Archived: Meadowcroft Residential Care Home

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

People told us they felt safe and that staff were kind and caring. One person told us, “The best thing is the people here and the helpers. They make us very comfortable. There is nothing I would change.” Staff understood how to support people safety through managing people’s medicines, using equipment and managing risks around infection.

People were at the heart of the service, and their choices and views were valued and respected. The culture of the staff and provider was positive, and person centred. Staff understood the importance of people making choices and decisions about their care and encouraged this.

People’s privacy and dignity was respected, and their independence encouraged and promoted. Staff knew people well and provided social and emotional support, in addition to meeting people’s care needs.

People, their relatives, staff and other professionals were engaged with and involved with the service. Their views were listened to and acted on. The provider encouraged engagement with the wider community and people were regularly visited by the children from a local nursery, college children on work experience and other people from the local area.

People’s needs were assessed before they moved into the home. Risks to people were considered and assessed and care plans supported staff to deliver personalised care. People were supported to maintain their health and access healthcare support. Staff worked in partnership with other agencies to ensure people received the right support.

There were enough staff available to support people. Staff were supported to meet the needs of people through training and supervision. Staff were supported with specialist training as needed, such as Parkinson’s and end of life care.

The home was decorated in homely way and people’s bedrooms were highly personalised. People were encouraged to bring things with them to make them more comfortable.

People and their relatives told us that if they had any concerns, staff and the provider would respond straight away. People knew how to complain and were confident to do so. When things went wrong, lessons were learnt and actions put in place to prevent reoccurrence.

Rating at last inspection: At the last inspection the service was rated Good. (19 July 2016)

Why we inspected: This was a planned comprehensive inspection.

Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule.

Meadowcroft had a sole individual provider who had day-to-day oversight of the operations. Therefore a registered manager was not required, so the service did not have one.

People who lived at Meadowcroft told us they were safe. One person said “I feel perfectly safe” “If I have any problems the carers are there immediately, I ring my bell”. Another person said “The staff make me feel safe, they are very kind”. People said they felt safe as they were cared for by staff that knew them well and were aware of the risks associated with their care needs. There were sufficient numbers of staff in place to keep people safe and staff were recruited in line with safe recruitment practices. Medicines were ordered, administered, recorded and disposed of safely. Staff had received training in safeguarding adults.

People could choose what they wanted to eat from a daily menu or request an alternative if wanted. People were asked for their views about the food and were involved in planning the menu. They were encouraged and supported to eat and drink enough to maintain a balanced diet. One person said “The food is excellent”.

Staff were appropriately trained holding a Diploma in Health and Social Care and had received all essential training. Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation, which they put into practice.

People were cared for by kind and compassionate staff. People told us how well the staff knew them. One person said “Staff are pleasant and kind and nice to talk to, lucky to pick this home, one of the best, all the girls are friendly and enjoy their work.” People told us that they were treated with dignity and respect and we observed this to be the case on the day of our inspection.

Care plans provided detailed information about people and were personalised to reflect how they wanted to be cared for. Staff followed clinical guidance and ensured that best practice was followed in care delivery. Daily records showed how people had been cared for and what assistance had been given with their personal care. There was a range of social activities on offer at the home, which people could participate in if they chose. There was a complaints policy in place and a procedure that ensured people’s complaints were acknowledged and investigated promptly.

The home was well-led by the provider who was also the manager. A positive culture was promoted. People and staff told us that first and foremost Meadowcroft was a home where people were put first and there was a family atmosphere. The provider told us “I want to have a person centred service, I want people to say, this is my home and this is how I want to live.” There was a range of audit tools and processes in place to monitor the care that was delivered, ensuring a high quality of care. These included monthly reviews of care. People could be involved in developing the home if they wished through questionnaires and residents meetings.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

People who lived in the home told us they felt safe and were well treated by staff. When asked if they ever witnessed anyone being badly treated, one person said 'Oh no, none of that stuff goes on in here '. Another person said in response to the same question 'No, the staff are all great in here". A lot of them have been here a long time so we have got to know them very well' 'We spoke with the manager and four members of staff on duty. They knew about the different forms of abuse, how to recognise the signs of abuse and how to report any concerns.

There were arrangements in place to deal with foreseeable emergencies. The manager said staff received first aid training and were instructed to call out the paramedics if they had any concerns.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which applies to care homes. The Deprivation of Liberty Safeguards is in place to protect people's human rights. The manager said they had not needed to submit a Deprivation of Liberty Safeguards application to-date. However, the manager was aware when an application should be made and knew where to go if an application was required.

There were a range of health and safety policies and procedures in place. We saw evidence of current risk assessments for fire safety, portable appliance testing, premises and grounds. We observed the environment throughout the home looked well maintained.

Is the service effective?

People told us the manager and staff were effective in meeting their care and support needs. They were encouraged to be as independent as possible and were supported to achieve the best quality of life possible.

One person said 'They look after you when you aren't very well. They are very quick to get the G.P in if they are a bit concerned about you. They pick up on symptoms and are on the phone to the doctor with no hesitation'. Another person said 'I've been looked after extremely well. This is a very friendly and supportive home and they have their finger on the pulse'.

People's care plans contained information about their support needs and personal preferences. People's needs were assessed before they moved to the home to ascertain whether the service could meet their requirements. People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met

Is the service caring?

People who lived in the home were complimentary about the staff. One person said 'I can't speak too highly about the manager and the staff. They are all very caring'. Another person said 'The staff are excellent. They are lovely people and very good at caring for us, they definitely go the extra mile'.

We saw staff treated each individual with dignity and respect. They spoke to people in a caring, polite and friendly manner. One person said 'They always treat you with respect and never talk down to you'.

We observed staff knocked on people's doors and asked for permission before entering their rooms. All of the rooms had en-suite bath and/or shower facilities. This meant the environment supported people's privacy and dignity.

People told us they received visits from friends and family on a regular basis. There were no restrictions on visiting times and people we spoke with said seeing all their family and friends made it feel like a 'home from home.' Another person said 'The staff put themselves out to encourage visits from family and they always include them in any activities the home organises'.

Is the service responsive?

People who lived in the home told us the manager and staff were always responsive to their needs and preferences. We spoke with seven people who lived in the home. They told us they were able to make their own daily living choices such as meal choices and activities.

One person said 'The food is absolutely wonderful. It's a bit like a hotel. It's so varied and changes every day. We always get a choice of two meals and can ask for an alternative if we like'. Another person said 'You can have company or privacy as you like. You can watch TV with others in one lounge, or sit quietly in the other lounge or in the conservatory, or watch TV in your own room'. We spoke with one person who didn't like to eat in the main lounge and had their meals in their room.

We observed people had their own space but staff were on hand when they were needed. One person said 'We can come and go as we wish. Where people had requested to remain in their rooms, or have their meal in their rooms in private, this was recorded as a preference in their care plan.

Is the service well led?

The manager said as a small care home they monitored the quality of service by using questionnaires given to people who had direct contact with the home, but their main monitoring tool was through their daily contact with people and their families. People told us 'I would give the home 10 out of 10'; 'The manager is excellent and on top of everything' and 'The owners are extremely nice and caring. They are here all the time'.

The manager was an active member of the care staff and supervised the other staff on a daily basis. The manager told us most of the staff had worked at the home for several years. This meant people were supported by a small experienced team providing a consistent level of care.

A member of staff said they received practical in-house training from the manager including first aid and food hygiene. They also completed a rolling programme of training that had been delivered either in- house by an external trainer or on-line learning modules. This included protection of vulnerable adults, equality and diversity, fire safety, administration of medicines and dignity and respect.

There was a clear staffing structure in place with clear lines of reporting and accountability. The member of staff said they always received excellent support and appropriate advice from senior staff and the management team.

The staff also told us they felt valued and supported by the management and had their training needs met. The staff told us they felt confident that the quality of individualised care delivered in Meadowcroft was of a very high standard. We found care plans, staff records and other records relevant to the management of the home were accurate, reviewed regularly and fit for purpose.

The people who use the service were supported to have adequate nutrition and hydration. People were given choices of food and drink to meet their diverse needs.

The home had systems in place to assess and continually review the service that it provided and had made improvements where needed. We found that people were involved in all aspects of their care, and in any changes to the service that may have affected them.

We also looked at other records to help us understand the needs and views of the people who used the service. These included residents, relatives and health professional satisfaction surveys, resident's meeting minutes, staff personnel files, the home's incident and complaints log, the communication book and the home's operational policies.

We spoke to eight people living at the service and five visitors. Everyone we spoke with at the home confirmed that the staff were kind and caring. People told us that 'nothing is too much trouble.' Everyone spoken with said that they liked living at the home. Visitors said that they were always made welcome and told us 'it's like home from home when we visit, always offered a drink, which (my relative) feels is important.'

We spoke to the manager, three care staff and the cook. Our observations provided evidence that people's individual wishes and needs were considered and met. The staff were aware of people's likes, dislikes and abilities and through observation, discussion and review of individual records we saw how these were appropriately supported.

We looked at five care records which provided person centred information, assessment of needs, preference's, likes and dislikes and daily activities and provided detailed records of the persons care.

People told us that if they were unhappy about anything they would report it to the provider or another member of staff and they felt confident that it would be dealt with.