Meadway Court

Updated 18 March 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Meadway Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Meadway Court is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection the named manager registered with CQC was not in post at Meadway Court and had not been managing this service for some time. The service, therefore, did not have a registered manager in post at the time of inspection. We requested the provider take appropriate action to ensure the named registered manager deregistered as the registered manager for Meadway Court and submit the required statutory notification to CQC in retrospect. A new manager had begun at the home a few weeks before our visit and told us they intended to submit an application to registered with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included any information of concern and notifications the service is required to submit regarding any significant events happening at the service. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed staffing levels and walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with 8 people who use the service, 4 relatives and 12 members of staff, including the manager, deputy manager, senior care workers, care workers, auxiliary staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records including 5 people's care records. We looked at 4 staff files in relation to recruitment, training and support. We reviewed 4 people’s medicine administration records and looked at medicines related documentation and management arrangements. A variety of records re

Updated 18 March 2023

About the service

Meadway Court is a residential care home providing personal care to up to 42 people aged 65 and over. At the time of our inspection there were 32 people using the service, many of whom were living with dementia. Care is provided across two floors with a variety of single person bedrooms, some of which are ensuite, and shared communal areas.

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

Medicines were not always being safely managed. Risks were assessed and equipment was in place, but checks were not always robust enough to ensure these were working and set appropriately. Suitable staff recruitment processes were followed but there was not always enough staff who knew people and their needs. The home was clean and tidy, although robust infection prevention processes were not always being followed. People felt safe.

The was no registered manager maintaining oversight of the service in post and a notification regarding this had not been submitted to CQC at the time. The provider and managers from other services had supported Meadway Court and completed various checks and audits. These were not always robust and had not always led to appropriate action. Families and staff felt that some areas of communication could be improved. A new manager had been recruited and was keen to drive improvement and engage people, families and staff. Feedback about the manager and deputy manager was mainly positive.

Staff had completed relevant training and the new manager had begun to look at supervision and support for staff. Good practice guidance was not always followed. Work to improve the environment was being undertaken. People had mixed views about the food, and the quality of support people received varied. Records did not always demonstrate that people who required specific types of diet were receiving these and people did not always have access to drinks.

People were generally supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; policies and systems were in place to support this practice. Oversight of people who were subject to restrictions was not sufficiently robust and improvements were needed regarding record keeping.

Care plans did not always contain the most up to date person-centred information about people, and this had been identified as an area for improvements. It was not always evident that people were receiving person-centred care as some staff did not know people or their support needs. Group activities were available for people to engage with. Records did not always evidence how people who chose to stay in their rooms were supported to engage in meaningful activities.

People generally spoke positively about staff and were happy with the care they received. Not all staff knew people well and we noted some shortfalls in how care was delivered during the inspection.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 February 2020). The provider was asked to complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. The service remains requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about the care people were receiving and a recent safeguarding concern. A decision was made for us to inspect and examine those risks. This inspection was also undertaken to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to the management of medicines and systems for oversight and managing the service.

We have made a recommendation about staffing levels and the how people are supported to eat and drink enough for their wellbeing.

Please see the action we have told the provider to take at the end of this report..

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.