Meadway Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People generally had assessments of their individual needs and their risk assessments were regularly reviewed. One relative told us, “On admission we went through [family members] needs and what equipment was needed which was a profiling bed which is lowered and a sensor mat.”

We found examples where assessments were not completed in line with the person’s current needs and it was not clear that this had, or would have been, identified by the providers own systems for oversight.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

At the last inspection we found concerns in relation to how much fluid people were supported to drink. Following that inspection, the provider told us they would implement additional checks of people’s fluid intake. However, this was not in place at this assessment and we found people did not have access to drinks in their room on the first day we visited, and where people were on a fluid target this target was not always being met. People’s access to drinks had been improved on our second visit to the home.

The kitchen staff had a good understanding of people’s needs and how to support people who were at risk of weight loss or required a modified diet due to their swallowing difficulties. Information about modified diets and thickened fluids was generally well recorded but information about additional snacks and supper time food intake were not consistently being maintained.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The staff team told us they generally worked well together. One staff member commented, “Every day is different, it can be challenging but staff pull together and it is teamwork.” Another staff member commented, “Sometimes you can be met with a ‘that’s not my job’ but it has been noted by the management team and they have started to reinforce the importance of working as a team.” People told us generally the staff were good and they had no concerns in this area. We observed staff generally worked well together but were not always proactive at engaging with people and promoting independence and choice.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People felt confident they would get the support they needed to live healthier lives. Most people told us staff would respond to any requests for medical help with one person commenting, “If I was unwell, I would speak to staff and they would call the GP.” However, it was not always clear in care records how people were supported to remain physically active and if one to one exercise routines were completed.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Although the provider had systems for oversight, it was not evident that these were used effectively to review people’s care, including risks associated with constipation and fluid levels and to ensure appropriate action and learning was taken in response to incidents and falls.

The provider did not always demonstrate how they were telling people about their rights around consent and did not always respect their rights when delivering care and treatment.

We were unable to establish how the provider had ensured appropriate consent to care was given as the electronic care plans did not reflect consent had been given by the person or their legal representative, and signed consent documentation was not found within the electronic care records.

Capacity assessments were in place and overall contained detail about how an appropriate assessment of capacity had been completed. Information about people’s capacity was not always clearly recorded, including where people had nominated an individual to make decisions for them under a lasting power of attorney, if they lacked capacity.