Meadowyrthe

Updated 23 November 2022

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 conducted by 2 inspectors.

Service and service type

Meadowyrthe 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. Meadowyrthe 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 not a registered manager in post. A new manager had been in post for just over one month and had submitted an application to register. We are currently assessing this application.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we had previously conducted an unannounced inspection which had to be terminated due to inspector illness.

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. 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 5 people who used the service and 2 relatives about their experience of the care provided. We also spoke with 6 staff, the deputy manager, the manager and the operational lead for residential care, acting on behalf of the provider. Following the inspection, we also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records, these included 6 people’s care records, medicines administration records, complaints, health and safety and quality assurance records. We also looked at 2 staff recruitment files.

Updated 23 November 2022

About the service

Meadowyrthe is a residential care home providing personal care to up to 41 people. The service provides support to people aged 65 years and over, some of who are living with mental health conditions or dementia. At the time of our inspection there were 33 people using the service.

Meadowyrthe accommodates people across four separate households, each of which has separate adapted facilities. One of the households specialises in providing care to people on short term respite stays.

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

Systems used for the management of medicines were not always safe. Records did not accurately reflect the medicines stored at the home. The provider’s governance and oversight systems were not always effective in identifying areas of concern or requiring improvement.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Staff did not always follow national guidance in relation to people’s capacity and applications to lawfully restrict them.

People were supported by staff who knew how to identify signs of potential harm and abuse. Staff had received training in safeguarding and reported concerns for people’s safety. Risks to people’s safety were assessed and recorded so staff knew how to protect them from avoidable harm. People received their medicines as prescribed. There were enough staff to meet people’s needs and they had been safely recruited. Where events took place, the provider had systems in place to ensure learning took place and any improvements identified were made.

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.

People’s needs had been assessed and care plans developed which reflected their individual needs. Staff received an induction to their role and training to give them the skills and knowledge required to support people. People received support with food and drink to maintain a healthy diet. People were supported with their health needs by staff and healthcare professionals. A refurbishment of the home was underway, which was planned to reduce disruption to people’s daily living environment.

People were supported by caring staff who knew them well. Staff treated people with respect and acted to ensure their dignity and privacy. People received support that promoted their independence.

People received support that reflected their current needs and was responsive to any changes in their health or well-being. Staff understood people’s individual preferences, likes and dislikes. People were supported to maintain relationships that were important to them and visitors were welcomed at the home.

People were supported to take part in activities that interested them and they found enjoyable. People and relatives felt able to raise concerns about their care and there was a system in place to manage complaints. People’s wishes relating to end of life care were recorded, including spiritual and religious wishes.

People, relatives and staff spoke positively about the management team. The new manager was aware of their responsibilities and was open to feedback about areas of improvement. Staff felt they could offer feedback about how the home was run and described the manager as approachable. The provider was receptive to the findings of the inspection and advised they would take action to drive the necessary improvements.

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 the service under the previous provider was requires improvement, published on 4 December 2019.

Why we inspected

The inspection was prompted in part due to concerns received about medicines. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to medicines management and good governance 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.