Meadowcroft Residential Care Home

Meadowcroft Residential Care Home is a residential care home providing personal and nursing care to up to 17 people. The service provides support to younger people and older people, some of who may be living with dementia. At the time of our inspection there were 15 people using the service.

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

Systems were not effective in ensuring medicines administration was completed effectively. Medicines stock was not always accurate, and medicines were not always stored safely.

People were safe living at the service, staff understood how to keep people safe from the risk of abuse. Where people were at risk, assessments had been completed and staff were aware of the management plans in place to keep people safe. There were enough staff to support people safely and recruitment had been completed following safe procedures. Infection prevention control procedures were in place and when things went wrong there was a process in place to learn from these incidents.

People were 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; the policies and systems in the service supported this practice.

People and their relatives were involved in the service and there were processes in place to ensure staff received support. The provider had systems in place to learn and improve the service and they worked in partnership with other agencies. People were supported by staff who understood their needs and the atmosphere at the home was calm and people were happy.

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 7 December 2018).

Why we inspected

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

Enforcement

We have identified breaches in relation to governance arrangements for medicines administration at this inspection.

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

Follow up

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 alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿Although visits were restricted due to local guidance, people’s individual wellbeing was considered and some visits went ahead by appointment. Visiting procedures were in place and Personal Protective Equipment (PPE) was available for visitors.

¿People utilised technology such as video calls and a social media page hosted by the service to maintain contact with family and friends.

¿Staff ensured people were able to celebrate their birthdays and shared photographs with relatives and friends to ensure they felt part of the occasion.

¿Staff worked closely with infection control professionals and had introduced new isolation procedures to ensure infection outbreaks were effectively prevented or managed.

¿The environment was clean. Staff completed regular touch point cleaning and deep cleans to ensure the risk of cross transmission was reduced.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection visit took place on 14 November 2018 and was unannounced.

There was a registered manager in post and they were present during the inspection. 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 received medicines as required, although some small changes were needed to ensure that the number of medicines coming into the home were recorded adequately. People continued to receive care that made them feel safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and guidance about how to manage these was available for staff to refer to/follow. Safe recruitment of staff was carried out and adequate numbers of staff were available to people.

People continued to receive effective support from staff with a sufficient level of skills and knowledge to meet their specific needs. 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 support this practice. People were assisted to access appropriate healthcare support and received an adequate diet and hydration.

The care people received was provided with kindness, compassion and dignity. People were supported to express their views and be involved as much as possible in making decisions. Staff supported people to have choices and independence, wherever possible. People’s diverse needs were recognised and staff enabled people to access activities should they so wish.

The provider had effective systems in place to regularly review people’s care provision, with their involvement. People’s care was personalised and care plans contained information about the person and their needs, choices and cultural needs. Care staff knew people’s needs and respected them. People were able to speak openly with staff and understood how to make a complaint.

The service continued to be well-led, including making detailed checks and monitoring of the quality of the service. People and staff were positive about the leadership skills of the registered manager.

Meadowcroft residential care home provides accommodation and care for up to 17 older people who may be living with dementia. The service does not provide nursing care

There was a registered manager in post at the time of our inspection. 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 they felt safe although we saw some occasions where staff used equipment to help people stand that may not have been appropriate. People said staff responded to their requests for assistance and there was sufficient staff available to keep them safe. Staff were knowledgeable about how to escalate any concerns about people’s safety. People said they had their medicines when needed, with support from staff if required. Staff new to the service were appropriately checked by the provider before commencing work.

People’s rights were promoted, and their best interests considered. People expressed confidence in staff who they felt were skilled, competent and able to look after them well. People had a choice of nutritious food and drink they said they enjoyed, and we saw any risks to people due to weight loss or eating were well managed. People’s health care needs were monitored and promoted by staff.

People said staff were kind, caring and compassionate. People were treated respectfully and their dignity promoted. People’s privacy was promoted by staff. People were able to make choices with the support of staff were needed, this in respect of their care and how they spent their day. People’s independence was promoted.

People had involvement in planning their care and staff were knowledgeable about people’s individual preferences. People were able to spend their time involved in activities they enjoyed with support from staff to do so. People felt able to complain and were confident issues raised would be addressed, but said they had no complaints.

People were confident in the provider, registered manager and staff, and told us the service was well led. There were systems to in place to ensure people were actively encouraged to share their views, and where specific requests were made these were responded to. The provider had systems in place to monitor the quality of the service. Staff felt well supported by the provider, this meaning they enjoyed their job and were able to do it well.

We saw and heard from people we spoke with that their choices were listened to by staff and considered when they were provided with care and support. An example of this was food choices with one person telling us, 'There are lots of foods I can't eat but they will find something else'.

People told us that they consented to the care they received. Where people were unable to clearly express consent staff were aware of how to understand when they did not want assistance or expressed a preference in respect of such as food choices.

We saw people received care that was planned and delivered in a way that was intended to ensure people's needs were met and their safety and welfare was promoted. People told us that they were able to access external healthcare as needed with one person saying, 'Anything wrong a doctor comes'.

We saw that people were supported with their nutritional needs and the home had sought advice from healthcare professionals when needed to ensure people's nutritional needs were met.

People's views were taken into account as to how the service was provided and any complaints made were acted upon.