CQC report explained · a nursing home
What the CQC found at Meadow Bank House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Medicines, risk assessments, staffing, recruitment and infection control were managed safely.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Good
- Inspectors found an open culture, regular quality checks and a management system that tracked improvements. Earlier issues had been included in the home improvement plan and were reported as resolved.
What inspectors found, December 2023
Rated Good after a focused inspection found safe care and stronger management, with earlier pressure-care concerns addressed.
This was an unannounced focused inspection on 16 and 17 November 2023. One inspector and one Expert by Experience spoke with people, relatives, staff and managers. They observed care and reviewed care records, risk assessments, medicines records, staff files and quality checks.
The home was rated Good for Safe and Well-led. Inspectors found medicines were managed safely, risks were assessed, staffing was sufficient, recruitment was safe and infection-control practices were followed. People and relatives spoke positively about the care and staff.
The inspection followed concerns about pressure-care needs. Inspectors found that actions from the previous inspection had been completed, including better records and monitoring. The overall rating improved from Requires Improvement to Good, but the other three quality areas were not inspected during this visit.
Safe medicines support
Inspectors found that medicines records and staff checks supported safe administration. Records for fluid thickeners and creams had been reviewed and improved.
“People were supported to receive their medicines safely.” from the report
Kind and respectful care
People and relatives said staff were kind, respectful and attentive. Inspectors also saw staff showing a caring attitude and understanding people's needs.
“People told us they were well treated, and their equality and diversity respected.” from the report
Clean home
The home was clean during the visit, with staff seen cleaning. Inspectors found effective infection-control processes and training.
“The home was clean throughout, and we observed staff actively cleaning the premises during the inspection.” from the report
Improvement tracking
Managers used a home improvement plan to track actions from audits. Inspectors said issues found at the previous inspection had been addressed and resolved.
“A home improvement plan (HIP) helped to identify and track actions from audits, in order to improve the quality of care provided.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now assess and record each person's pressure-care needs?
- 02How often are pressure-relief and continence charts checked, and what happens if a record is missed?
- 03How will you keep the improvements from the home improvement plan under review?
- 04What were the previous ratings for Caring, Effective and Responsive, which were not reassessed in this inspection?
- 05How are relatives involved when risks or changes in care needs are reviewed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 15 December 2023 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, October 2022
Rated Requires Improvement; inspectors found good care and infection control, but medicines records, engagement and care records were not always reliable.
This was a focused inspection. Inspectors visited on 14 and 21 September 2022, spoke with people, relatives and staff, and checked care records, medicines, risk assessments, audits and other documents.
People said they felt safe and received good care from staff who knew them. The home was clean, infection control was effective, staff training and healthcare support were good, and people were happy with the food and choices available.
Improvements were needed because medicines systems were not always followed. Records for thickening drinks and applying creams were incomplete or unclear. Records for pressure relief and continence care were also not always completed. There had been too little formal involvement of people and relatives in the running of the home.
The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Effective remained Good. The provider had identified most of the problems and put them on an improvement plan.
People felt safe
People and relatives told inspectors they felt safe. Staff knew how to recognise and report safeguarding concerns.
“People told us they felt safe living at the home and received good care from staff who knew them well.” from the report
Clean and good infection control
Inspectors found the home clean, with cleaning arrangements and infection control processes in place.
“The home was clean with effective cleaning and infection control processes in place.” from the report
Good staff support
Staff had ongoing training, supervision and an induction process to help them carry out their roles.
“Staff had been provided with ongoing training and support which enabled them to carry out their roles safely and effectively.” from the report
Food and choices
People spoke positively about meals and were offered choices. Inspectors saw staff provide encouragement and help where needed.
“People spoke positively about the food provided and confirmed they were offered choices.” from the report
Medicines records
seriousStaff did not always follow medicines procedures. Records for thickening drinks and applying creams were unclear or not completed on time, so inspectors could not confirm medicines were always managed safely.
“This meant we could not confirm medicines had consistently been managed safely.” from the report
Limited time for personal attention
needs fixingAlthough basic needs were met, some people, relatives and staff said staff were busy and care could feel focused on tasks rather than personal engagement.
“Don't feel staff get enough time with residents, tends to be short but sweet, more task orientated.” from the report
Incomplete care charts
needs fixingRecords for pressure relief and continence care were not always completed. This meant the home could not confirm that planned care had happened each time.
“This meant we could not confirm planned interventions had been carried out each time they were required.” from the report
Limited resident and relative involvement
needs fixingThere had been only one resident meeting in two years and no relative meetings. The home was considering a virtual relatives' meeting, but people's views had not been gathered through the recent questionnaire.
“There had been only one resident meeting within the last two years and no relative meetings.” from the report
- 01What has changed in the way staff record thickened drinks, including the amount used and the available stock?
- 02How are cream applications now recorded and checked for completion?
- 03How do you check that pressure relief and continence care have been provided and recorded?
- 04How will residents and relatives be involved in meetings, care decisions and feedback about the home?
- 05What progress has been made on the improvement plan since this inspection?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the overall rating used the previous ratings for the questions not inspected. This explanation was written from the published report of 27 October 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.
Every inspection of Meadow Bank House
5 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Bolton
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 92 can care for a couple. 10 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.