providing personal and nursing care for up to 53 people. The service provides support to younger and older adults and people living with dementia, or a physical disability. At the time of our inspection there were 42 people living at the home.

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

Some people reported issues with uncertainty about their care, due to being discharged to the service for assessment from hospital. People expressed their frustration at delays to their longer term care arrangements.

The provider and regional director were open and transparent throughout the inspection. They told us their focus had been on recruiting a new manager to the service. We found the lack of oversight and governance had led to our inspection identifying areas for improvement.

Improvements were required to the provider's systems and processes to assess and monitor the safety and quality of people's care as they had not identified the issues we found during the inspection.

Staff had not always followed the procedure for the administration of medicines or the monitoring of safe medicine management. People did not always live in an environment with safe infection and prevention measures.

People and their family members told us they felt safe at Meadow View Care Home, as staff were available to help them when required. People were supported by staff who had undergone a safe recruitment process.

People's health and wellbeing needs were assessed, and their health and welfare monitored by staff. Staff liaised with health care professionals about people's care. People's dietary needs were met and people were assisted by staff where required to eat and drink. Snacks and drinks were served throughout the day. A plan for ongoing improvements to the mealtimes was in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service mostly supported this practice, however inspectors identified improvements were needed for one person at the service.

People and family members were generally complimentary about the staff and care their relatives received. The provider sought feedback from family members about the quality of the service.

The provider had identified areas for improvement, which included the performance management of staff, recruitment, care records and housekeeping.

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 7 July 2022).

Why we inspected

The inspection was prompted due to concerns received about the management of the service and safeguarding concerns in relation to wound care. A decision was made for us to inspect and examine those risks.

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.

You can see what action we have asked the provider to take at the end of this full report. During the inspection the provider worked with the local authority and the local integrated commissioning board (ICB) to reduce the risks at the service, however improvements were still needed.

We received concerns in relation to the management of the service, recruitment and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to safety and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.