Meadow Rose Nursing Home

Updated 1 October 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Meadow Rose Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service a short notice of the inspection the day before. This was because we wanted to discuss any current impact of Covid-19 in the service.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and clinical commissioning group who commission care from the provider. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used information we gathered through our Emergency Support Framework (ESF) Call. We have used the ESF framework to gather information from health and social care settings registered with CQC during the COVID-10 pandemic. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and six relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, nurse, senior care workers and care workers.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at audits and handover records.

Updated 1 October 2020

About the service

Meadow Rose Nursing Home is a care home providing personal and nursing care for up to 56 people. Meadow Rose is a purpose-built accommodation with three floors, each floor has a communal area and there is also access to a garden.

People’s experience of using this service and what we found

Risks in relation to restraint had not been adequately assessed, monitored and reviewed and staff had not received the appropriate training. Staff had knowledge of safeguarding, but some staff had failed to recognise and report a safeguarding incident. Some recruitment records required improvement.

At our last inspection we found the provider’s governance system required improvement. This remained a concern at this inspection and systems to monitor the quality and safety of the service had not identified the areas for improvement found at this inspection.

People and relatives told us they were safe. There were sufficient staff to meet people’s needs. Some people felt call bells could be responded to more quickly. Our observations were people did not wait to receive care and there was ongoing monitoring of call bells response times by the registered manager. Medicines were managed safely and infection control procedures were in place and followed by staff.

People, relatives and staff spoke positively about the management at the service and staff felt supported. The registered manager was open to feedback and following the inspection took action to address the concerns raised.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 03 October 2019) and there was a breach of regulation 17, good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We received concerns in relation to the safety and care provided to people in relation to the use of restraint. As a result, we undertook a focused inspection to review the key questions of safe and well- led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service remains the same. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see safe and well-led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadow Rose Nursing Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to regulation 12, safe care and treatment and regulation 17, good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.