Archived: Meavy View Retirement Home

Updated 6 April 2024

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 Health and Social Care Act 2008.

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 carried out by 2 inspectors and 2 Experts by Experience, one of whom carried out phone calls to relatives of people living at the home, the other attended the home and spoke with people who lived there. 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

Meavy View Retirement Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Meavy View Retirement Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

We visited the home on 2 occasions, which was the 30 January 2024 and the 8 February 2024. Although the provider knew we were returning to complete a second day, we did not tell them when this would be.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed how staff provided support for people, to help us better understand their experiences of the care they received. We spoke with 13 people in person and 4 relatives via telephone, to gather their views of the care and support provided. We spoke with 6 members of staff, including the registered manager and the nominated individual. The nominated individual is responsible for the management of the service on behalf of the provider. In regard to Meavy View Retirement Home, the nominated individual is also the provider.

We reviewed a range of records, including 4 people care records, records relating to medicines, staff recruitment, training and supervision, building maintenance, equipment checks, accident and incidents and safeguarding. We also reviewed a variety of records relating to the management of the service, including audits, policies and procedures.

Updated 6 April 2024

About the service

Meavy View Retirement Home is a residential care home providing accommodation and personal care for up to 32 people. At the time of our inspection there were 23 people using the service.

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

Improvements continued to be required in relation to risk assessment and management, management of medicines, infection control, person centred care, premises and equipment, staff training and supervision, record keeping and the audit and governance process.

Risks were not always assessed or timely action taken to address identified risks. We identified gaps or a lack of detail in people’s risk assessments. Medicines were not always managed safely, as we identified a number of issues with record keeping including accurate and contemporaneous completion of the medicines administration records. Appropriate infection control measures were not always followed or implemented. Further work was required to improve the standard of the décor, fixtures and fittings. Work continued to be required to ensure the safety of the premises and equipment, helping to reduce potential risks to people’s health and well-being. We received mixed feedback about staffing levels. Staff absence was not always covered. Rotas confirmed the required number of staff had not always been deployed. Relevant recruitment checks had been carried out, though verification of staff’s references was not currently being completed.

We have made a recommendation about the recruitment process.

Staff supervision was not being provided in line with the provider’s policy. We could not be assured the training matrix was an accurate reflection of training provided at the home, as the registered manager admitted to including training a staff member said they had completed in previous employment. Where people required a modified diet, we found care plans and risk assessments were either inaccurate and/or lacked detail. Guidance from professionals, such as speech and language therapists was not available when requested. Thickening powder used to manage people’s risk of choking had been incorrectly added to one’s persons drinks for the last 4 months, as a result of inaccurate record keeping. 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 were largely complimentary about the care and support they received and the staff who provided this. Some positive observations of care were noted on both days of inspection. It was apparent staff knew people well and vice versa, with people being comfortable in staff’s presence.

Although we noted some improvement with activity provision, further work was needed to ensure people had access to meaningful activities of interest to them throughout the week. The provider did not provide information in alternative formats, to ensure it was accessible to all people living at the home. Overall, care plans contained a range of personalised information and explained how people wanted to be supported. However, information would benefit from being more specific. For example, some people’s care plans included guidance such as ‘check person regularly’, with no indication of how often this should be. Complaints had been managed in line with the providers policy.

The providers audit and governance processes were not robust, nor completed in line with specific timescales. Internal checks had not identified the majority of concerns we noted on inspection. Where issues had been noted through audits and monitoring, actions taken were either not clear, detailed or completed timely. The provider did not use an overarching action / improvement plan, to ensure effective oversight and demonstrate improvements were being made and monitored. Annual surveys were circulated; however, no actions were taken with the feedback received. Resident and relative meetings were not held, nor had people’s views been sought about whether they would find these meetings useful. Staff told us they enjoyed working at the home and felt supported by the registered manager.

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 inadequate (published 28 June 2023). At this inspection we found the provider remained in breach of regulations and remains rated inadequate. The provider has been rated either requires improvement or inadequate at the last 5 inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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 Meavy View Retirement Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred care, risk assessment and risk management, medication management, infection control, oversight of the premises and equipment, governance and record keeping, staff support and training.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.