Meadow View Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At the last inspection the provider was in breach of regulation 12, Safe care and treatment, in relation to people's health, environmental risks, management of medicines and care records. At this assessment the provider had made enough improvements and was no longer in breach of this regulation. We assessed all the quality statements in safe and there was evidence of good practice. People were enabled to take positive risks and were involved with managing their care and support. People told us they felt safe and were protected from the risk of harm and abuse. Staff demonstrated an understanding of how and who to report concerns to. People were supported by enough skilled and trained staff; some had worked at the service for a long time and knew them well. The management team and staff had made improvements at the service and had clear processes in place to enhance a positive learning culture. They and their staff worked to support people effectively when they required support from external health professionals.

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 told us staff were approachable and they felt comfortable raising concerns. One relative told us, “If I ever have any questions, they always get back to me.” Healthcare professionals told us people’s needs were assessed to ensure staff could meet their needs. One healthcare professional said, “It’s an absolutely joy now to come and see people at Meadow View Care Home. If the care home staff are worried about anything, they know we will work with them.” Another healthcare professional said, “[The new management team] appears to have done a great job in moving Meadow View forward over the last 12 months.”

Staff told us a lessons learned process was in place when things went wrong to reduce the likelihood of a recurrence. One staff member said, “We have email that the manager and deputy email from, to all the employees, also when we have a staff meeting once a month and they always mention incidents that have happened, especially safeguarding, that we’ve had, so we can all learn.”

Systems were in place to record, monitor and learn lessons from accidents and incidents. For example, a falls tracker was in place and action taken as required to keep people safe. The manager reported notifiable incidents to external agencies, such as the Care Quality Commission and the local authority.

People’s wishes and needs were assessed prior to moving into the service. People had health and social care input, the management team liaised with the relevant professionals before, during and after the admission process. One relative told us, “We met the manager at the hospital before [our relative] was discharged.”

The manager told us, “People’s needs are assessed before they move into the home so we can make sure we are able to meet their needs and also make sure we have all the right equipment we need before they move in. Any information we receive from the person, their relatives and or external partners, we use this to inform our practice and care. It’s an ongoing process and all the information is added to their care plans.”

A health professional provided positive feedback on how the service liaised with them supporting people’s changing health needs, and told us, “The management team have done a great job with the staff managing the expectations. We are confident now, agreed actions for people are carried out by staff. [The staff team] do their upmost. Works from the top down.”

We reviewed assessments that demonstrated people’s needs had been assessed before they moved into the home. Following admission, further assessments had been completed to gain a better understanding of the person including a life history. All this information formed the basis of person centred care plans.

People and their relatives told us they felt safe living at Meadow View Care Homes. One relative told us, “[The staff] keep [my relative] safe by always making sure [they have the walking aid they need]. [Staff] do seem to manage [my relatives] needs well.”

Staff knew how to recognise signs of abuse and where to report their concerns, both internally and externally. One staff member said, “I assess the risk, give support to the person, inform the seniors and nurses, as well as the manager. Keep the person calm, explain I need to inform the line manager, who can give help and support with the concern. When I report the abuse, I will use the persons own words. If there is any immediate risk of harm and I will contact the emergency services.”

We observed staff speaking kindly and respectfully with people. People appeared to be comfortable living at the home, and in the company of staff supporting them. The atmosphere was calm, and people were relaxed.

Safeguarding referrals for reportable incidents had been received by the local safeguarding team. The provider’s systems to safeguard people from the risk of harm or abuse were followed. The provider’s policy was clear for staff to understand should they have a safeguarding concern. Staff had received safeguarding training, and this was regularly updated to ensure staff understood and followed best practice guidance. People’s mental capacity had been assessed and best interest discussions had been documented in their care notes. Staff and management were improving their understanding of working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The manager tracked DoLS authorisations for people at Meadow View Care Home to ensure they were in date and remained relevant.

People and their relatives told us they were involved in discussions to manage risk. One relative told us, “Staff explained about the risks to [our relatives] skin as they are now spending more and more time in bed. [Staff] put [our relatives] bed sides up and they make sure they’re padded. There is also a sensor mat on the floor, [to keep our relative safe].” A healthcare professional told us, “For example, last week, staff contacted us with a concern over a person’s eye. They shared a photograph and staff brought the person to the GP surgery to be checked over. The person was also checked over at hospital as appropriate. It is all about communication and focus on the person’s needs.”

Staff knew how to identify and reduce the risk of harm to people living at Meadow View Care Home. Staff told us they reviewed people’s needs monthly during care plan reviews or as soon as a change happened. One staff member said, “We follow the risk assessments [we have created for people]. For example if a person is at a high risk of falls. We assess how we can make them safe [at Meadow View]. If they are unsteady, we can also seek advice/guidance from the Occupational Therapist to come and assess them too.” Another staff member told us, “If a person wants to go to another part of the care home, we check the environment and make sure it is safe for them to do so. Allowing them the choice.”

We observed people being encouraged to do things for themselves such as walking around the home with a walking aid, moving from chair to chair with staff supporting people where needed. People were not rushed and given time to make a decision. We saw interactions between staff and people where risks were explained, and staff respected people’s wishes. However we did observe some staff naturally becoming more anxious when faced with one person who was distressed quite often. We spoke with the manager and they spoke to the staff concerned and ensured they reviewed the agreed care instructions and polices, so staff were clear on the expectations on them.

Care plans and risk assessments contained essential information for staff to be able to provide safe care and support. The risks to people’s care and support needs and their health and safety had been assessed and robust care plans put in place to guide and inform staff on how to care for people. Where able, the risks to people’s health and safety and the subsequent care required to keep them safe had been discussed with the person and/or an appropriate person such as a relative. Care plans were in place for high risk areas such as personal care, falls and medicines. Any actions needed by staff to reduce the risk had been recorded. Environmental risks had been discussed with people and recorded within their care records. Agreements on how to make a person safe in an emergency had been agreed and recorded. This helped to keep the person safe.

People found the environment, premises and equipment to be safe and well maintained. A relative said, “The nice thing about the home is it’s very clean.” People were cared for in a clean, safe and well-maintained home. There were quiet seating areas, communal lounges where people and visitors could sit together. The provider and management team manager had taken appropriate action in response to environmental and fire safety concerns raised by the last CQC inspection.

Staff told us of the improvements made to the home and the ongoing monitoring of the environment to ensure safety is maintained. A staff member said, “All equipment in the home is regularly serviced, deep cleans take place. Everything is checked regularly and cleaned regularly.” The manager advised of the systems and processes that monitored the environment, premises and equipment. In addition, housekeeping staff and kitchen staff explained their roles and responsibilities of ensuring a safe environment.

We observed the environment, premises, equipment and outdoor space to be safe, and maintained. We observed people to be cared for safely. Staff followed guidance provided in care plans to manage and mitigate risks.

The provider and management team had systems and processes to monitor and maintain the health and safety of the environment including water and fire safety. Improvements had been made following the last CQC inspection. Risks and actions involving health and safety were discussed during daily meetings. Staff completed health and safety checks and recorded these in the daily hand over document. The manager also completed daily walk arounds and this included a health and safety review. Monthly governance meetings included a review of health and safety.

People and relatives told us there were sufficient, experience and competent staff who understood their care needs. A relative said, “Staffing has improved in the last three months. There are now enough staff based on the needs of the people. In the course of the last six months, [Meadow View Care Home] has improved enormously. There are more staff and the staff follow things through.” Another relative said, “Staffing has become more consistent now.”

Staff confirmed recruitment checks were completed before they commenced their role. Staff were positive about the ongoing training and support they received. A staff member said, “ We have supervisions at least every three months or as and when needed. I feel very well supported. I have a very good manager.” Staff confirmed they had competency assessments completed in some areas of care to ensure they were following best practice guidance and were competent. Staff were confident there were sufficient numbers of staff to meet people’s individual needs and safety. A staff member said, “I am happy with the staffing level at Meadow View Care Home, we never have to use agency staff now, always enough staff.” The manager told us how staffing levels were calculated using a dependency tool.

We observed there to be sufficient staff to meet people’s individual safety, care and treatment needs. Staff were well experienced, competent and knowledgeable about people’s individual needs. Staff were organised, attentive and responsive. Positive staff engagement was observed. Staff were kind, caring and patient, and had time to spend with people. Care and support was individual and unrushed.

The providers processes ensured there were enough suitably competent and qualified staff available to meet people's needs. There was a robust recruitment process. Staff had their competency checked in areas such as medication awareness and moving and assisting. The manager had an up to date schedule to ensure staff received regular supervisions and an annual appraisal. The provider had a dependency tool in place to ensure there were adequate staffing levels. Dependency needs were regularly reviewed and staffing levels adjusted accordingly.

Feedback from people and their relatives confirmed they were positive about the cleanliness and hygiene of the service. A relative said, “The home is always clean.” Another relative said, “[The staff] seem to be able to coax [our relative] into having a wash and [they] always have clean clothes on. [Our relative] allows the staff to change [them] because [they staff] have taken their time to allow [them] to trust them.”

Staff confirmed they had completed training in infection prevention and control and demonstrated a good understating of the measures to manage and prevent the spread of infection. A staff member said, “We have had online training and also face to face training with the local NHS. Good hand hygiene is important, washing your hands, wearing correct personal protective equipment (PPE), disposal correctly. And isolating people if they are unwell.” The manager told us of the training staff were required to complete, what audits and checks were completed to ensure good standards of cleanliness and hygiene were maintained and how PPE stocks were managed.

Observations of the environment, premises and equipment was positive. The service was clean and hygienic with no malodour. Housekeeping staff were present and observed to be following best practice guidance in cleaning tasks. PPE was available and procedures were in place to reduce the risk of cross contamination.

The provider has a robust IPC policy and procedure. The manager was aware of how to manage an infection outbreak safely. Cleaning schedules daily, deep cleans were completed and there was evidence these were monitored by the leadership team. Health and safety audit included checks on cleanliness and hygiene.

Feedback from people and their relatives confirmed they received their prescribed medicines safely and when required. One relative told us, “The handover of information between staff and other services works well. [The staff] are doing a medication review as [my relative] is not sleeping well. Staff have referred [them] to different health teams already.”

Staff responsible for managing and administering medicines confirmed the ongoing training they were required to complete, including observations and competency assessments. Staff also told us of the process of administering covert medicines when appropriate. A staff member said, “We are given the authorisation from the GP. People have it administered differently depending on the authorisation. One person might have their medication in yogurt and one person have theirs in water. We have a file in the office for authorisations.” The manager told us of the procedures that monitor medicines and how people’s medicines are reviewed by the GP and other health practitioners such as the community mental health team.

People received their medicines on time and as prescribed. The training matrix confirmed staff responsible for managing medicines had completed annual refresher training and a sample of competencies confirmed these assessments were robust. People were supported to self-medicate where this was requested, risk assessments and oversight procedures were in place to ensure safety. Medicines were booked in, administered and managed safely. We saw evidence the management team had completed regular medication audits.