28 June 2023
During an inspection looking at part of the service
Meadow View is registered to provide accommodation and personal care for up to 42 people, including people living with dementia. At the time of our inspection visit there were 32 people living at the home. The home is split into a large main building which provides care to people on a permanent basis. There is a separate building known as ‘The Poppies’ which provides respite care. Respite care is planned or emergency temporary care. Some people living at the home were living with dementia. People have use of a communal lounge and dining area, as well as occasional seating throughout corridors. People’s bedrooms are ensuite and there are further communal bathroom facilities located around the home. People can access outside spaces.
People's experience of using this service and what we found
At our last inspection, we found significant improvements were required around managing people’s risks and risks within the environment, medicines management, quality of record keeping and quality assurance processes. At this inspection, some improvements in medicines management an understanding people’s risks had improved. We found some improvements to the provider’s quality assurance systems.
However, we found the provider's systems and processes to monitor the quality of the whole service people received, continued to require improvements to embed those systems into everyday practice. We found some actions identified as improved, had not been improved consistently. We found the provider remained in breach of a regulation.
People received their medicines from trained staff. Medicines were stored safely and securely. People were assessed and protocols were in place for medication prescribed to be taken on an 'as required basis.’ Time critical medicines were administered in line with their prescribed instructions. However, some medicines such as topical creams and pain patch medicines required better recording to ensure staff administered these medicines safely.
Infection, prevention and control practices had improved. People’s bedrooms, communal hallways and lounge areas were clean and uncluttered.
The provider had sufficiently trained and suitable staff on shift to meet people’s needs. The registered manager was not required to cover kitchen duties as this had been recruited to. Vacancies were still advertised however regular staff picked up shifts were required. Agency staff were utilised but this had reduced since our last visit. Staff told us they worked well as a team.
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 supported this practice.
Relatives were pleased with the support and care their family member received. Relatives were complementary of the staff, how their met their family members needs and wishes and they were also complementary of the management of the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 19 May 2023).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made but these had not become embedded into everyday practice. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. The providers action plan told us what they would do and by when to improve. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadow View on our website at www.cqc.org.uk.
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.
Enforcement
We have identified a repeated breach in relation to regulation 17 (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.