CQC report explained · a residential care home
What the CQC found at Generals Meadow
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found suitable risk guidance, safe medicines management, enough staff, safe recruitment, effective infection control and learning from accidents.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Well-led?
- Good
- Inspectors found effective checks and audits, an open management culture, and evidence that people's and relatives' suggestions were acted on.
What inspectors found, July 2022
Generals Meadow was rated Good; inspectors found improvements in safety and management since the previous inspection.
This was an unannounced focused inspection on 20 June 2022. One inspector spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment records and management checks.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staffing levels were suitable, and infection control arrangements were effective.
The home had improved since its previous inspection, which was rated Requires Improvement. Problems with risk guidance, medicines and quality checks had been addressed, and the provider was no longer in breach of regulations.
Only Safe and Well-led were inspected during this visit. The other key question ratings were carried forward from the previous inspection when calculating the overall Good rating.
Improved risk management
The home had added guidance for risks including diabetes, blood-thinning medicines and pressure damage. Environmental and equipment checks were also in place.
“At this inspection, improvements had been made.” from the report
Safe medicines
An electronic medicines system recorded administration, highlighted missed doses and used bar codes to reduce the risk of errors.
“The electronic system had guidance for staff about how to administer 'as and when' medicines such as pain relief.” from the report
Enough suitable staff
People and staff said there were enough staff. Inspectors saw staff responding quickly to call bells and spending time with people.
“Staff answered call bells quickly and people were comfortable to ask for support.” from the report
Learning from incidents
Accidents and incidents were investigated and reviewed for patterns. Action such as referrals and safety equipment had helped reduce falls.
“The reports were reviewed each month to identify any patterns or trends, the action taken had been effective in reducing falls.” from the report
Open management
People, relatives and staff said managers were approachable. Suggestions about the environment, activities and food had been acted on.
“There was an open and transparent culture within the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you checking that individual risk guidance, such as for diabetes and blood-thinning medicines, remains up to date?
- 02How does the electronic medicines system alert you to missed or incorrect doses, and how are these followed up?
- 03What checks are currently used to review falls, accidents and incidents, and what changes have resulted?
- 04How do you make sure there are enough staff at all times, including when someone is absent?
- 05What were the previous ratings for Caring, Effective and Responsive, and when will these areas next be inspected?
This was an unannounced focused inspection of Safe and Well-led; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2019
Rated Requires Improvement; inspectors found kind, responsive care, but safety checks, medicines records and management oversight were not reliable enough.
The inspection was unannounced and took place on 7 October 2019. One inspector spoke with people, relatives and staff, and checked care plans, medicines records, recruitment files and management records.
People said they felt safe and were treated kindly. Inspectors found enough staff, good support with food and healthcare, respectful care, activities and help to stay in contact with relatives.
There were important safety gaps. Risks were not always assessed properly, guidance for staff was sometimes missing, and medicines records and instructions were not always accurate or complete.
The overall rating was Requires Improvement. Safe and Well-led were also Requires Improvement, while Effective, Caring and Responsive were Good. The provider breached Regulation 17 on good governance and was asked to send an action plan.
Enough familiar staff
Inspectors found enough staff to meet people's needs. Staff absence was covered by permanent staff, helping people receive consistent care from people they knew.
“There were enough staff on duty to meet people's needs. People told us, there were always staff to help them when needed.” from the report
Kind and respectful care
People were treated with compassion and respect. Staff supported privacy, personal choices and independence.
“We observed people being supported with compassion. Staff spoke to people in a kind and gentle way, they were discreet when speaking to them privately.” from the report
Good activities and family contact
People could take part in activities they enjoyed, join trips and keep in touch with relatives and friends.
“People were encouraged to take part in activities they enjoyed. People told us how much they enjoyed playing Whist.” from the report
Learning from incidents
Accidents and incidents were reviewed for patterns. Changes such as bed rails, movement alert mats and a stand aid were followed by no repeat accidents.
“The accidents had not happened again following the action.” from the report
Risk assessments were incomplete
seriousSome risks to people's health and safety did not have clear assessments or instructions for staff. Inspectors also found repeated problems with pressure mattress settings and concerns about hot water temperatures.
“Potential risks to people's health, welfare and safety had not been consistently assessed and guidance made available for staff.” from the report
Medicines were not always managed safely
seriousSome handwritten medicine instructions were not checked and signed by two staff. Medicine records contained incorrect dates, and instructions for medicines given when needed were sometimes not detailed enough.
“Medicines were not always managed safely. When medicine directives were handwritten, they had not been consistently signed by two staff to confirm the directive was correct.” from the report
Management checks missed problems
needs fixingAudits had not identified the safety, medicines and emergency-plan shortfalls found during the inspection. Actions taken did not always prevent problems from happening again.
“However, these had not been effective at identifying the shortfalls found at this inspection including lack of guidance for staff to mitigate some risks to people's health, welfare and safety, shortfalls in medicines management and personal emergency plans.” from the report
Care plans lacked detail
needs fixingCare plans did not always fully record people's preferences or all the care being provided, including some personal hygiene preferences.
“Care plans did not always contain the detail to reflect all the care that was being given in order for the provider to be assured people's needs were being met.” from the report
- 01What action has been taken to make sure risks linked to diabetes, blood-thinning medicines and pressure mattresses are clearly assessed and monitored?
- 02How are medicine records now checked for correct dates, signatures and clear instructions for medicines given when needed?
- 03How are personal emergency evacuation plans kept so staff can find them quickly in an emergency?
- 04What changes have been made to audits so they identify problems before they put people at risk?
- 05How are care plans now updated to record each person's personal hygiene preferences and the care being provided?
This was an unannounced planned inspection covering all five CQC questions, including the premises and care provided; the previous Good rating was from December 2016 and the provider had since changed. This explanation was written from the published report of 15 November 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Generals Meadow
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2018
Registered with the Care Quality Commission on 23 November 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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