CQC report explained · a nursing home
What the CQC found at Meadows House Residential and Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Risks, medicines, infection control, recruitment and learning from incidents were managed safely, although night staffing on the nursing unit had been under review and was increased after the inspection.
- Effective?
- Good
- People's health, nutrition and consent were supported well. Staff received training, but some staff were not always able to interact creatively with people living with advanced dementia.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in choices about their care and were supported to remain as independent as possible.
- Responsive?
- Requires improvement
- Activities and stimulation were not always suited to people's advanced dementia needs. Some care plans did not record enough appropriate ways for staff to engage and support people.
- Well-led?
- Good
- The home had visible and approachable leadership, regular checks and systems for learning and improvement. Inspectors recommended reviewing how people's experiences and feedback were gathered.
What inspectors found, September 2019
Rated Good overall, but inspectors found the home was not always responsive to people with advanced dementia.
Inspectors visited unannounced on 29 and 30 August 2019. They spoke with people, relatives, staff and visiting professionals. They observed care and reviewed care plans, recruitment and training records, audits and other records.
The home was rated Good for being safe, effective, caring and well-led. Inspectors found people were protected from abuse, medicines were managed safely, staff were trained and kind, and people's health, nutrition, privacy and dignity were supported.
Responsive care was rated Requires Improvement. People with advanced dementia did not always receive suitable stimulation or creative support. Some care plans did not explain enough different ways for staff to engage and support people.
The overall Good rating means the service met the required standard in most areas, but improvements were needed. The responsive rating had fallen from Good at the previous inspection, published in January 2019.
People felt safe
People and relatives said they felt safe. Staff understood safeguarding and risk management procedures.
“People and their relatives told us they felt safe from harm, neglect or discrimination.” from the report
Safe medicines and risk management
Medicines were administered and stored safely. Risks such as falls, nutrition and moving and positioning were assessed and reviewed.
“Medicines were managed, administered and stored safely.” from the report
Kind and respectful staff
Staff knew people well and supported their dignity, privacy, choices and independence.
“We observed staff knew people well and interacted with them with warmth.” from the report
Good food and health support
People's nutritional needs were assessed and supported, including modified diets. Staff arranged timely contact with health professionals when needed.
“Where people needed modified diets to reduce the risk of choking, they received the correct diet that met their needs.” from the report
Strong management oversight
The management team was visible and approachable. Audits, meetings and improvement plans were used to monitor quality and safety.
“There was a system to monitor the quality and safety of the service.” from the report
Not enough meaningful dementia activity
needs fixingPeople with advanced dementia sometimes spent long periods without meaningful stimulation. Staff did not always use available equipment or activities in ways suited to each person's dementia needs.
“There were long periods on the units where people with advanced dementia were sitting in their rooms, or in communal areas without meaningful activity.” from the report
Dementia support and care plans
needs fixingSome staff were not confident in engaging people creatively. Two care plans did not include enough different ways to support people whose behaviour might require a response.
“Care plans for two people with dementia where their behaviour may require a response did not always include different appropriate ways for staff to engage and support them.” from the report
Feedback may not capture everyone's views
minorInspectors were unsure whether surveys properly captured the views of people who could not complete them or may not have understood the questions. They recommended reviewing the feedback process.
“We recommend the provider review its systems for gathering feedback and consults best practice guidance to consider how best to capture people's voice and experiences of their care.” from the report
- 01What changes have been made to activities and daily stimulation for people with advanced dementia since the inspection?
- 02What dementia training do staff now receive, especially staff supporting behaviour that may require a response?
- 03How are individual care plans kept up to date with different ways to engage and support people with dementia?
- 04How do you gather the views of people who cannot complete surveys or communicate their views in the usual way?
- 05What are the current night staffing levels on the nursing unit, and how do they meet the needs of people who require two staff to reposition them?
This was an unannounced planned inspection covering all five key questions and both the premises and care provided; the previous rating was Good, published in January 2019. This explanation was written from the published report of 19 September 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.
What inspectors found, January 2019
Meadows House Residential and Nursing Home was rated Good; inspectors found safe care and effective management, with some records and premises checks needing closer attention.
Inspectors made an unannounced focused visit on 11 and 12 December 2018. They were responding to concerns about falls and the safety of the building. They reviewed records, medicines, staff files, maintenance checks, audits and meeting notes. They also observed care and spoke with relatives and staff.
The home was rated Good for Safe and Well-led. Inspectors found that falls, medicines, staffing, safeguarding, infection control and emergencies were generally managed safely. They also found that managers investigated incidents, shared learning and used audits and improvement plans.
Some staff did not always complete new electronic risk assessments accurately. Information about equipment was not always included in care plans. Window restrictors were being reassessed after a person left through a ground-floor window, and some premises action plans were not routinely shared with the provider.
Falls were investigated
Inspectors found that falls were assessed and followed up. Staff used checklists and care guidance to reduce the chance of further falls.
“A falls checklist was completed following a fall to ensure all possible actions to reduce risk had been considered.” from the report
Medicines were managed safely
Inspectors found no concerns when checking medicines on two units. Staff had training and competency checks.
“Staff who administered medicines received appropriate training and a competency check to ensure they understood how to administer medicines safely.” from the report
Enough staff were available
Staffing was assessed against people's needs. Inspectors observed enough staff to support people, including at mealtimes.
“There were enough staff to meet people's needs.” from the report
Management systems were active
The home used regular audits, meetings and an improvement plan to identify and track issues.
“A range of regular monthly audits were completed to monitor the quality of the service.” from the report
Risk records were not always accurate
needs fixingSome staff did not consistently record previous falls correctly in the new electronic system. Equipment used to reduce risk was not always added to care plans.
“However, we found staff were not always consistently completing the risk assessment template accurately to indicate any previous falls.” from the report
Window safety needed follow-up
needs fixingA person had left through a ground-floor window and external gate. The home took immediate action, but the risk assessment for the window restrictors was still being reviewed.
“The provider was reviewing the risk assessment in relation to the use of the window restrictors with the landlord's premises contractor.” from the report
Premises information was not always shared
needs fixingAction plans from the premises contractor were not always routinely passed to the provider. This included an action plan about legionella.
“We found action plans in relation to the premises were not always routinely shared with the provider.” from the report
- 01How do you now check that staff complete electronic falls risk assessments accurately?
- 02What refresher falls training have staff completed, and how do you check that it has improved practice?
- 03What checks are now made on window restrictors, and how would you respond if one failed?
- 04How are action plans from the premises contractor, including legionella work, shared with the home and followed up?
- 05Can you explain how equipment such as crash mats is recorded in each person's care plan?
This was an unannounced focused inspection of Safe and Well-led only; the other three questions were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 23 January 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 Meadows House Residential and Nursing Home
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Meadows House Residential and Nursing Home →
- January 2019Goodstayed GoodSafe: GoodWell-led: Good
Read what inspectors found at Meadows House Residential and Nursing Home →
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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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