Background to this inspection
Updated
6 March 2021
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 Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by two inspectors.
Service and service type
Upper mead is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was to establish the safest and most appropriate way of carrying out our inspection visit during the COVID-19 pandemic.
What we did before the inspection
Before the inspection, we reviewed information we held about the service. We considered the information which had been shared with us by the provider as well as the local authority, other agencies and health and social care professionals.
We looked at safeguarding alerts which had been made and notifications which had been submitted by the provider. A notification is information about important events the provider is required to tell us about by law. This is necessary so that, where needed, the Care Quality Commission (CQC) can take follow up action.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service about their experience of the care provided. We spoke with 12 members of staff including the nominated individual, registered manager, quality lead, registered nurses, assistant manager, senior care workers, care workers and the chef.
We reviewed a range of records. This included 13 people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We sought feedback from relatives and professionals who had experience of the service and the care provided.
Updated
6 March 2021
About the service
Upper Mead is a residential care home and provides personal and nursing care for up to 48 people. At the time of inspection, 32 people were living at the service. People were aged 60 and over and lived with a range of mental health and physical health needs including age related frailty, diabetes and degenerative conditions such as dementia and Parkinson’s disease.
The building was purpose built over two floors. The building and courtyard garden were fully accessible, and the first floor was accessed by a lift. One wing specialised in providing care to people living with dementia.
Upper Mead is owned and operated by the provider Sussex Healthcare. Services operated by the provider had been subject to a period of increased monitoring and support by local authority commissioners. As a result of concerns raised, the provider is currently subject to a police investigation in relation to incidents that occurred between 2016 and 2018. The investigation is on-going, and no conclusions have yet been reached. The investigation does not include Upper Mead specifically.
People’s experience of using this service and what we found
People were happy with the care they received and felt safe with the staff that were supporting them. People were safeguarded from situations in which they may experience harm. Risks to people's safety had been assessed, and people were supported to stay safe. Staff knew how to identify potential harm and report concerns. People received their medicines safely from registered nurses. Checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service.
The culture of the service was positive, and people and staff were complementary of the management and provider. Improvements had been made to systems and process that monitored the quality of the service being delivered and accuracy of records. These improvements need to be sustained and become fully embedded into practice.
Care was personalised to meet people’s individual needs and preferences. Care plans provided information and guidance for staff. Staff knew people well and provided support in line with people’s preferences. People’s diverse needs were catered for and they were treated with dignity and respect.
People described the staff as caring and thoughtful and said they were treated with care and kindness. Feedback about the service from people and those close to them was positive. People and relatives told us they received good care and could not praise the service highly enough. People repeatedly told us that staff had made a positive difference in their lives during the past year and had kept them safe and well during the global COVID-19 pandemic.
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. There was a flexible approach to risk management which promoted people’s independence and provided opportunities for new experiences.
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 11 May 2020) and there were two breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 20 and 21 February 2020. Two breaches of legal requirements were found in relation to Regulation 12, safe care and treatment and Regulation 17, Good Governance. The provider completed an action plan after the last inspection to show what they would do and by when, to improve their governance processes. However, positive changes made at Upper Mead will need to be embedded and sustained in practice and we will check on progress with this.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection. This is the third consecutive inspection where the service has been rated requires improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Upper Mead on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.