Meadowside Residential Care Home

Safe arrangements were in place for professionals visiting the service. This included a confirmed negative lateral flow device test result, proof of vaccination against COVID-19, hand sanitisation and wearing personal protective equipment (PPE). We were able to observe a visiting professional going through this process.

The service was clean and fresh, staff carried out a regular cleaning schedule. Regular infection control audits took place and actions had been followed up when required. An additional cleaning schedule had been introduced to ensure robust measures to reduce infection risks, including additional tasks such as cleaning of any regular touchpoint surfaces.

The provider had robust systems to ensure safe admissions, including only allowing new admissions after a confirmed negative result of the Covid-19 test. The provider had also assessed the environment, with consideration given where to allocate people should they need to isolate.

Staff had received training on infection prevention and control guidance. This included updates on the use of PPE and how to put it on, take it off and dispose safely. Staff's competency around infection control and PPE was checked regularly to prevent staff complacency. There was a designated area for donning and doffing PPE. There was signage all around the service on donning and doffing PPE and handwashing.

The provider ensured there was a sufficient stock of personal protective equipment (PPE) and the vetted supplier ensured it complied with the quality standards.

The provider participated in the Covid-19 regular testing programme for both people and staff.

There was a comprehensive contingency plan of what to do in case of an outbreak. The management team completed risk assessments to assess and mitigate risks in relation to COVID-19.

Meadowside Residential Care Home accommodates a maximum of 13

people in one building. At the time of our inspection there were 12 people who lived in the home.

At the last inspection in May 2016 the service was rated as Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

People continued to receive care and support that was safe. Staff were knowledgeable in how to safeguard and protect people and understood their responsibilities to report concerns promptly. People were supported with medicines and received them safely and when they were required. Risks to people’s welfare and the environment were assessed and actions taken to minimise them without restricting people’s freedom. Appropriate recruitment checks were carried out before new staff commenced employment. Not all staff files contained the full information required by the regulation, however, the registered manager took immediate action to rectify this. There had been no negative impact on people using the service as a consequence of the missing information. Appropriate personal protective equipment was supplied and used to prevent the spread of infection. Accidents and incidents were monitored for trends so appropriate action could be taken to reduce the risk of recurrence.

People continued to receive effective support from staff who were trained and had the necessary skills to fulfil their role. Staff were well supported by the registered manager and the two deputy managers. They had regular supervision meetings and an appraisal of their work annually. People were supported with maintaining a balanced diet and staff encouraged them to maintain good hydration. A number of changes to the environment had created additional areas for people to enjoy and relax in. People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

The service remained caring. People, their relatives and visitors told us staff were kind, caring and patient. People’s privacy and dignity were protected and people told us staff treated them with respect. People and when appropriate relatives were fully involved in reviewing and making decisions about their care. Staff encouraged people to maintain as much independence as possible.

The service remained responsive to people’s individual physical, mental, social and cultural needs. Staff knew people very well and paid attention to finding out about their personal preferences. This enabled care and support to be focused to achieve people’s desired outcomes. Individual care plans were person-centred; they considered the diverse needs of each person, taking into account any protected characteristics. People and their relatives knew how to raise concerns or make a complaint; they felt confident they would be listened to if concerns were raised. Regular activities were available for people to take part in if they wished and time was invested in developing projects to further enhance the activity programme. People had the opportunity to make plans regarding care they wished to receive at the end of their life. We have made a recommendation regarding the accessible information standard.

The service was well-led, with strong leadership from the registered manager and the two deputy managers. Records were relevant, complete and reviewed regularly to reflect current information. The registered manager promoted an empowering, person centred culture which was open and transparent. The values of the service were embedded in the way the service was led. Feedback was sought and used to monitor the quality of the service. Audits were conducted and used to make improvements. The service worked in partnership with other agencies and promoted links with the local community.

Further information is in the detailed findings below.

At our most recent inspection on 4 June 2014 we found the service was meeting the requirements of the regulations in place at the time.

Meadowside is registered to provide care for up to twelve older people. Eleven people were being cared for at the time of our visit.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

We received consistently positive feedback on the quality of the service from people who lived in Meadowside and their relatives. “Everything is fine” and “The care is wonderful” were two typical comments made to us.

There were safeguarding procedures in place and staff received training on safeguarding vulnerable people. This meant staff had the skills and knowledge to recognise and respond to safeguarding concerns.

Risks to people were identified and managed well at the service so that people could be as independent as possible. A range of detailed risk assessments were in place to reduce the likelihood of injury or harm to people during the provision of their care.

We found set staffing levels were adequate to meet people’s needs effectively. The staff team worked well together and were committed to ensure people were kept safe and their needs were met appropriately. The senior management team gave additional support when required.

Staff had been subject to a robust recruitment process. This made sure people were supported by staff that were suitable to work with them.

Staff received appropriate support through induction and supervision. All the staff we spoke with said they felt able to speak with the senior management team or senior staff at any time they needed to. There were also team meetings held to discuss issues and to support staff.

We looked at summary records of training for all staff. We found there was an on-going training programme to ensure staff gained and maintained the skills they required to ensure safe ways of working.

Care plans were in place to document people's needs and their preferences for how they wished to be supported. These were subject to review to take account of changes in people's needs over time. We found the new format for care plans which had been introduced was very concise, clear and sufficiently comprehensive to ensure people were protected by accurate and up to date records of their care.

Medicines were administered in line with safe practice. Staff who assisted people with their medicines received appropriate training to enable them to do so safely. Where the storage temperature of medicines was measured and found to be higher than recommended, appropriate action was taken to address this.

The service was managed effectively. The registered manager and provider, together with the service’s management team regularly checked quality of care at the service through audits and by giving people the opportunity to comment on the service they received and observed.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard people they supported.

The manager had in place risk assessments for how care was provided and the environment people lived in.

Where the potential for unsafe care was detected, the manager took the appropriate steps to protect people from the risk of harm.

No Deprivation of Liberty Safeguards (DoLS) applications had been made to the local authority, however people's mental capacity was monitored and where changes occurred the provider acted in the person's best interest.

Is the service effective?

Consent was obtained from people before care was delivered.

People's changing needs were noted and care and support was reviewed in line with people's requirements.

Where people had dietary needs these had been recognised and appropriate action had been taken to ensure their health and wellbeing was maintained.

Where people had raised concerns the manager had responded promptly and appropriately to address those concerns.

Is the service caring?

People told us the service was caring. Staff were described as 'excellent.'

We observed how staff interacted with people in a positive and caring way.

We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'The staff are wonderful.' And 'Whatever you need the staff will help you with it.'

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly.

People told us they knew how to make a complaint if they were unhappy. One person said that they had made a complaint and were satisfied with the outcome. We looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely. People can therefore be assured that complaints are investigated and action is taken as necessary.

Is the service well-led?

The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities.

People told us they had access to the manager and felt comfortable speaking to them about the service they received.

During this follow up inspection we spoke with the manager, four people who lived in the home and read documentation relevant to the inspection.

We found that the provider had made improvements to the premises, had reconsidered their staffing levels and was actively recruiting to ensure sufficient staff were available throughout the day and night.

We read documentation that showed how people had been consulted. One person who had been consulted about their care told us 'things are now ok'..I am much happier and getting more sleep.' Another person told us 'I am very happy here, otherwise I wouldn't be here.'

We spoke with relatives of people who used the service. Everyone told us they were happy with the care provided. A couple of people told us they were concerned about the changes that had taken place since the new provider had taken over in 2012. The provider told us that they had reviewed the way they had managed the service, and had made the necessary changes.

We observed staff treating people with respect and dignity. We spoke with three people who lived at Meadowside about the care they received. One person told us it was 'very comfortable and friendly' another person said 'they really look after you here.' We read care plans and these reflected the needs and wishes of the people who use the service. We saw that people and their families had access to the care plans and were involved in how the care was provided.

We had some concerns about the layout of the lounge furniture and the laundry equipment, as they presented a risk to people. We spoke with the manager about these concerns. We were told by the manager that the concerns would be addressed.