Meadow Court

Updated 2 February 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.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 4 January 2023 and ended on 5 January 2023. We visited the service location on both days.

What we did before the inspection

We reviewed the information we had received from and about the service.

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 met with 8 people who used the service. Some people were unable to verbally express their views to us, but we were able to observe their interactions with staff. We spoke with the management team and 5 members of staff. We received written feedback from two visiting professionals.

We looked at a variety of records relating to people’s personal care and support and the running of the service. These included, 5 care and support plans, 2 staff recruitment files, a sample of medication administration records and a sample of personal financial records.

Updated 2 February 2023

About the service

Meadow Court is a domiciliary care agency. It provides care and support to people living in their own flats in a supported living complex on the outskirts of Taunton.

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 specialises in supporting people who have mental health and/or learning disabilities. At the time of the inspection the service was supporting 13 people with personal care. Care provided ranged from a few hours a day to 24-hour care and support.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People lived in individual flats which had been adapted to meet their specific needs. The supported living complex was situated on the outskirts of Taunton, within walking distance of a bus route.

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.

Staff enabled people to access specialist health and social care support in the community.

People were able to follow their own routines and were helped to make decisions about their day to day lives.

People were supported by staff to pursue their interests and take on new challenges to enhance their quality of life.

Right Care:

People were supported by staff who knew them well and understood their needs. However, care plans and risk assessments were not always comprehensive and up to date.

People received their medicines safely from trained staff. However, there were no individual protocols in place for medicines which were prescribed to be given ‘as required.’ This could place people at risk of receiving these medicines inconsistently which may not always promote their comfort and well-being.

People were kept safe from avoidable harm because staff knew how to recognise and report any indicators of abuse. Staff spoken with said they would be confident to report any concerns about possible abuse or poor practice

People felt safe with the staff who supported them. We observed good interactions between people using the service and staff.

People’s needs were assessed, and they received person-centred care to meet their needs. Staff worked with other professionals to make sure people received the care and support to meet their individual needs and wishes.

People’s legal rights were protected and, where needed, appropriate legal authorisations were in place.

Right Culture:

Improvements were needed to make sure there were effective systems to monitor the quality of the service and plan improvements. The lack of effective quality monitoring systems is a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The ethos of the service was to provide person-centred care and promote people’s independence and well-being. People were encouraged to try new activities to enhance their enjoyment and quality of life.

Some people using the service did not use verbal communication. Staff used their knowledge of people and skills to support people to make choices. Staff told us about how different people expressed themselves and their wishes. This all helped to make sure care and support was tailored to each person’s needs and preferences.

People and those important to them, including advocates, were involved in planning their care.

There was an open and inclusive ethos within the service. People and staff told us they would be comfortable to discuss any worries or concerns with the provider and the management team.

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 good (published 20 March 2018.)

Why we inspected

This inspection was prompted in part due to concerns raised with us about how people were supported to manage their personal finance and how people were offered choices about their meals. 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.

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

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 and well led sections of this full report. We have identified a breach of regulation in relation to quality monitoring and planning improvements.

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