Meadows Edge Care Home in Boston, Lincolnshire, has again been rated inadequate overall by the Care Quality Commission (CQC) after it has failed to improve the standard of care it was providing, since a previous inspection. It remains in special measures following this inspection in October, to protect people whilst CQC take further regulatory action.
Meadows Edge Care home provides personal and nursing care to up to 45 people. It provides support to adults, including those living with dementia. At the time of this inspection there were 29 people using the service.
This unannounced inspection was carried out to follow up on action CQC told the provider to take after the last inspection in February. At this recent inspection, CQC identified repeated breaches in relation to safe care and treatment, safeguarding people from abuse, good governance and staffing issues.
Following this inspection, the service has again been rated inadequate overall, as well as for being safe and well-led. How effective and caring the service is, was not included in this inspection and both remain rated as requires improvement from the previous inspection. How responsive they are was also not inspected and remains rated as good.
The home will again remain in special measures meaning it is still being kept under close review to keep people safe.
CQC are taking further regulatory action to protect people and will report on this when legally able to do so.
Greg Rielly, CQC deputy director of operations in the midlands, said:
“When we visited Meadows Edge Care Home, it was disappointing to see the provider hadn’t addressed the issues we found at the last inspection in February, and people still weren’t receiving the safe care they deserve. Also, there was no registered manager in place, who is legally responsible to manage the home to ensure people are receiving high quality, safe care.
“We found risks identified in incident forms weren’t assessed. For example, when a person showed signs of distress including attempting to bite others, this hadn’t been risk assessed to give appropriate guidance to staff on how to handle these situations. Also, information on what people did when they were distressed wasn’t always included in care plans to ensure staff were aware of people's reactions and the risks associated with them.
“Referrals hadn’t always been made to the local safeguarding team when people harmed each other. This meant the provider wasn’t working with external organisations to help prevent abuse and neglect where possible.
“Additionally, the provider hadn’t assessed the risks when renting out a house in the same grounds as the home. Inspectors saw members of the public walking around where people from the care home were with staff. Additionally, there were car tyre marks in the gardens near the rented house which put people living at the home at risk. Also, several bedrooms were facing the rented house with no privacy screening which meant people's dignity and privacy was potentially at risk.
“We’ve told the provider exactly where improvements need to be made and will be monitoring the service closely to make sure people are being cared for safely during this time. We’re also taking further regulatory action which we’ll report on when we’re legally able to do so.”
Inspectors found:
- Important information was not always available in people's medicine records to ensure staff had the appropriate information to provide safe care and treatment
- Notifications were not always made to CQC when required which didn’t enable CQC to intervene to keep people safe, a key part of regulations
- There was a heavily stained and worn carpet in the stairwell, cracked basins and scuffed paint on the walls
- The systems and processes to review incidents were not robust and did not evidence learning lessons
- Medicine and maintenance audits did not show who was responsible to complete actions and if they had been completed.
However:
- Terminology and language used in care plans and other records was respectful and there were no indications of a closed culture
- 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.
The report will publish on CQC’s website in the next few days.