CQC report explained · a residential care home
What the CQC found at Meadowside
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks were assessed, fire safety equipment and doors had been replaced, medicines were managed safely, and incidents were investigated.
- Effective?
- Good
- Care plans covered people's health needs, choices and preferences. Staff training had improved, and people were supported with food, drink, healthcare and activities.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well and used communication aids and Makaton to help people express themselves.
- Responsive?
- Good
- Care plans were updated when people returned to the home. People were involved in planning their stays and were supported to try activities and develop independence.
- Well-led?
- Good
- Inspectors found strong leadership, regular checks and an open culture. The manager and provider used feedback, audits and action plans to improve the service.
What inspectors found, April 2019
Meadowside was rated Good; inspectors found kind, safe and personalised care, with major improvements since the previous inspection.
The inspection took place on 1 and 4 March 2019. One inspector reviewed three care plans, medicines records, staff records, complaints and accident logs. They spoke with three people, three staff members, the manager and one relative.
The home provides occasional overnight respite for people with learning disabilities. It can support up to 10 people and provides respite support for 84 people in total. Six people were staying during the inspection, including one person on a longer-term placement.
Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. They found people were treated kindly, supported to make choices and develop independence, and helped to take part in local activities.
The previous inspection had found four breaches and rated the home Requires Improvement. Inspectors found these problems had been addressed. Fire safety, care planning, staff training, incident recording, medicines checks and quality monitoring had all improved.
Improved safety
The home had addressed earlier fire safety and risk-management problems. New fire systems and fire doors had been installed and checked.
“The service had invested heavily in fire safety equipment, implementing a new fire alarm and emergency lighting system and replacing all fire doors.” from the report
Personalised support
Care plans included people's preferences, communication needs and positive behaviour support. Staff updated plans when people's needs changed.
“People and their relatives/carers took an active role in developing their care and support plans and these were reviewed each time a person revisited the service to ensure information was up-to-date.” from the report
Kind and respectful care
People appeared relaxed and happy with staff. Staff knew their interests and respected their privacy, dignity and communication needs.
“People were treated with kindness and compassion. People appeared relaxed in the company of staff and they smiled and laughed together.” from the report
Independence and activities
People were encouraged to make drinks, help with meals, do laundry and try new activities. They were also supported to use local community facilities.
“People were encouraged to be as independent as possible, staff supported people to challenge themselves and to set goals.” from the report
Stronger management checks
The home had introduced regular checks of medicines, care plans, daily records and staff training. Shortfalls were added to an action plan.
“A series of daily, weekly and monthly checks were carried out by staff, the registered manager and provider to maintain the quality of care provided to people.” from the report
Staff vacancies
needs fixingSome staff said there were sometimes not enough staff, although they felt this had improved and agency support was available. The home was still advertising three vacancies.
“Staff told us that sometimes it felt like there were not enough staff, but they thought this had improved recently and were getting support from agency staff.” from the report
No lift at the time
minorPeople with limited mobility could not use the upstairs area at the time of the inspection. The home said a future refurbishment would include a lift and a specialist bathroom.
“At present there was not a lift so people with limited mobility could not go upstairs.” from the report
- 01How many staff vacancies are there now, and how do you make sure there are enough familiar and trained staff during each respite stay?
- 02How would you support my relative if they have limited mobility and need to use areas that are upstairs?
- 03How will you update my relative's care and positive behaviour support plan before each return visit?
- 04How will you support my relative to communicate choices, pain, illness or distress?
- 05What progress has been made with the planned lift and specialist bathroom?
This was a scheduled inspection covering the home, the care provided and all five CQC questions; inspectors reviewed three people's care plans and spoke with three people and one relative. This explanation was written from the published report of 4 April 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, March 2018
Meadowside was rated Requires Improvement; inspectors found progress in staffing, medicines and activities, but serious gaps in fire safety, risk management, training and records remained.
Inspectors visited the home without warning on 9 January 2018. They spoke with people using the service and staff, observed care and activities, and checked care plans, risk assessments, medicines records, staff files, rotas, training records and audits.
The home provides overnight respite for people with learning disabilities. It can accommodate up to 20 people, although the manager said no more than 12 people would be supported at one time. Six people were staying during the inspection, including two people on long-term placements.
Some improvements had been made since the September 2016 inspection. Staffing levels and medicines management had improved, and people were supported with meals, activities and healthcare. However, the provider had not completed its action plan and four legal breaches continued.
All five areas were rated Requires Improvement. Inspectors found that care was not consistently safe, effective, caring, responsive or well-led.
Medicines
Medicines were stored at a safe temperature, checked at shift changes and recorded when given. Staff followed the routines people used at home.
“People received their medicines safely and when they needed them.” from the report
Staffing
There were enough staff during the inspection, based on people's assessed support needs. Recruitment checks had been completed safely.
“Throughout the inspection there was enough staff to meet people's needs.” from the report
Meals and health
People had a choice of meals and received support with special diets and drink consistencies. Staff worked with healthcare professionals when needed.
“People were supported to eat and drink enough to maintain a balanced diet.” from the report
Activities and relationships
People were supported to go out, join activities and maintain relationships with friends and loved ones.
“People had been supported to buy presents for loved ones.” from the report
Respectful support
Staff generally treated people discreetly and with respect. People were supported to bring familiar belongings and, where possible, have the same bedroom when they stayed.
“Staff spoke to people in a discreet way.” from the report
Fire safety
seriousSeveral fire doors were missing smoke seals, emergency lighting was not working and the fire alarm system was old. Essential work had still not been completed more than 10 months after the fire risk assessment.
“The provider had not completed essential maintenance works to keep people safe in the event of a fire.” from the report
Risk assessments and incidents
seriousSome risk assessments gave unsafe or unclear advice, including advice about preventing slips. Behaviour incidents were not consistently reported or analysed, so triggers and patterns could be missed.
“The provider had failed to assess the risks to the health and safety of people and take action to mitigate the risks.” from the report
Staff training
seriousStaff had not received all the required training in learning disabilities, person-centred planning, positive behaviour support, epilepsy and emergency medicines. The manager also lacked a complete overview of staff training.
“The provider had failed to ensure staff received appropriate training and professional development to enable them to carry out their duties.” from the report
Lawful restrictions
seriousThe provider did not have a policy for DoLS applications for people staying for short periods, and applications had not been made when required.
“The provider failed to ensure constant supervision and any deprivation of liberty was lawful.” from the report
Care plans and monitoring
seriousCare plans did not always explain people's preferences or give staff enough detail about how to provide support. Formal quality and safety audits had not been established.
“The provider had failed to maintain accurate, complete and contemporaneous records in respect of the care and treatment provided.” from the report
Communication
needs fixingSome staff did not understand people's individual signs, and there was not always guidance explaining how each person communicated.
“There were occasions when people used sign language, staff did not always understand what people were trying to say.” from the report
- 01Have all the fire doors, emergency lighting and fire alarm issues identified in the March 2017 risk assessment now been completed?
- 02What current training and competency checks do staff have for epilepsy, emergency medicines, learning disabilities and positive behaviour support?
- 03How do you make sure each person's risk assessment gives safe, detailed instructions, especially for mobility and behaviour?
- 04How are DoLS applications made for people who may not be able to consent to a short respite stay?
- 05How have care plans been improved so they clearly record each person's choices, preferences and required support?
This was an unannounced comprehensive inspection covering all five key questions, the building and the care provided. This explanation was written from the published report of 1 March 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 Meadowside
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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