Background to this inspection
Updated
5 December 2019
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.
Inspection team
The inspection team consisted of an inspector, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Meadowyrthe 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 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 unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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.
During the inspection
We spoke with two people who used the service and four relatives about their experience of the care provided. People living at the service were not all able to communicate with us at length therefore we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with eight members of staff including the registered manager, deputy manager, care workers, domestic staff and the chef.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked quality assurance records. We spoke with two healthcare professionals who regularly visit the service.
Updated
5 December 2019
About the service
Meadowyrthe is a residential care home providing personal care to 36 people aged 65 and over at the time of the inspection, some of whom were living with dementia. Meadowyrthe supported people across four separate households, each of which has separate adapted facilities. The service can support up to 41 people.
People’s experience of using this service and what we found
People were not always supported to have their needs met by staff in relation to pressure relief and personal care in a timely and consistent way. There were not sufficient staff to meet people’s needs in a flexible and meaningful way based on people’s preferences.
People were not consistently supported to receive their medicines as prescribed by staff who understood how to administer medicines safely. Medicines records did not always contain clear guidance for staff to follow in relation to ‘as required’ medicines.
People were not consistently supported to have maximum choice and control of their lives. Despite this, staff supported people in the least restrictive way possible and in their best interests. However, the systems in the service did not always support this practice as people’s records had not always been completed.
People’s care files did not consistently contain accurate and up to date information to enable staff to meet their needs. People had access to healthcare professionals. However, staff did not consistently follow professional guidance to ensure people received safe care.
People were not consistently supported to make choices around their meals and how to spend their time. People were not supported to access regular meaningful activities.
People were not always supported in a caring way which respected their dignity. We made a recommendation that the management team review their systems to ensure people receive care which promotes their dignity.
Quality assurance tools were not effective at identifying where improvements were required at the service. The management team had not ensured systems were effective at sustaining quality and improvement.
People were supported by staff who understood safeguarding and made referrals to the safeguarding team where required. People were supported by safely recruited staff. People were supported to maintain their independence.
People knew how to complain and the registered manager acted on people’s concerns. People found the registered manager approachable. The registered manager sought and shared people’s feedback about the service.
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 10 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment, consent, person centred care and the governance of the service.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.