CQC report explained · a nursing home
What the CQC found at Meadowbeck
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, and medicines were managed safely. However, oral care risks were not always assessed or recorded consistently.
- Effective?
- Requires improvement
- Care records did not always show that personal care had been provided, and staff did not consistently support people with brushing their teeth. Some staff supporting people at the end of life also needed further training.
- Caring?
- Good
- This area was not inspected during this focused visit. The report says the previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The report says the previous rating was used in calculating the overall rating.
- Well-led?
- Good
- The home had a positive culture, staff felt supported, and the manager used audits and feedback to identify improvements. Staff, relatives and professionals spoke positively about communication and management.
What inspectors found, September 2020
Rated Good overall; inspectors found people were safe and the home was well-led, but effective care records and oral health support needed improvement.
This was a focused inspection following concerns about oral health, personal care and weight loss during the COVID-19 pandemic. Inspectors visited on 30 July and 5 August 2020. They spoke with people, relatives and staff, and checked care records, medicines, staff files and management records.
The home was rated Good for Safe and Well-led. People were protected from abuse, medicines were managed safely, the home was clean and infection control measures were in place. Staff knew people well, and inspectors found a positive culture with good communication with relatives and other professionals.
Effective was rated Requires Improvement. Oral health assessments and care plans were not complete for everyone. Records of bathing and showering were not always clear, and staff had not consistently supported people to brush their teeth. The manager introduced new paperwork during the inspection and said further training and reviews would take place.
People felt safe
People and relatives said they felt safe. Staff had safeguarding training and knew how to raise concerns.
“People and their relatives told us they felt safe” from the report
Nutrition was monitored
People were offered choices of food and drinks. Weight was monitored, and professional advice was sought when people lost weight.
“Peoples nutrition and hydration needs were effectively met.” from the report
Positive staff culture
Staff knew people well and described feeling supported. Inspectors found a calm atmosphere and positive relationships.
“There was a positive culture in the service.” from the report
Good communication
Relatives were kept informed, including during visitor restrictions in the pandemic. The home also worked well with health professionals.
“Communication has been great, we regularly get text and emails to keep us up to date.” from the report
Oral health records
needs fixingOral health assessments, care plans and risk records were not completed for every resident. The provider was asked to consider current guidance and improve its practice.
“Oral health care assessments, care plans and risks were not completed for every resident.” from the report
Personal care records
needs fixingDuring the pandemic, records did not always show whether people had received a bath or shower, or what happened when this was not possible. The paperwork was changed during the inspection.
“records did not always identify where people had been supported to have a bath or shower or what action was taken when this was not possible.” from the report
Tooth-brushing support
needs fixingStaff had not consistently supported people to brush their teeth, and there was not always action when people declined support. New paperwork was introduced during the inspection.
“Staff had not consistently supported people to brush their teeth, and no action was taken where residents declined support.” from the report
Further staff training
needs fixingStaff supporting people at the end of life did not always have the right training. The manager said training would be reviewed.
“Care staff supporting people at the end of life had not always had appropriate training for this.” from the report
- 01What has changed since the inspection to make sure every resident has a completed oral health assessment, care plan and risk assessment?
- 02How do you now check that bathing and showering are provided and recorded for each resident?
- 03What training have staff received on oral health care and supporting people at the end of life?
- 04How do you check that staff respond appropriately when someone declines help with brushing their teeth?
- 05How have you reviewed staffing levels since staff said the dependency tool did not always reflect people's needs?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used. This explanation was written from the published report of 16 September 2020 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 2018
Rated Good; inspectors found safe, kind and responsive care, with improvements since the previous inspection but some staff records and support arrangements still being checked.
Inspectors visited the home on 29 August 2018, spoke with people, relatives, staff and visiting professionals, observed care and meals, and checked care, staff and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People generally said they felt safe, staff were kind, medicines were managed safely, and care plans reflected people's needs.
The home had improved since the June 2017 inspection. The previous breach about respecting people's preferences and care choices had been met. Staffing arrangements and quality monitoring had also improved.
Inspectors still found some areas needing attention. These included gaps in some interview records, supervision meetings that were not all up to date, and one occasion when a person was not offered a choice of meal.
Safe staffing
Inspectors found sufficient staff on duty and saw that rotas showed consistent staffing levels. People generally said help came quickly.
“We saw that there were sufficient staff on duty and the rotas confirmed that the numbers remained consistent.” from the report
Safe medicines
Medicines were stored securely, records were complete and staff had their medicines skills checked regularly.
“Medicine administration records (MAR's) had been completed fully to show the treatment people had received.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff protecting privacy, asking for consent and supporting independence.
“People's privacy and dignity was respected. Care workers were careful to close doors and draw curtains when providing personal care in a person's bedroom.” from the report
Improved management
The report says the home had improved since the previous inspection. The new manager had an action plan and staff found the managers approachable.
“We could see that improvements to the service had been made which benefited people receiving a service and staff.” from the report
Recruitment records
needs fixingSome staff interview records had gaps. The manager had identified this and was reviewing recruitment and training files.
“Staff were recruited safely although we identified gaps in interview records for some people.” from the report
Staff supervision
needs fixingSupervision meetings were not all up to date, and some staff said there could be a long gap between meetings.
“Supervisions were not all up to date. Staff told us they had supervisions but sometimes there was a long gap before the next one.” from the report
Choice at mealtimes
minorMost people were offered choices, but inspectors saw one person being given a meal without being offered a choice. The manager said this would be addressed.
“In one case a person was not offered a choice and instead staff made the decision about what they would like to eat.” from the report
Dementia-friendly environment
minorImprovements had started in the dementia unit, but more work was still planned.
“More improvements were planned but progress in making the unit dementia friendly was underway.” from the report
Falls prevention guidance
needs fixingA falls risk assessment explained what staff should do after a fall, but did not include preventative measures staff could take.
“There was however, no detail about preventative measures staff could take to prevent falls.” from the report
- 01How have you completed the review of staff recruitment and training files, and are all interview records now complete?
- 02How often will staff receive supervision, and how do you make sure there are no long gaps?
- 03How do you make sure every person is offered a real choice at mealtimes?
- 04What further dementia-friendly changes have been made since this inspection?
- 05What preventative steps do you now include in people's falls risk assessments?
This was a planned inspection covering all five rating areas, including the premises, care, staffing, records and management; the report also refers to the previous inspection on 20 and 21 June 2017. This explanation was written from the published report of 6 November 2018 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 Meadowbeck
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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