We carried out this inspection on 12 July 2017 and our visit was unannounced.Swallows Meadow Court provides accommodation and nursing care for up to 70 people. There are four units providing residential, nursing and care for people who may have a diagnosis of dementia. The home specialises in providing end of life care to people. There were 68 people living at the home on the day of our inspection.
We last inspected this service on 16 and 17 June 2015 and gave the home a rating of ‘Outstanding’ in caring and ‘Good’ overall. At this inspection we found the ratings remained the same.
There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The registered manager, deputy manager, provider and staff team continued to make sure people were cared for in an environment where people were supported to carry on living their lives as they wished. People continued to be encouraged and supported to pursue their interests and hobbies, as well as maintaining relationships important to them.
Staff continued to demonstrate they had an understanding of the visions and values of the home which were to ensure people remained as comfortable and well cared for as possible. This included providing compassionate care for people nearing the end of their life and included support for their family members. People were treated with respect and dignity at Swallows Meadows Court. Family members and friends were encouraged to visit as often as they wished.
The registered manager understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Where people’s care plans included restrictions on people’s right, choices or liberties, the registered manager had applied to the Supervisory Body for the authority to do this in people’s best interests.
People told us they felt safe at Swallows Meadow Court. The registered manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. Staff had a good understanding of risks associated with people’s care needs and how to support them.
There were enough staff at Swallows Meadow Court to support people safely and at the times they preferred. Recruitment procedures made sure staff were of a suitable character to care for people at the home.
Medicines were stored and administered safely, and people received their medicines as prescribed. Regular audits were carried out of medicines to ensure they were managed in line with good practice guidelines.
People were supported to attend health care appointments to maintain their health and well-being and received support with food and drinks that took account of their preferences and dietary needs. People’s health needs were regularly monitored and they were referred to external healthcare professionals when a need was identified and especially when people were at end of life.
Staff were caring, kind and supportive and ensured people’s privacy and dignity needs were met. People were encouraged and supported to maintain their independence. The management team and staff had a good understanding of people’s individual needs and preferences.
The registered manager and staff were focussed to ensure a person nearing the end of their life was comfortable and pain free. Staff worked collaboratively with other healthcare professionals and agencies to provide support to the person and their family and friends. Families were supported to be involved in their relation’s care planning and were kept regularly informed with any changes.
People were supported to pursue their hobbies and interests both within and outside the home. One activity coordinator had recently left the service which had impacted on the amount of activities offered, however the provider was addressing this. People who lived at Swallows Meadow Court were encouraged to maintain links with friends and family.
People and relatives knew how to make a formal complaint and told us they felt comfortable raising any concerns they had with the staff. The provider had systems in place to monitor complaints so they could identify areas where improvements could be made.
Most staff, and healthcare professionals, felt the management team were supportive and promoted an open culture within the home. Staff were able to discuss their own development and best practice during one to one supervision and team meetings. A programme of training and induction provided staff with the skills and knowledge they needed to meet people’s needs.
The registered manager and deputy manager felt well supported by the provider. The management team carried out a range of audits to check the support and care people received to continually monitor and improve the quality of the service.
People and relatives were encouraged to share their views about the quality of service provided through regular meetings, ‘drop in’ sessions and quality surveys.
The provider remained a member of recognised good practice initiatives and continued to work with agencies and organisations to develop new and caring ways of supporting people, especially those who were at end of life.