CQC report explained · a residential care home
What the CQC found at Meadow View
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Meadow View rated Requires Improvement; inspectors found better safety arrangements but repeated failures in quality checks and record keeping.
This was an unannounced focused inspection on 28 and 29 June 2023. Inspectors checked whether the home had acted on its previous improvement plan. They spoke with people, relatives and staff, and reviewed care, medicines, risk, recruitment and quality records.
The home had improved from its previous Inadequate rating. Staff understood people's risks, staffing levels had improved, medicines were stored safely and infection control was satisfactory. However, some medicines records and risk records were incomplete, and environmental safety issues included faulty fire doors and an unlocked room containing chemicals.
The home remained in breach of Regulation 17 on good governance. Its checks and audits had improved but were not yet reliable enough to identify and fix problems consistently. The overall rating changed from Inadequate to Requires Improvement, but the report says there was still an increased risk that people could be harmed.
Staffing
Inspectors found enough staff to meet people's needs. Staff said deployment and breaks had improved, and people did not have to wait long for help.
“We found the deployment of staff had improved, and breaks were now coordinated, so sufficient staff were available to assist people if required.” from the report
Understanding risks
Staff generally understood people's risks and worked with health and social care professionals to reduce them. Inspectors found this had helped one person's wellbeing and reduced their medicines.
“Staff had a good understanding of people's risks and gave us examples showing how they had worked with other health and social care professionals to help to reduce people's risks.” from the report
Infection control
The home was clean and uncluttered, and inspectors were assured about its infection prevention arrangements.
“People's bedrooms, communal hallways and lounge areas were clean and uncluttered.” from the report
Family communication
Relatives said they were kept informed, involved and listened to. They were also positive about the management and staff.
“All relatives felt involved, included and listened to and staff knew them well.” from the report
Incomplete care and risk records
needs fixingSome records did not reflect recent seizures, changes in health or current support needs. This could make it harder for staff to provide consistent care.
“Care evaluations had been completed but examples we saw had not always reflected changes in people's needs or important events that could impact on a person's health.” from the report
Medicine recording
needs fixingRecords did not always show where patches had been applied, when creams were opened or when they should be disposed of. Guidance for variable medicines was also not detailed enough.
“We found no harm to people, but further development of systems for administering people's medicines was required to promote people's safety further.” from the report
Fire doors and hazardous substances
seriousThree fire doors did not close properly, and a room containing chemical products was left open despite being marked to stay locked. Immediate action was taken during the inspection.
“A door marked as 'keep locked' was open, this contained chemical products that could put people at unnecessary harm.” from the report
- 01How will you make sure medicines such as patches and creams are recorded correctly every time?
- 02How are you checking that care plans and risk assessments are updated promptly after seizures or other important health changes?
- 03What has been done to make sure all fire doors close properly and hazardous substances remain locked away?
- 04How will you show that the Regulation 17 action plan has been completed and that improvements are now embedded?
- 05How do senior staff check that issues recorded in handover books and daily checks are followed up?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 3 August 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, May 2023
Rated Inadequate and placed in special measures; inspectors found serious safety and management failures.
Inspectors visited the home on 16 and 17 March 2023. They spoke with people, care staff and managers, and reviewed care records, medicines records, risk information, staff files and quality checks.
They found serious problems with managing risks, fire safety and infection control. Care plans were sometimes inaccurate or conflicting. Fire doors needed repair, and COVID-19 outbreak measures were not always followed. Some medicines were given above the recorded maximum dose.
The home's checks and audits did not identify or fix important problems. Staffing was generally described as sufficient, but staff breaks and record writing sometimes left parts of the home without staff nearby. People said they felt safe and staff had medicine training, but the overall rating fell from Good at the previous inspection in 2019 to Inadequate.
Only Safe and Well-led were inspected at this visit. Both were rated Inadequate, and the home was placed in special measures while the CQC monitors improvements.
Medicine training and storage
Staff had training before administering medicines, and medicines were stored safely and securely. Time-critical medicines were given according to instructions.
“Staff had training in medicines before they were able to administer medicines.” from the report
People reported feeling safe
The people inspectors spoke with said they were happy with their care and felt safe when staff supported them.
“People we spoke with told us they were happy with their care and support and that they felt safe when staff supported them.” from the report
Mental Capacity Act practice
Inspectors found that the provider was working within the Mental Capacity Act principles and that required legal authorisations were in place where needed.
“We found the provider was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Fire safety
seriousFire safety issues identified months earlier had not been fixed. Some fire doors did not close properly or closed too quickly, creating risks to people.
“We found a number of fire safety checks known in November 2022, continued to require action to make safe.” from the report
Infection control
seriousDuring a COVID-19 outbreak, masks were not always worn correctly, some people were not supported to isolate, and clinical waste was not managed safely.
“Effective measures to manage and limit the spread of infection was not sufficient.” from the report
Inaccurate care records
seriousCare plans and risk assessments sometimes conflicted or lacked important information. This meant staff might not have had the information needed to manage people's risks safely.
“We checked examples of people's care plans and found these were not always accurate or they held conflicting information.” from the report
Medicines given above recorded limits
seriousFor one person, inspectors found two occasions when the maximum number of as-required medicine doses had been exceeded. The records did not explain why.
“for 1 person we found 2 separate occasions where their dose had exceeded the maximum number of doses.” from the report
Weak management checks
seriousAudits and checks were completed but failed to identify serious problems. Incidents were not always reviewed or reported, and lessons were not consistently learned.
“The provider had systems to check and ensure the quality of service supported good outcomes for people. There were records of audits and checks completed but they failed to identify the issues we have reported on.” from the report
Staffing arrangements
needs fixingAt times, staff breaks and record writing happened together, leaving parts of the home without staff nearby. Not everyone had a call bell or could call out for help.
“This meant at times, parts of the home had no staff on hand to respond to people's calls for assistance.” from the report
- 01What has been done to repair and test every fire door, and when was this completed?
- 02How are you now managing infection outbreaks, including mask use, isolation and clinical waste?
- 03How do you make sure care plans and risk assessments are accurate, consistent and updated when people's needs change?
- 04How do you check that as-required medicines are given only within the prescribed limits and as a last resort?
- 05How will staffing arrangements ensure that all areas have staff available when people need help?
This was a focused inspection of Safe and Well-led prompted by concerns; the other key question ratings were not inspected and carried over from the previous inspection. This explanation was written from the published report of 19 May 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.
Every inspection of Meadow View
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- August 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2023InadequateSafe: InadequateWell-led: Inadequate
- October 2021Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 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.
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