Meadow View

Meadow View is a residential care home providing accommodation and personal care to 80 people. At the time of the inspection 72 people were using the service.

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:

The setting at Meadow View was based in a rural location, which enabled people to have access to the countryside. Staff also ensured people had links to shops and other community services People were protected from the risk of harm because robust safeguarding processes were in place. Risks to people’s safety were considered and the registered manager made sure there was a culture of person-centred care and support. 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.

Right care:

Care was person-centred and promoted people's dignity, privacy and human rights. Education and learning were promoted. People were supported to lead active lifestyles of their choosing. People’s wellbeing was promoted, and their communication needs were assessed. People were supported to use various communication tools to assist in their engagement with others. People received good quality care, support and treatment because trained staff could meet their needs and wishes. People were supported to maintain good health, were supported with their medicines and had accessed healthcare services when needed.

We have made a recommendation about the management of some medicines.

Right culture:

There was a positive culture of person-centred care for people. The ethos, values, attitudes and behaviours of leaders and support staff made sure people were leading confident, inclusive and empowered lives. People and their families and advocates were informed, engaged and involved in developing and improving the service. Families told us the registered manager was approachable and good at listening. They were very happy with communication and engagement from the service. Families felt that the staff promoted a safe, consistent and predictable atmosphere which met people's individual needs

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 26 February 2019.).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding people, staffing and medicines. 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 these concerns. Please see the safe, effective and well-led sections of this full report.

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.

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 remains good. 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.

Follow up

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

We found the following examples of good practice.

The service had a suitable system in place to support people to maintain important relationships with their relatives and friends. This included promoting visits within the service and in the local community. Visitors were required to follow various safety measures such as completing a COVID-19 test prior to entering the service.

Staff had received training about how to keep people safe from the risk of infection and how to use personal protective equipment (PPE) correctly. The provider ensured there was enough PPE available for staff at all times and we observed staff wearing appropriate PPE.

Tests for COVID-19 were being carried out in line with government guidance, by both staff and people living in the service, when this was appropriate.

This inspection took place on 23 January 2019 and was unannounced. At our last inspection in June 2016 we rated the service overall as good. At this inspection we found the evidence continued to support the overall rating of good. There was no evidence or information from our inspection and ongoing monitoring which demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

The service was developed and designed before the guidance, Registering the Right Support came into being. However, the service worked to make sure it was run in line with the values that underpin this and other best practice guidance. These values include choice, promotion of independence and inclusion.

There were enough staff to meet people’s needs. Staff retention had improved and with this, the need to use agency staff had decreased. There were effective systems in place that helped make sure people’s medicines were managed safely.

People were protected from abuse and avoidable harm. Staff had received training and were confident to raise any concerns they had.

Staff had received training and understood their responsibility regarding the Mental Capacity Act 2005 (MCA). People's capacity to make decisions had been assessed when planning care. Staff confirmed they asked for people's consent before providing care and they respected and promoted each person's choices.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

Care planning was person centred, with detailed records of people’s preferences. People were supported to access the local community. Complaints were responded to appropriately.

Quality and safety management systems were effective. There was evidence of continuous improvement. Systems were in place to gather feedback from people and their relatives. The service worked in partnership with other agencies and followed up-to-date legislation.

As a result the service was rated Requires Improvement. You can read the report from our last inspections, by selecting the 'all reports' link for ‘The Hesley.Village’ on our website at www.cqc.org.uk’

The Hesley Village is registered to provide accommodation for up to 80 people. The village is on the outskirts of Tickhill, near Doncaster. There are several houses and flats, set in extensive grounds, with shops, a cinema and a café. The village is for people with a learning disability and autistic spectrum disorder. Most people who live there have behaviour that can be challenging. At the time of our inspection there were 71 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection we found that improvements had been made since our last inspection in November 2015. A number of new staff had been recruited and had started work. Others were awaiting recruitment checks, or undertaking induction training. There were adequate staff on duty at the time of our inspection. However, there was a need for continued improvement in recruiting and deploying staff to the core teams supporting people, and new staff needed time to settle in, in order to be able to respond well to people’s needs.

The need to use agency staff had decreased, and the provider had taken steps to ensure that where they were used, this was in a more consistent way and they were better equipped to support people who used the service. Relatives we spoke with told us improvements were taking place in staffing and the use of agency staff, but there was still ‘a way to go’ with this. They said that, the service mostly provided good care and support and the staff were caring and kind and respected peoples choices and decisions

Medicines were managed safely and improvements had been made to ensure the management of medicines was of a consistent standard throughout the service.

People’s needs were identified, and improvements had been made in the way people’s plans and assessments were reviewed. This helped to protect people from risk and helped to make sure they received care and support that met their changing needs.

There was a robust recruitment system and all staff completed an induction to the service. The induction had been improved to help equip new staff for their role and to help with staff retention. Staff received formal supervision and annual appraisals of their work performance.

There were systems in place for monitoring the quality and safety of the service. These had been improved, so that they were more effective. Where they identified issues and areas of concern, these had been addressed and followed up to ensure continuous improvement.

The service had received a reduced number of complaints since our last inspection, and these had been dealt with following the company’s procedures, to ensure people were listened to and their complaints acted on.

We saw that staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this and people who used the service had been assessed to determine if an application was required.

Staff we spoke with told us that staff worked well as a team, and things were improving They felt supported by their line managers, and felt the higher management team were more in touch with the day to day challenges, and were providing clearer leadership.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

There was an effective complaints system available. One person told us they would speak to staff, managers and at the residents' council if they were not happy.

We saw that there were opportunities for people using the service to make choices and have a say in how their treatment or care was delivered. We found that care and treatment was personalised and equality and diversity taken into account. There was evidence that people took part in range of activities in the community.

Staff protected people from any negative effects of other people's actions or behaviour. People said they thought the Hesley Village was a safe place to live. One person said, 'I am happy.'

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Throughout our inspection we observed good interactions and found people who used the service were relaxed and happy in the care of the staff. One person who used the service said they liked the staff. The quality of the services was regularly assessed and monitored to ensure that it was safe and was meeting people's needs.