Lower Meadow

Updated 27 July 2022

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 two inspectors and an Expert by Experience who supported the inspection by making telephone calls to relatives to gain their feedback of the experience of care provided. 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

Lower Meadow 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. Lower Meadow 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a manager in post whose application to become registered with us was being assessed at the time of our inspection visit.

Notice of inspection

This inspection was unannounced.

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 and professionals who work with the service such as 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 spoke with five people and seven relatives about their experience of the care provided. We spoke with 14 members of staff including the manager, the deputy manager, three care team leaders, five care assistants, the activities co-ordinator, a housekeeper and two members of catering staff. We also spoke with the provider’s regional operations director and two visiting healthcare professionals.

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 reviewed a range of records. This included three people’s care plans in detail and specific areas of four other people’s care plans. We checked nine people’s medicines records, two staff files in relation to recruitment and a variety of records related to the management of the service such as quality assurance checks.

Updated 27 July 2022

About the service

Lower Meadow is a purpose-built residential home registered to provide accommodation and personal care for up to 69 people, including people with dementia. At the time of our inspection visit there were 48 people living at the home. Care is provided across two floors. Communal lounge and dining areas were located on both floors. People's bedrooms were en-suite and there were further communal bathroom facilities located on each floor.

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

Improvements had been made since our last inspection. There was a new management team who were committed and motivated to improve standards and ensure positive outcomes for people. Staff, people and relatives confirmed the management team were visible and they felt able to approach them with any concerns or issues they had.

The governance and oversight of the service had improved, but we found further progress was required to ensure records accurately reflected people’s needs and records to evidence risk management were completed accurately.

There were enough staff to keep people safe. Staff told us staffing levels were sufficient but acknowledged there were times when they were very busy. They told us staff worked as a team to ensure people’s needs were met.

Risks to people’s health and wellbeing had been identified and records guided staff on what to do to minimise identified risks and help keep people safe. Staff understood their responsibility to report any concerns or poor practice and the manager had had made safeguarding referrals to external professionals when necessary. Any learning from accidents and incidents was shared with staff so they could understand where changes in practice were required.

Medicines were ordered, stored and administered safely.

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.

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 Requires Improvement (published 30 September 2021) and there were breaches of regulation. 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

The inspection was prompted in part due to information received about staffing levels and a closed culture within the home. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We also checked the provider had followed their action plan submitted following our last inspection and to confirm they now met legal requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from the concerns raised. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.