Meadows Edge Care Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At this assessment we did not assess all quality statements within this key question. People’s care plans were not always up to date with the most relevant information. Information regarding people’s capacity had not been updated when their needs had changed, and care plans did not always reflect people’s communication needs. Even though there was a diverse range of people living at Meadows Edge care home, information displayed on boards in the home were in small print and available only in English. End of life care plans did not clearly record people's preferences and choices for their end-of-life care. It was not clear who had been involved with the planning, managing and making decisions around people’s care at the end of their lives.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s views had not always been sought when decisions were made about their care and support. A person told us they had moved bedrooms and although they were not consulted about moving, they did not mind as they were now happier. People were supported flexibly in line with their preferences, for example, we observed staff offering alternative options at mealtimes and responding to people’s requests when they wanted to do something else.

Care plans included how people liked to be supported and what their likes and dislikes were. However, some information was not always in line with what we were told by staff and managers, and it was evident care plans had not always been reviewed when people’s preferences had changed. Staff were able to tell us how they supported people to make choices. A staff member told us most people did not have capacity, but they could say, 'yes' and 'no' and choose what they wanted. Key words had not been included in care plans for non-English speakers to ensure staff had a basic understanding of what people may be saying. However, a staff member told us they had learnt phrases from others, and they could identify signs of pain by people’s facial expressions.

We observed staff working with people, demonstrating their knowledge of each person. For example, we saw a person who wasn't eating their lunch and a staff member asked if they'd prefer to eat a bit later. Additionally, we saw a staff member fully supporting someone to eat their meal. They were stopping and communicating with them to ensure their support was appropriate and in line with their preferences.

There was mixed feedback on how well the service communicated with them. A relative told us, “The communication from the home to the relative’s did go down a bit but it has started to get a bit better.” Another relative said, “I am never contacted by any staff to tell me how my relative is.” We were told by another relative, “The home contact me when they need to.”

Staff told us there were a range of languages spoken by people and staff. They explained how there was always a staff member available who could communicate with a person, so they would ask for help if required. Additionally, staff told us there was a booklet that could be used to establish whether a person was in pain or not. It was not evident if staff were effectively communicating with all people using the service as information we were told about a person, conflicted with the information in their care plan.

Care plans included how people communicated, although not all information was accurate or in line with what we had been told. For example, it was not clear what language a person spoke or what language was best to communicate with them. Information was not always available in formats that people understood. For example, information on display boards was in small print and only written in English even though there was a diverse range of languages spoken. The manager told us the boards were not effective and believed they did not belong in a person's home anyway. Although we were told easy read information was available, including easy read guidance on how to make a complaint, evidence of this was not shared and more importantly not accessible for people and their relatives to use.

Relatives told us that recently they were being invited to be more involved in reviewing their family member’s care and support. A relative told us, “It was good to have the meeting about our relative’s care plan as it had not been discussed for a while.” Another relative told us, “I have been to a relative’s meeting recently where I have been the only relative and that is a shame as the home is trying to involve us.” We were told by another relative, “I have been invited in to discuss my relative’s care plan which I am invested in.” This had not always been the case as another relative told us they had recently discussed their family member’s care needs for the first time even though they had been living at the service for 3 years. People and their relatives felt able to speak up if they had concerns.

The manager had implemented a digital reception that asked for feedback when visitors signed in and out. They explained how they could change the questions weekly to request different feedback. Although this was a good tool, feedback was without context and there had been no analysis to understand what the feedback meant and if improvements could be identified. However, the introduction of the electronic system had improved the service’s compliance with the General Data Protection Regulation (GDPR) by not showing past visitors names.

There were systems in place to request feedback, but these had not always been effective. There had been no analysis of feedback and no evidence it had been used to improve the service. We saw information on the, ‘You said, we did’ board had not changed since our last inspection in April 2024. The manager had put new systems in place to gain feedback from people and their relatives. Although this was newly introduced, there was some evidence of how it had been effective in improving the service. For example, feedback had led to improving people’s experiences at mealtimes. The manager stated various staff meetings had taken place, but they were not satisfied with the current quality of those. Although we requested evidence relating to staff meetings, only the most recent meeting information was shared so we were unable to establish if these had been effective in obtaining staff feedback to improve the quality of the service.

A person’s relative told us staff had monitored their family member’s care when they were vulnerable to experiencing inequality. One relative said, “When my relative came here they had been kept in bed with incontinent pads, they had nearly lost the ability to walk, and I was having to go in every day. Within a fortnight this home had got therapists in and had worked with my relative to get them using a walking frame. It was incredible the change.” However, another relative told us, “Last month I was phoned and asked to go to the home for a meeting. During this meeting we discussed my relative’s care plan, bearing in mind my relative has been there about 3 years, this is the first time this has been discussed with me.” Additionally, it was not always evident how other people had been supported appropriately to ensure they had equal experiences when for example, they did not have family to support and speak up for them.

Staff requested feedback from people’s families when they visited to ensure they were happy with the support they were giving their family member. The manager was working closely with healthcare professionals to improve communication and ensure referrals were made for people when required. There were some barriers to people’s care and support as the provider had not always communicated effectively with other healthcare professionals to ensure people received joined up care. For example, a medical professional requested a change to the method used to administer a person's medicine. Staff failed to implement the change for a number of months as information had not been effectively communicated

People’s care was not always delivered in a way which promoted equality and ensured good outcomes. Information about people’s health needs had not always been shared promptly with other healthcare professionals to ensure people experienced good outcomes. Changes in people’s needs were not always acted upon promptly to ensure referrals were made to relevant health professionals. This meant people did not always experience well-coordinated care. There were policies and processes in place for people and their relatives to speak up.

People had respect forms in place. Respect is a national document completed following an advance care planning conversation between a person and a healthcare professional.  Where possible, they record people’s preferences and guidance for emergency care and treatment. However, it was not clear when or if planning for the future had been discussed with people to ensure that was what they wanted.

When discussing the quality of the current end of life care plans, the manager told us they needed to do some further training with staff around end-of-life care planning. Staff told us there were not many people currently being supported who were at the end of their life.

Staff requested feedback from people’s families when they visited to ensure they were happy with the support they were giving their family member. The manager was working closely with healthcare professionals to improve communication and ensure referrals were made for people when required. There were some barriers to people’s care and support as the provider had not always communicated effectively with other healthcare professionals to ensure people received joined up care. For example, a medical professional requested a change to the method used to administer a person's medicine. Staff failed to implement the change for a number of months as information had not been effectively communicated