Meadow Home Care Services Ltd

Updated 7 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.

Inspection team

Three inspectors completed on site visits, one inspector and two Experts by Experience made telephone calls to staff, people and their relatives. 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

This service is a domiciliary care agency. It provides personal care to people living in their own houses.

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

The inspection commenced in May with phone calls to people, relatives and staff, although due to unforeseeable circumstances a visit to the office was unable to take place until 03 August 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 information gathered as part of monitoring activities to help plan the inspection and form our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and 24 relatives about their experience of the care provided. We spoke with nine staff members including the registered manager, care coordinator, administration staff and carers. We reviewed a range of records including three people’s care records and a range of medication records and staff files. A variety of records relating to the management of the service including policies and procedures were reviewed.

Updated 7 September 2022

About the service

Meadow Home Care Services Limited is a domiciliary care agency registered to provide personal care to people living in their own home. The service provides support to people under and over 65 years of age and those living with a physical disability. At the time of our inspection there were 87 people using the service.

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

The provider had not ensured all records such as risk assessments were up to date and contained enough detail to reflect the level of support people required. The service had an established staff team who knew people well so this mitigated the risk however new staff joining the service would not have the information they needed to provide care.

The provider had failed to follow the lone worker policy and ensure staff working alone in the community had a risk assessment in place which would support them to know what to do in an emergency or if they felt unsafe.

The provider completed audits but follow up actions from these did not always take place and when they did, they were not recorded in detail. The use of paper records meant audits of medicines were not completed in ‘real time’ so it was difficult for managers to know when medicines had been refused or missed so appropriate action could be taken.

The provider had not followed the processes required when investigating staff disciplinary matters. This had led to safeguarding concerns not being reported to the appropriate authorities. The policy was unclear and did not support managers to fulfil their role in this area of their work.

Staff wore personal protective equipment during visits and people and their relatives said there had been no concerns with this.

Staff were experienced and had recently renewed all mandatory training. They found managers to be supportive and enjoyed working for Meadow Home Care. Managers and staff worked closely with other professionals to ensure care was appropriate and delivered in a timely way.

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.

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 21 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about recording of information. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led.

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. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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 and the actions the provider has already taken to mitigate the risks identified.

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

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 monitor the service and will take further action if needed.

We have identified breaches in relation to recording of information to keep people and staff safe and staff disciplinary policy and procedures 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.