Archived: 80 Meridian Walk

Updated 7 September 2022

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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

80 Meridian Walk is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement depending on their registration with us. 80 Meridian Walk is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during the inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our insepction there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection

What we did before inspection

We reviewed the information we already held about the service. This included information collected through our monitoring activities and feedback from relatives. We sought feedback from the local authority and safeguarding teams. 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We communicated with two people who used the service. We spoke with one family member and received additional feedback from three other relatives. We made extensive observations of the care and support people were receiving. People who used the service who were unable to talk to us used different ways of communicating. We observed their body language and how they reacted to staff and the environment around them.

We spoke with five members of staff including the registered manager, the regional manager and three support workers.

We reviewed a range of records. This included three people’s care records and their 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.

We sought clarification from the Provider about some issues and received and reviewed additional information including audits, records of care and other records relevant to the management of the service. The provider sent us further information and updated records.

Updated 7 September 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

80 Meridian Walk is a residential care home providing personal care to six people at the time of the inspection. The service can support up to six people.

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

Right Support

The service did not support people to have the maximum choice, control or to be as independent as they could be. While people’s bedrooms were highly personalised, the communal areas of the home were in a poor state of repair and were not homely. For long periods during the inspection people were left with minimal stimulation and engagement while music played and the television was on with a low volume. There was limited evidence that people were supported to explore their interests. People had been assessed as lacking capacity to consent to their care and treatment. Where specific decisions needed to be made, appropriate best interest decision making processes had been followed. People were supported by staff to take their medicines, but records contained conflicting information about what medicines people were prescribed.

Right Care

Staff knew about people’s cultural backgrounds, but there was a reliance on people’s families to meet cultural needs. Staff knew people and their needs but did not demonstrate compassion or respect in their interactions with people. Information about people’s communication needs and styles was limited and some information showed misunderstandings about different tools of communication. People’s care was not planned in line with best practice guidance; people were not supported to identify goals or ambitions. People were not receiving care as planned and were rarely supported with activities and were not active members of their community.

Right culture

Staff were not ambitious for the people they supported and did not show they understood how to engage people with all aspects of their own lives. The service had recently recruited additional staff but the use of agency staff to fill rotas remained high. The agency staff were well known to people but the way staff were deployed showed there was a task focussed approach to support. The provider had allowed a culture of low ambition and aspiration to flourish in this home.

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

Rating at last inspection

The last rating for this service was good (published 26 February 2018)

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right Support Right Care Right Culture.

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement

We have identified breaches in relation to Person Centred Care, Dignity and Respect, Safe Care and Treatment and Good Governance.

We served the provider and registered manager with Warning Notices which required them to meet the regulations by a specified date.

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 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.