1 February 2023
During a routine inspection
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.