Meadows House Residential and Nursing Home

Updated 19 September 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

On the first day the inspection team consisted of an inspector, a specialist advisor 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. On the second day a single inspector returned to complete the inspection.

Service and service type

Meadows House Residential and Nursing Home is a care home that provides accommodation, nursing and personal care for older adults. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this 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.

Notice of inspection: This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service. This included details about incidents the provider must tell us about, such as any safeguarding alerts they had raised. The provider also completed a provider information return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority who commissions the service to ask for their views. We used this information to plan our inspection.

During the inspection

We spoke with three people, seven relatives, a volunteer and two professionals who were visiting the home. Most people were not able to express their views about the care provided; so, we used our Short Observational framework tool (SOFI) in different units at eh home. We observed aspects of people’s care in the communal areas to help us better understand their experiences of the care they received. We tracked the care they received to ensure their needs were reflected in the assessed plans for their care. We spoke with a housekeeper, four nurses, four care workers, two senior care staff, an activity coordinator, the chef and the maintenance person and maintenance manager. We also spoke with the acting deputy manager, the registered manager and regional manager for the service.

We reviewed a range of records. This included seven care plans and two staff recruitment and training records. We also reviewed records used to manage the service, for example, monitoring records, audits and meeting minutes.

After the inspection

We continued to seek clarification from the provider to validate some of the evidence we found and spoke with the operations manager about their dementia strategy.

Updated 19 September 2019

About the service

Meadows House Residential and Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Meadows Residential and Nursing Home provides care and accommodation for up to 59 people across four separate units; three residential units and one nursing unit each of which have separate adapted facilities. One of the residential units specialises in providing care to people living with dementia with behaviour that may require a response. At the time of the inspection there were 56 people using the service.

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

There were a range of activities provided. However, we found for some people living with advanced dementia some improvement was needed to ensure there was appropriate stimulation available. Staff received training and support to meet people’s needs but we observed staff were not always able to respond in the most creative way to people's advanced dementia needs. The provider was reviewing their dementia strategy at the time of the inspection and had recognised staff needed more support to respond in the most appropriate way throughout people’s dementia journey.

We will follow up on the progress with these issues during our monitoring and at the next inspection.

We have also made a recommendation for the provider to review how feedback from people is gathered on the experiences of their care.

People told us they felt safe. Staff understood their roles in safeguarding people from harm. Risks to people had been assessed and staff knew how to manage these risks safely. There was a process to identify learning from accidents, incidents and safeguarding concerns. Appropriate recruitment checks took place before staff started working at the home. Medicines were safely managed. Staff worked in ways to reduce the risk of infection. There were enough staff to meet people’s needs.

People’s needs were assessed before they started using the service. Staff asked for people’s consent before they provided 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’s nutritional needs were assessed and met.

Staff treated people with care and kindness. People were consulted about the support they received. Staff treated people with dignity, respected their privacy and encouraged their independence. People’s needs in respect of their protected characteristics were assessed and supported.

People had a personalised plan for their care. These were up to date and reflected their needs. People’s wishes relating to their end of life care needs had been discussed with them or their relatives, where appropriate.

Relatives knew how to complain and expressed confidence that any issues they raised would be addressed. The registered manager understood the responsibilities of their role. Staff spoke positively about the support they received from the registered manager and management team. The provider gathered feedback from staff and people about the service.There was an effective system to monitor the quality and safety of 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 inspection rating for this service was Good (report published January 2019)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.