Meadowfold Hyndburn Ribble Valley Short Break

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. This is the first assessment for this service. This key question has been rated outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. Feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them. People’s support plans were thorough and person-centred. They included information about what a ‘good day’ or a ‘bad day’ may look like for them. This enabled staff to have a good understanding of people’s needs and how these may present at different times. Relatives were contacted during annual reviews and prior to stays, to discuss changes to people’s care needs; and partners were involved where required. People’s communication needs were assessed to enable them to engage in their care and have the best possible outcomes. We observed staff communicating with people both verbally and non-verbally. A recent team meeting included a speech and language therapist. They spoke to staff about intensive interactions; and how these could be used to better relate to people and develop communication skills, to maximise the effectiveness of care. The service was specifically designed to provide unpaid carers with respite or support during an emergency, so people could remain in their family homes for longer. Staff spoke about additional help provided to unpaid carers to support their health and wellbeing. For example, accommodating longer stays during ill health, supporting relatives to resolve issues with people’s medicines, and helping with practical arrangements such as transport. The registered manager said, “[Person’s] mum is struggling at the moment, so we extend [person’s] stays where we can to help.”

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards. The registered manager was a PBS trainer so received updates to changes in legislation, which were cascaded to the team. They also explained about their involvement within registered manager networks and regular peer meetings, designed to share good practice and improve standards within short break services. New monitoring tools had been introduced as a result. People’s allergies and dietary needs were detailed in their support plans and staff confirmed food and fluid intake was monitored if required. Staff had access to the appropriate equipment, and we observed them prepare a person’s meal which had been softened to the required level to prevent choking incidents. Other people were supported with percutaneous endoscopic gastronomy (PEG) feeding, which staff received training for. A system had recently been introduced to colour code and store people’s PEG equipment, so it was easier for staff to identify who it belonged to and prevent issues. PEG feeding is a method of feeding someone directly into their stomach. Partners gave positive feedback about how staff had engaged with them, ensuring they stayed up-to-date with good practice and improved the way the service delivered care to people. A partner told us, “The service is responsive to professional’s input. They have shown eagerness to attend training to support an individual’s needs”.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once. Staff told us information was shared amongst the team effectively and we observed systems in place to support this. For example, a central notice board, daily diaries and a staff communication book. People had communication books which moved between the service, people’s homes and other services; sharing important information and concerns for monitoring. A relative said, “There is good information sharing, I can call any time.” The registered manager spoke about the service co-ordinating and collaborating with others involved in people’s care, and partners emphasised this in feedback. A partner told us, “I shared information by email. When I visited the unit, staff were up to date with information, and this was reflected in their interactions with myself as the allocated worker and in how they supported the person. It was an evolving situation with regular updates, so the information sharing was effective.” Another added, “Day service managers and the team at Meadowfold have developed a positive working relationship over the years. This has helped facilitate effective communication, to enable consistency of support for people using both services.”

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Changes in people’s presentation, emotional state or distress which may indicate deterioration to their health or wellbeing were recognised by staff; and concerns shared with relatives, partners or other services. A staff member said, “There are regular reviews of people’s health. We see people quite regularly so will monitor them and have known some people for quite a long time, so notice small changes too.” Partners confirmed the service took appropriate action to manage people’s health needs. The service advocated for people struggling to access healthcare reviews, and supported people to attend healthcare appointments during longer stays or emergency placements. One person could not use standard transport to attend appointments, so staff provided support using their adapted minibus; to ensure their disability did not prevent them from accessing treatment. A nutrition and hydration champion had designed games to promote hydration during hot weather and this had been well received. They explained how staff actively promoted healthier living, “We sometimes use recipes with hidden vegetables. There’s a lot of walking to encourage physical exercise, and we have tried wheelchair exercise.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. Support plans included information about how people could be supported to develop or maintain different skills; and identified steps which could be taken to reduce restrictive practices in place. A relative told us, “We are currently going through a process to help [person] with their communication. The learning disability team have been going into Meadowfold.” Partners gave several examples of how the service had supported people to improve their outcomes. One partner told us, “An autistic person with complex support needs had a difficult time settling in, they did not want a bath or a shower (including long stays). Meadowfold managers led a multi-disciplinary team meeting (MDT) with day services, their personal assistants and family to review support and identify effective routines. There are now systems in place where day services ring Meadowfold when they are leaving, so staff can run a bath and [person] can access this immediately on arrival. This has been very successful with [person] accepting support and appearing more relaxed.” The registered manager spoke about a person using the service who had extreme anxieties around food. The service had suggested the person become more involved with planning their own menu, with them sending in a copy of their chosen meals by email or text before stays. We saw evidence this information had been shared with staff to ensure shopping lists and menus were updated. This had resulted in a positive impact on the person’s mood and behaviours.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Capacity assessments and best interest decisions were documented in support plans for those without capacity, and consent to care and treatment forms had been completed with input from relatives. People’s views and wishes were considered when their care was planned. A relative said, “Staff always ask. They always ask if they can take [person] out or buy them anything.” Whilst staff had a good understanding of The Mental Capacity Act 2005 (MCA), some had not had this refreshed within 12 months as per the provider’s own policies. The registered manager put an action plan in place following inspection, to ensure staff training levels were regularly reviewed.