Meadow View Care Home

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.

Meadow View Care Home is a residential care home providing personal and nursing care for up to 53 people. The service provides support to older people. At the time of our inspection there were 27 people using the service.

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

People felt safe within the service, and staff followed and understood safeguarding procedures.

Risks were assessed to ensure people were kept safe, and staff understood individual risks present within people’s lives.

There were enough staff within the service to safely support people. Staff were recruited safely.

Medicines administration and management was safe.

Training and support was in place to ensure that staff knowledge was up to date, and competent to provide care.

People’s health needs were met, which included being encouraged to eat and drink and maintain a balanced diet.

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 were caring in their approach towards people, and knew their individual needs and preferences.

Care plans were personalised, and documented people’s likes and dislikes. Activity staff provided a range of activities for people to join in with.

A complaints systems was in place and people knew how to use it.

Audits and checks were in place to ensure any mistakes or errors were found and acted upon promptly.

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 requires improvement (published on 21 July 2022).

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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

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.

This comprehensive inspection was prompted in part due to concerns received about staffing levels and management within the service. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

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

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Meadow View Care Home is a residential care home, providing personal or nursing care to up to 53 people, some of whom are living with dementia care needs. At the time of inspection, 30 people were living at the service.

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

Medicines were not always managed effectively. People told us they had at times ran out of required medicines.

Staffing levels had not always been sufficient. Staffing skill mix had not always been sufficiently distributed throughout the service.

Records had not always been completed accurately to evidence whether essential care tasks had been carried out.

People and staff did not feel the service had been well managed and were lacking in confidence at times.

Audits and checks were not robust and had not always picked up errors, or actioned improvements.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

The service was clean, tidy, and staff followed infection control procedures.

Staff treated people with kindness, dignity and respect. We observed positive interactions between people and staff, and feedback from people about staff relationships were good.

A new management team had been brought in to raise standards within the service. Staff felt well supported by the new manager, and were motivated that suggested changes would result in improvements within the service

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 Requires Improvement (published 1 October 2020)

Why we inspected

We received concerns in relation to staffing numbers within the service and oversight. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety, quality and governance 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.