We carried out a review of the data available to us about Meadowfields Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Meadowfields Care Home, you can give feedback on this service.
Meadowfields Care Home is a residential care home providing personal care to 62 people at the time of the inspection, some of whom were living with dementia. The service can support up to 65 people.
Meadowfields Care Home accommodates people over two floors, each of which has separate adapted facilities.
People’s experience of using this service and what we found
People felt safe. They were supported by trained staff who knew how to protect them from abuse and avoidable harm. Risks to people were assessed and mitigated, including risks associated with the environment. There were enough staff to support people safely and people got their medicines as prescribed. The environment was clean, and we were assured that staff followed safe infection control practices.
The registered manager was approachable and supportive. There was a positive atmosphere within the home where staff knew people well and supported them to achieve the best outcomes. The provider and registered manager had good oversight about the risks and quality of the services provided and had a commitment to continuous learning.
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 2 July 2019).
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service sustained a serious injury. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of falls from height. This inspection examined those risks.
We found no evidence during this inspection that people were at risk of ongoing harm from this concern. Please see the safe and well-led sections of this full report.
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.
We received concerns in relation to the management of the service and the way in which people’s needs were met. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained good. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meadowfields Care Home 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.
We found the following examples of good practice.
• A visiting policy and procedure was in place which had been shared with relatives. A ‘visiting hub’ had been implemented within the lounge area of the home with a clear screen and intercom in place. This meant people were protected when they had visits from relatives.
• When visits had been restricted other methods of communication were used to ensure people continued to have contact with their loved ones such as, video/telephone calls and letter writing. The registered manager kept in regular contact with relatives to provide updates on their relatives’ wellbeing.
• People continued to be supported with activities to maintain their emotional wellbeing. During the summer a drive through cinema event was arranged which allowed relatives to be involved whilst remaining at a safe distance in their vehicles.
• The environment was well maintained and clean. Additional cleaning had been implemented to lower the risk of cross transmission.
• The registered manager had carried out a ‘trial isolation’ to assess how this affected people, ensuring lessons were learnt. This helped to ensure isolation and cohorting of staff to specific areas ran smoothly during an outbreak.
• Staff were supported by the registered manager during periods of anxiety and staff had been signposted to external wellbeing services.
Meadowfields is a care home which accommodates up to 65 people across two floors. Within Meadowfields there are three separate wings, each of which has adapted facilities. At the time of the inspection, the service supported 63 people, some of whom were living with dementia.
People’s experience of using this service and what we found
People were supported by trained staff. Staff were knowledgeable about the different types of abuse and were able to raise concerns to ensure people remained safe.
People received their medicines as prescribed by trained staff. People were supported in a clean environment and staff wore protective equipment where required to reduce the risk of infection. Any accidents and incidents were reported by staff to the management team and actions were taken to reduce any future risk.
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’s privacy and dignity was respected by staff.
People were supported to maintain a healthy diet and had access to healthcare professionals should they need them. People had detailed care plans which were updated when their needs changed. This ensured the staff knew people well and provided care which was effective.
People were treated with kindness and compassion. People were supported to plan for the end of their lives with families and other professionals where they wished. There were sufficient numbers of staff to meet people’s needs and to allow people time to build relationships with staff.
The provider learned lessons when things went wrong and completed regular reviews of the quality of the service to ensure continuous improvements to people’s care. The provider sought and acted of people's feedback about the service. This meant that people's voice was heard.
The provider had quality assurance tools in place to monitor the quality of care and support they provided. The provider took action where improvements were required to ensure people continued to receive safe and effective care.
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 10 January 2019). 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 significant improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received about the service not engaging with health professionals in a timely way and staff training. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the ‘Effective’ and ‘Well-Led’ sections of this full report.
Meadowfields 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.
Meadowfields Care Home accommodates up to 65 people in one building. At the time of the inspection, the service supported 62 people.
At the last inspection in 2017 we rated the service as requires improvement. We asked the provider to complete an action plan to show what they would do and by when to make improvements to how people’s risks were managed. At this inspection we found that these improvements had been made, although improvements were still required to ensure a consistently safe and well-led service.
The service had a registered manager. 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.
Some improvements were required to ensure that systems in place to monitor the quality of services were effective in identifying areas for improvement and ensuring that action was taken. Improvements were needed to ensure systems for protecting people from potential abuse and avoidable harm were effective.
You can see what action we told the provider to take at the back of the full version of the report.
People received their medicines as prescribed, however improvements were needed to the management of medicines to ensure they were consistently safe.
People’s risks were assessed and managed to help keep them safe. There were enough suitably skilled staff to meet people’s needs. People were protected from the risk of infection.
People’s needs were suitably assessed before they moved to the service and care plans were developed in line with best practice guidance. Staff were trained and suitably skilled. People had their nutritional needs met and there were systems in place to ensure people received consistent care and support. People were supported to have healthier lifestyles by having timely access to healthcare services and professionals.
People had their consent sought in line with the principles of the Mental Capacity Act 2005. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People received support that was delivered in a caring and compassionate way and people were treated with dignity and respect. People, where possible were consulted about how their care was provided and were given choices in their day to day lives. People’s communication needs were met.
Staff knew people well including their likes, dislikes and preferences. People had access to activities. There was a complaints procedure available to people and their relatives and people were supported at the end of their life to have a dignified and comfortable death.
People, relatives and staff felt the management team and provider were approachable and supportive. People and relatives’ feedback was requested and responded to.
The service worked in partnership with other organisations to improve outcomes for people.
Meadowfields Care Home provides support and care for up to 65 people, some of whom may be living with dementia. At the time of this inspection 61 people used the service.
The service had a registered manager. 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.
Risks to people's health and wellbeing were not managed to keep them safe from harm. Some situations which could be harmful to people were risk assessed but staff did not always follow the plans put in place to reduce risks. People's medicines were not always managed safely.
There were sufficient numbers of suitably trained staff to provide people with the support they required. However, there were occasions when people experienced delays in receiving the support they required because of the lack of organisation of staff.
People were supported by staff that had been recruited using safe recruitment procedures to ensure they were of good character and fit to work with people who used the service. People were supported by staff who knew how to recognise and report potential abuse to safeguard them from harm and abuse.
People's rights were protected as the provider followed the principles of the Mental Capacity Act 2005 (MCA). People were offered and supported to make choices about their care and support.
Staff had been recruited using safe recruitment procedures to ensure they were of good character and fit to work with people who used the service.
People were not always provided with the appropriate support to eat their meals. People told us the quality of the food was good however they were not always given their preferred choice of food.
People’s privacy and dignity was upheld but there were occasions when staff did not support people consistently in a caring or sympathetic way.
People received regular health care support and were referred to other health care agencies for support and advice if they became unwell or their needs changed.
People were provided with a varied recreational and leisure activity programme.
People and their representatives (where appropriate) were involved in the planning and review of their care. The provider had a complaints procedure and people knew how and to complain when they had concerns.
The provider had made improvements to the systems in place to assess, monitor and improve the quality of care. However, some further improvements were needed to ensure all areas of care were assessed and monitored to mitigate potential risks to people and to improve the quality and consistency of the service.
This inspection took place on 20 October 2015 and was unannounced. This is the first inspection since the service changed ownership. Meadowfields Care Home provides accommodation and personal care for up to 65 people. At the time of this inspection 33 people used the service. The service was undergoing refurbishment, one of the units was closed and in the process of redecoration.
The service had a registered manager. 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 felt safe and comfortable. Staffing levels were sufficient to support people individually and in their preferred way. Recruitment for additional care staff was on-going to reduce the need and use of agency workers. The provider had a recruitment process in place. Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed.
People’s medicines were administered to them by staff; staff were knowledgeable and supported people with their medicines as required. Arrangements were in place for the safe storage, administration and management of medicines.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs) and to report on what we find. The Mental Capacity Act (MCA) is designed to protect people who can't make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty safeguards ensures that people are not unlawfully restricted. People were consulted with making decisions and offered choices and options regarding their daily lives. The registered manager told us that they had raised several DoLS referrals with the local authority.
People told us they enjoyed the food, had plenty to eat and drink and lots of choice. Where people needed help with their nutritional requirements, staff provided the level of support that each individual person required.
Health care professionals were contacted when additional support and help was required to ensure people’s health care needs were met.
People were treated with respect and approached in a kind and caring way. People told us they found the staff caring, friendly and helpful. People were able to see their friends and families as they wanted. There were no restrictions on when people could visit the home. Visitors we spoke with told us they were made welcome by the staff in the home.
Leisure and recreational activities were provided in house; these were either on a one to one basis or in groups. People could choose whether they wished to participate or not and staff respected their choices. The activity programme was being reviewed.
People were aware of the complaints procedure and knew how and to whom they could raise their concerns.
The home had a registered manager but a new person has been recruited to take over this position. The registered manager had planned to work closely with the new person to ensure continuity and stability of the service.
There were some quality assurance audits and checks in place but these did not give a comprehensive overview of the quality and safety of the service. Some records were not in sufficient detail to ensure care was provided in a consistent and reliable way. However, staff were knowledgeable regarding people’s individual care and support needs.