Meadow View Care Home

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• 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

During the assessment we looked at how people’s needs were assessed and consent to care and treatment. We found people were supported positively and staff provided a good standard of care. Staff understood people’s needs, preferences and choices and we observed people being supported in the way they preferred. People were supported to make as many choices as possible and staff respected their decisions.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives confirmed how they were involved in the assessment, development and review of their care and treatment needs. A person said, “I am involved in decisions about my care.” A relative said, “I have been involved in assessments at the beginning and will be involved in future ones I am told. I get telephoned or emailed with any changes and the staff regular discuss [my relatives] care with me.”

Staff were positive about the guidance and support provided in how to meet people’s individual needs. Staff advised guidance was sufficiently detailed and regularly reviewed to ensure it reflected people’s current needs. Staff demonstrated a good understanding of people’s care needs, including the importance of people’s communication, emotional and well-being needs. Staff were aware of the importance of consistency and continuity in care. The manager advised how care plans were reviewed and amended to reflect any changes. In addition, changes to people’s needs were discussed during the daily staff handover and daily flash meetings.

The manager had a pre-assessment process. This included a face to face pre- assessment meeting with the person and family or loved ones before people transferred to the service. Pre-assessments records reviewed were found to be well completed, detailed and included all aspects of physical, emotional and well-being care and support needs. This included routines and preferences and personal history to support staff. New admissions were discussed with staff during the daily flash meetings and daily handover meetings. Care plans and risk assessments were developed with the involvement of the person and or their relatives. There was a process of care plans and risk assessments being reviewed monthly and amended if required or sooner if changes occurred. Changes were clearly recorded to support staff awareness and understanding. Care plans overall were found to reflect people’s individual needs, routines and preferences. This included people’s communication needs. Information could be provided in easy read, large print, audio or braille if required. The manager had an open door policy and met with relatives at any time they requested to discuss their loved ones care and treatment. The staff used recognised assessment tools to assess and monitor people’s care needs, such as Malnutrition Universal Screening Tool (MUST), moving and assisting and oral health.

People and their relatives confirmed the care and treatment they received was based in their individual needs. People spoke positively about the quality and choices of the menu. A person said, “You cannot be on a diet here as the food is too delicious.” A relative said, “The care [my relative] gets is exemplary. All the staff know [them] from the cleaners to the kitchen staff. Everybody’s so helpful. It’s an amazing care home. All the assessments are in place. Staff kept to their word and a meeting has just happened to discuss [their] needs, now [we are] awaiting the outcome.”

Staff told us how changes to policies, procedures and guidance were communicated with them. This included completing refresher training to ensure their practice was based on current best practice guidance and legislation. Staff told us how they monitored people’s food and fluid to ensure risks associated with malnutrition and hydration were manged and mitigated. The manager confirmed policies and procedures were up to date. The manager confirmed the monitoring arrangement of people’s food, fluid and weights, and the actions taken if concerns were identified.

The provider had up to date policies, based upon current legislation and guidance. Recognised assessment tools were used to assess and monitor people’s needs. Policies and procedures were discussed in staff meetings and supervisions. The provider and manager kept up to date with best practice via external and internal meetings and forums, this information was shared with staff. Processes were in place to assess and monitor nutrition and hydration needs for individuals. People's dietary needs and preferences were shared with kitchen staff in addition to detailed associated care plans and risk assessments for care staff to follow. People’s food and fluid input was recorded where required and monitored. Clinical needs were regularly reviewed and discussed during clinical needs meeting and via a weekly GP practice visit held at the service.

People and their relatives were positive about how staff worked with healthcare professionals to ensure their health conditions and care and treatment needs were consistently met. A relative said, “The staff had the opticians come into the care home and [my relative] has some new glasses. [My relative] has also been seen by the GP and was referred to Mental health team by the staff at [Meadow View Care Home].”

Staff confirmed the processes and procedures in place to share information with others such as the ambulance service and hospital staff to ensure people received consistent care. A staff member said, “We regular share information as appropriate to do so with other agencies, such as ambulance or nurse from GP surgery. We give an explanation of the care people are receiving, and we make sure we have recorded everything as required to do.” The manager advised of the procedure of people transferring to other care facilities and what documentation was shared to ensure people’s needs were known and understood.

Feedback from external healthcare professionals working with the service and commissioners, was positive regarding how well staff from the service worked with them. A professional said, “I am always welcomed by all the staff [at Meadow View Care Home]. And the manager is always happy to ask questions, really on the ball and the communication is really good. It is a really nice environment.”

Staff worked collaboratively with external health and social care professionals such as social workers, GP's, physiotherapists, occupational therapists, speech and language team, and community nursing team. All admissions were reviewed by the local GP. Any treatment plan that has been prescribed by a visiting health professional was incorporated into the individual person's care plan. Copies were also scanned into the provider's electronic care records platform so all care staff are able access any additional information that has been supplied by external agencies or professionals.

People and their relatives told us how well staff supported them with their health and well-being needs. One relative told us, “As a result of [our relatives] test with the Speech and Language Therapy Team (SALT) whilst being at the home, kitchen staff make sure [they] have soft food and staff never leave [them] alone during mealtimes because [they] have a choking risk.” Another relative said, “[The staff at Meadow View Care Home] have put colour back in [my relative’s] face. I’d recommend it, I really do. I’d move in myself!”

Staff confirmed they had guidance about people’s health conditions and guidance of how to meet these and had received training to enhance their understanding. Staff confirmed how people were supported to attend health appointments and access health services and screening. The manager and deputy manager confirmed how people’s health and well-being was monitored and how any changes or concerns were shared during staff hand overs and during the daily meetings. The manager also told us how they had oversight to ensure health needs were followed up as required with health professionals.

The provider had systems and processes that assessed and monitored people’s health care and treatment needs. Records demonstrated partnership working with health care professionals and any recommendations being implemented. The provider was able to demonstrate how people were supported to attend health appointments and health screening. People were also encouraged to take part in activities to help their physical wellbeing.

People and their relatives confirmed they were well supported with their health, care and well-being needs. A relative said, “Since being in Meadow View, we’ve noticed [our relatives] speech coming along and [they are] more confident. [The staff] take time to talk to [our relative], and the staff go into [their] room and chat about [their] photos.”

Staff confirmed the process of how people’s health care needs were monitored and gave examples of action taken when concerns were identified. The manager said, “ We hold daily meetings with key staff where we discuss any clinical of the risks and we also have a weekly visit by the GP practice. Any clinical needs or concerns are quickly identified and followed up.”

The provider had systems and processes that continually assessed and monitored people’s individual health and well-being needs. This included monthly care plan and risk assessment reviews. These reviews would be completed sooner if changes occurred. A weekly GP practice visit supported people and staff in reviewing healthcare needs quickly. The management team had robust communication systems to enable staff to effectively exchange information quickly and easily. This ensured people’s needs and outcomes were acted upon and monitored. The staff used evidence based clinical guidance to support people to achieve positive outcomes. The use of assistive technology supported people identified at being at risk of falls.

People and their relatives told us consent was sought before care was provided. One person said, “Staff are so lovely and help me so much, always asking if things are ok with their help.” A relative said, “[The staff at Meadow View Care Home] are all nice and have patience with [my relative].” Another relative said, “[The staff] seem to understand what makes [our relative] happy.”

Staff showed a basic understanding of the mental capacity act (MCA) principles. They understood the importance of seeking consent before care and treatment was provided. The manager told us how they complete daily walkarounds and this included observations of staff engagement with people to ensure care was person centred, respectful and consent was sought before care was delivered.

Where people had capacity to consent to their care and treatment and the service they received, the person had confirmed their agreement by signing specific care plans and other relevant documentation. Where people lacked capacity to consent to their care and treatment, capacity assessments and best interest decisions had been completed. Records of MCA assessments and best interest decisions that we reviewed contained information for staff to follow.