We carried out this inspection on 23 August 2018. The inspection was announced. We contacted the service on 22 August 2018 to give notice of our visit on 23 August 2018 because this is a small service and people who live there are often out during the day. We needed to be sure people would be available when we visited. The Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides personal care and accommodation for up to six adults who have a learning disability and/or autism.
At the time of our inspection there were four people living in the home. Two people received support with their personal care and two people were provided with accommodation but did not receive personal care. Only the people who were supported with personal care were receiving a regulated activity. CQC only inspects the service being received where people receive accommodation together with personal care; such as help with tasks related to personal hygiene and eating.
At our last inspection of this service in November 2016 we found the service had been redesigned and refurbished to provide four self-contained flats to give people a high standard of accommodation and the opportunity to gain greater independence. At that inspection there was only one person using the service. We found no concerns with how the service was being provided but judged it was too early to give a quality rating for the home.
There had been an experienced registered manager employed until 1 August 2018. A new manager had been appointed to oversee the day-to-day management of the service and had applied to be registered with us. 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.
People told us the home was a good place to live and said they liked living there.
People were treated with kindness and respect. The staff knew people well and were trained to provide their support.
Although there were enough staff to provide people’s care, the staff told us there had been occasions when there were not sufficient staff to ensure the safety of the service. After our inspection the registered provider sent us detailed information about staffing levels and provided assurances that there were sufficient, suitably trained staff to ensure people were safe.
Safe systems were used when new staff were employed to check they were suitable to work in a care service.
The staff were trained in how to provide people’s care safely. Medicines were handled safely and people received their medicines as their doctors had prescribed.
The staff in the home were knowledgeable about The Mental Capacity Act 2005 and people’s rights were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Hazards to people’s safety had been identified and managed.
People were provided with meals, drinks and snacks that they enjoyed and were supported to make healthy eating choices.
People were supported to access local and specialist health care services to maintain good health.
The staff supported people to gain greater independence. People’s privacy and dignity were respected.
The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, the registered provider had not ensured people were only admitted to the home if they were compatible with individuals who already lived there. This had led to some people not always being able to enjoy their accommodation as they preferred.
People were supported to follow a range of activities they enjoyed in the home and the local community. They were able to see their families and friends as they wished and were able to maintain relationships that were important to them.
Care was planned and provided to meet people’s needs. Appropriate specialist services had been included in assessing people’s needs to ensure their care was based on best practice.
The registered provider had a procedure for receiving and responding to complaints.
Although there was no one in the home who required end of life care, people had been asked if they wished to share their wishes about how they wanted to be cared for as they reached the end of life.
The manager and staff in the home asked people for their views about the service they received. They carried out checks on the service to ensure people were safe and received a good quality service.