Thurlaston Meadows Care Home Ltd

Updated 6 June 2023

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. The Expert by Experience spoke with people and their representatives, to gather feedback on their experiences of the care provided.

Service and service type

Thurlaston Meadows Care Home Ltd is a 'care home'. People in care homes receive accommodation and nursing or personal 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 reviewed the information we had received about the service since the last inspection and any recurrent themes of concern. We sought feedback from the local authority and commissioners 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection.

We looked at 8 people's care records or medicines records, 2 recruitment records and a variety of information relating to the management of the service. We gathered feedback from 17 staff including the nominated individual, the registered manager, the human resources manager, the provider, the deputy manager, housekeeping and care staff including senior care staff, the catering manager, the activities coordinator and two maintenance staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 8 people who used the service and 3 relatives, about their experience of the care provided. We observed care and support in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 6 June 2023

Thurlaston Meadows Care Home Ltd is a care home providing personal care and accommodation for up to 45 older adults living with dementia, physical disability or sensory impairment. The service is a two-story building with 16 en-suite bedrooms and 23 bedrooms sharing bathroom facilities, some of which are for double occupancy. There are three communal lounges and a dining room. At the time of our inspection visit there were 26 people receiving care.

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

At our previous inspection we found risks were not always identified, assessed or well-managed and medicines were not always managed safely. At this inspection we continued to find similar concerns. People's medicines were not always administered as prescribed and or stored safely. We were somewhat assured infection prevention controls were being followed. The provider did not always mitigate risks to people by maintaining a safe environment. Events which called into question people's safety were not always identified or managed appropriately to ensure people were made safe in a timely way.

Improvements were needed to the admissions process, to ensure people’s needs and risks were assessed and used to develop care plans in a timely way. Improvements were needed to evidence and monitor the care people received in relation to their skin, fluid and nutrition, to ensure these were completed consistently, in accordance with people’s identified needs.

The provider had failed to demonstrate effective oversight to sufficiently improve the quality and safety of the service. There was a continued failure to act on identified concerns in relation to fire safety, which was identified at the two previous inspections. Quality assurance processes and oversight failed to identify the gaps and errors we identified in relation to people’s care records, and records of care and treatment provided.

There were sufficient staff at the service, and staff training had been improved since our previous inspection. Staff recruitment processes included background checks to review their suitability to work with vulnerable adults.

Staff spoke positively about their induction and training and could tell us how they used it to support people. People were generally positive about the food provided and told us they received a choice. However, there was a risk people were not supported to drink the right amount of fluids to meet their needs. 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.

Staff were kind, caring and compassionate and treated people with respect and dignity.

People told us they felt safe at the service, and staff supported them in a way they preferred. People made everyday choices about how they spent their time. Staff supported people to engage in a range of activities they enjoyed. People felt able to raise concerns with staff.

Most people and their relatives were satisfied with the service provided and spoke positively about the management of Thurlaston Meadows. People and their relatives told us they were encouraged to share their experiences of the service by completing surveys and attending meetings, and that they were kept informed about events that happened at the home.

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 inadequate (published 21 September 2022) and there were breaches of regulations. 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 the provider remained in breach of regulations.

This service has been in Special Measures since 21 September 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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.

We have found evidence that the provider needs to make improvements. Please see all sections of this full report for details.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and good governance at this inspection.

Follow up

We wrote to the provider and requested some information to be sent to us urgently and asked what they were going to do to mitigate the risks identified and to keep people safe. The provider responded demonstrating some immediate actions taken.