Meadway Court

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in continued breach of legal regulation in relation to the systems of governance to ensure people received safe, good quality care.

This service scored 57 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

There had been recent changes in the management team which had created a period of uncertainty for the staff team. Staff did speak positively about the management team with one staff member commenting, “The Manager is always good at seeing emails and keeping people in the loop and it is a nice company to work.” However, one staff member commented, “With a new manager, things change, expectations change in how they want things done.”

The provider had inclusive leaders who understood the context in which they delivered care, treatment and support.

People and relatives generally told us they felt managers were available and they could raise concerns. There had been a recent change of management at the home. One relative commented, “I am aware of the management changes and have met the new manager. The management team are approachable and easy to talk to. I have no complaints.” One staff member told us, “The deputy manager is very approachable and always has time to answer any questions and give me guidance.” Another staff member told us, “The manager is new but I

feel they are giving a good vibe and are approachable.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People, families and staff all told us they felt able to raise concerns and felt confident that action would be taken by the management team. One staff member told us “I generally feel able to raise concerns and feel listened to.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had a number of initiatives to improve staff wellbeing including wellbeing newsletters, mental health first aiders and ‘brew Monday’. Staff told us the provider would consider flexible working arrangements and that the provider was a good organisation to work for.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. Systems had not always been effective in acting on the best information about risk, performance and outcomes, or sharing this securely with others when appropriate.

Systems were in place for oversight and governance but were not always completed effectively to ensure safe practice. For example, the provider had not ensured sufficient oversight of controlled drugs within the home or that actions taken following the last inspection had been embedded and were effective. We found the service may not have notified us of events as required and we asked for further clarification on these matters.

The provider did not always effectively collaborate and work in partnership, so services worked seamlessly for people.

We received mixed feedback from other professionals about the effectiveness of partnership working. We noted that staff did make referrals to appropriate services when concerns were identified, for example, in relation to people’s skin, and appropriate medical attention would be sought following any incident. However, it was not clear that staff always sought clarity of advice where this was needed, for example, in relation to variable dose of medicines or when to provide an ‘as required’ medication such as to relieve the symptoms of constipation. Records did not always show that referrals were made to other services following incidents, such as in relation to mobility or eating and drinking.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider had various systems for learning and improvement but did not always have the oversight to ensure these systems were used effectively. For example, whilst there were various checks of staff compliance including medicines, these had not been effective in ensuring staff worked in line with policies through checks of storage of the controlled drugs, regular stock checks or reviewing care plans following an incident. Following the last inspection the service had completed an action plan around how concerns, such as fluid intake and oral care, would be addressed, which included daily checks of these records by the staff team. However, when we returned at this assessment, these checks were not being undertaken and we found ongoing concerns around personal care and oral care, and how people were supported to drink enough.