Croft Meadow

Updated 29 September 2022

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 two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Croft Meadow is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Croft Meadow is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 14 July 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service since the last inspection. 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 reviewed the environment of the home and met with the people who lived there. We observed people’s care to help us understand the experience of people who could not talk with us. We spoke with 12 people who used the service and seven relatives and friends about their experience of the care provided. The Expert by Experience made calls to relatives remotely by phone. We spoke with 17 members of staff including the area manager, operations manager, registered manager, deputy manager, registered nurse, senior care staff, care staff, domestic staff, the activities co-ordinators and the chef. We reviewed a range of records. This included eight people's care records and six medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the leadership team to validate evidence found. We looked at the staff dependency tool, minutes from meetings and audit and quality assurance records. We spoke with the registered manager and deputy manager and looked at further evidence relating to the environment and activities within the home.

Updated 29 September 2022

About the service

Croft Meadow is a residential care home providing accommodation and nursing care to up to 60 people in one adapted building. The service provides support to people living with a variety of health needs, including frailty of old age and dementia. At the time of the inspection there were 58 people using the service.

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

Since the last inspection the registered manager, deputy manager and staff had made improvements which had raised the quality and standard of care people received. Systems to ensure effective oversight and governance of the home had been revised, embedded and sustained in daily practice. People experienced person-centred care from staff who knew them well, had been appropriately trained and were competent in their role.

People were protected from avoidable harm as risks to people's health and safety were identified, assessed and mitigated. People and their relatives told us they felt safe and were cared for by staff who understood their risks and how to manage them. One relative told us, “[Person] is very safe there.” A person commented, “Yes, I am safe.” Staff understood their safeguarding responsibilities and knew how to report and escalate concerns. Accidents, incidents and safeguarding concerns were appropriately investigated with actions taken to reduce the risk of reoccurrence.

People and their relatives told us staffing levels varied but felt there was enough staff to meet their needs. Staff were recruited safely and received supervision where opportunities to develop and feedback about their practice was discussed. People received their medicines in line with prescribers’ guidelines and medicines were regularly reviewed. People were protected from the spread of infection in a clean environment by staff who had completed training in infection control and had their competence assessed. Comments included, “They keep everywhere clean and tidy, I’ve no complaints”, and, “The staff wear their PPE, it is difficult for the residents when staff wear masks, but I know they have to.”

People received a comprehensive assessment and were involved in discussions about their care. 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. People had access to external healthcare services and support, including hairdressing, chiropody and specialist health teams.

People had access to a range of activities in an environment that was being upgraded to meet their needs. People were supported to eat and drink enough and maintain a balanced diet. People spoke positively about the food and could choose from a varied menu developed by a chef who collated and acted on people's feedback.

The culture of the home was positive and promoted good outcomes for people. People and their relatives were complementary about how the home was managed. Staff felt supported by the managers and the provider. A staff member said, “I have the best team of people around me. I love it. Shaw (provider) are a good company to work for and things have vastly improved since [registered manager and deputy manager] have been in place." A relative said, “We love the home. It was the first one I looked around and I liked it as soon as I walked in. I was shown around by the deputy manager and they were very friendly. I was impressed that the residents don’t have to share a room and they have their own en-suite.”

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 14 November 2019) and there were breaches of regulation. 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.

At our last inspection we recommended that the provider consider current guidance on providing stimulating, meaningful and appropriate environments for people who are living with dementia. At this inspection we found the provider had made some improvements to the environment and improvements were ongoing.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 03 October 2019 and 04 October 2019. Three breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person-centred care, safe care and treatment and the governance of the service.

This inspection was prompted by a review of the information we held about this service. We also needed to check the service had completed their action plan and they now met legal requirements.

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.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will work with 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.