Archived: Meadowbank Care Home

Updated 8 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

Before our inspection we reviewed all the information we held about the service. We also examined notifications received by the CQC.

We visited the service on 19 and 20 January 2016 and the inspection was unannounced. The inspection team consisted of one Adult Social Care Inspector and one Specialist Advisor. A Specialist Advisor is someone who has professional experience of this type of care service.

We spoke with five people who used the service. We spoke with nine members of staff: the acting manager, the deputy manager, the area manager, four care staff, the cook and the cleaner. After the inspection visit we spoke with three relatives of people who used the service and three external healthcare professionals. We also spoke with local authority professionals who commission with the service and the infection control team.

During the inspection visit we looked at five people’s care plans, risk assessments, staff training and recruitment files, a selection of the home’s policies and procedures, information held on the home’s computer systems, meeting minutes and maintenance records. We spent time observing people in the living rooms of the home.

Updated 8 April 2016

The inspection took place on 19 and 20 January 2016 and was unannounced. This meant the registered provider or staff did not know about our inspection visit.

This was the first inspection of Meadowbank Care Home since the provider changed to Aspire Healthcare Limited.

Meadowbank Care Home is located in the village of Dipton near Stanley and is registered to provide accommodation and personal care for up to 14 people with learning disabilities. At the time of inspection there were eleven people using the service.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special Measures’.

The service will be kept under review and, if we have not taken action to propose to cancel the provider’s registration, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

The service did not have a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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. The service had a deputy manager in place since October 2015 and an acting manager who had been in post since November 2015. The area manager confirmed CQC would be notified when a suitable manager had been appointed at this location.

We found the fabric and condition of the premises to be in a state of disrepair; including two bathrooms that could no longer be used. All of the eleven people who lived at the home only had shared use of one ground floor shower room, which was not fitted with a bath. We saw that people’s bedrooms were personalised, but all were in need of refurbishment and repair.

We found medicines practices were unsafe, particularly with regard to the administration of medicines.

We found a range of infection control hazards such as a corroded shower chair, damaged furniture in people’s bedrooms and inadequate hand washing facilities. We found the home to be in need of refurbishment throughout.

We found there to be adequate numbers of staff to meet the needs of people who used the service when we inspected, with the deputy manager and manager also assisting with personal care.

People who used the service and their relatives told us they felt safe and that they had never had concerns about risks presented to people. We found Personalised Emergency Evacuation Plans (PEEPs) were in place, although these were not stored at hand in the event of an emergency.

Staff we spoke with were clear about their safeguarding responsibilities. However staff knowledge of whistleblowing procedures was inconsistent.

The provider had in place a range of mandatory training that helped equip staff to care for people who used the service. However refresher training was not well planned, with training information on the provider’s training matrix not matching training certificates in staff files. Staff feedback regarding moving and handling training stated was that it was poor. We also found one instance of managers being unable to assure us or themselves about staff training credentials due to hard copies of training certificates not being in place.

People who used the service and relatives we spoke with were complimentary about staff knowledge of people who used the service. Keyworkers we spoke with displayed a good understanding of the personal histories of people they cared for.

People who lived at the home had little input in the planning of the homes menu and only limited choice of main meals. We found the dining experiences we observed to be functional and an opportunity missed by the provider to ensure people had a sociable time. People did not appear to enjoy their dining experience and these were not upheld as sociable occasions by staff either. The home did not effectively support people who needed assistance with diet controlled diabetes.

People we spoke with and their relatives were positive about the care provided by staff. However we saw staff concentrated on practical tasks at the home rather than person centred interactions.

The provider did not ensure activities were planned in line with their policy. Activities were not person-centred or co-ordinated. Some staff we spoke with had good awareness of people’s likes, dislikes and life histories but did not engage with them in activities which reflected these.

Views of people who used the service had not always been sought or interpreted in ways which would help the service to improve.

Where complaints had been received, we saw they had been responded to and prompt actions taken.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. DoLS are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The acting manager was knowledgeable on the subject of DoLS and had provided appropriate paperwork to the local authority to deprive people of their liberty, where it was in their best interests. Staff we spoke with were not always knowledgeable in the subject of the DoLS.

We found there were widespread and serious failings within the culture at Meadowbank Care Home, which encouraged task-led rather than person-centred care.

Procedures to review and check the performance of the home, and to identify risks, trends and areas for service improvement were not effective. Practices were not in line with policies and the expectations set out in the providers Service User Guide.

During our inspection we found a number of breaches of the Health and Social Care Act 2008 Regulated Activities Regulations 2014. We are taking enforcement action against the registered provider and will publish details when the process is complete.