CQC report explained · a residential care home
What the CQC found at Meadowview Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2019
Meadowview Care Home was rated Requires Improvement; care was kind and mostly effective, but fire safety and management oversight needed improvement.
This was an unannounced inspection on 7 and 8 February 2019. Inspectors spoke with people living in the home, relatives, staff and health professionals. They also observed care and checked care records, medicines, recruitment files, training records, complaints and management audits.
The home was rated Good for Effective, Caring and Responsive. Inspectors found kind and respectful staff, person-centred care plans, good support for people living with dementia and appropriate training. People told inspectors they felt safe and that staff met their needs.
The home was rated Requires Improvement for Safe and Well-led. Fire safety work had been delayed and staff were not familiar with the evacuation plan. There was no registered manager, and the provider needed stronger checks to identify and prevent problems.
There was one breach of the legal regulations concerning safe care and treatment. The report also made recommendations about recording decisions for people who lacked capacity and considering equality and diversity in care planning. Some fire safety work and other improvements were completed before the report was published.
Kind and respectful staff
People, relatives and professionals gave positive feedback about staff. Inspectors observed calm, gentle and respectful interactions that protected people's dignity.
“Staff interactions were kind, caring and respectful. People's dignity and privacy was respected.” from the report
Dementia-friendly environment
The home had clear signs, coloured bedroom doors, memory boxes and adaptations to support safety and independence for people living with dementia.
“The home environment was tailored to support people's safety, independence and well-being.” from the report
Person-centred care records
Care plans included people's likes, dislikes, preferred routines, communication needs and life histories. Plans were reviewed monthly.
“The care files were person centred and recorded people's preferred routines and preferences around different aspects of their care.” from the report
Safe medicines management
Staff were trained and assessed as competent to give medicines. Medicines were stored securely, temperatures were checked daily and monthly audits took place.
“We looked at the systems in place for managing medicines within the home and found that the systems were safe.” from the report
Delayed fire safety work
seriousThe home did not respond promptly to fire risk assessment recommendations. Fire drills were not taking place and staff did not know the evacuation plan, although the report says the identified work was completed before publication.
“This oversight and delay in carrying out essential work was a breach of Regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak management oversight
needs fixingThere was no registered manager and no external provider audits. Inspectors said stronger quality assurance might have identified the fire safety problem sooner.
“There were no external audits in place from the provider to support the manager.” from the report
Some dietary communication problems
needs fixingAt lunchtime, people were not offered enough choice and one person's diabetic dessert requirement was missed. The manager introduced extra checks and whiteboards after inspectors raised this.
“The lunch time experience needed to be more person centred.” from the report
Limited activities for some people
minorSome people and a relative said there was little to do and that people could feel bored. A new activities coordinator, activities board and weekly plan were being introduced.
“There's not a lot to do to be honest but it's okay and they do have movie afternoons like they are today” from the report
Incomplete decision records
needs fixingRecords did not always explain how larger decisions were reached for people who lacked capacity, who was consulted or what factors were considered.
“Records for larger and one-off decisions did not always show how the decision was reached, the reasons for reaching the decision, who was consulted and what factors were considered.” from the report
- 01What evidence can you show that the fire doors and fire exit signs were repaired, and how often are fire drills now carried out?
- 02How do you check that all staff understand each person's fire evacuation plan?
- 03Who is currently responsible for managing the home, and when will the registered manager application be completed?
- 04What external checks now review the quality and safety of care?
- 05How do you make sure people's dietary choices and special diets are correctly passed between the kitchen and care staff?
This was an unannounced comprehensive inspection covering all five key questions, and the ratings for all five were given in the report. This explanation was written from the published report of 29 March 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, April 2017
Rated Good; inspectors found safe, kind and responsive care, with only minor improvements needed around medicines records and end-of-life wishes.
This was an unannounced inspection on 6 and 9 March 2017. Inspectors spoke with people living at the home and staff. They observed care, checked care and medicines records, and reviewed recruitment, training, meetings and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found safe medicines procedures, suitable staffing, a clean environment, good staff training and kind interactions. People had choices about food and activities, and care plans were personalised and regularly reviewed.
The last inspection in September 2015 found that medicines were not always administered safely. The home sent an action plan, and inspectors found the required improvements had been made at this inspection. They noted that end-of-life wishes in the care plans were limited, and one controlled drugs record had been signed by only one member of staff on one occasion.
Medicines improved
Inspectors found that the medicines problems identified at the previous inspection had been addressed. Records were complete and medicines were stored and administered safely.
“We looked at ten medicines administration records (MARs) and found they had been completed accurately.” from the report
Kind care
People said staff were kind, and inspectors saw good, respectful interactions. Care plans recorded people's likes, dislikes, choices and preferred routines.
“We observed there were good interactions between staff and people who used the service.” from the report
Personalised support
Care plans explained the support each person needed and were reviewed regularly. Activities were based on people's interests and included one-to-one options.
“Plans of care were personalised to each person and recorded their likes and dislikes, choices, preferred routines, activities and hobbies.” from the report
Clean and maintained home
The home was clean, tidy and homely. Equipment and safety systems, including fire arrangements, were checked and maintained.
“During the tour of the building we noted everywhere was clean, tidy, well decorated and there were no malodours.” from the report
Supportive management
People and staff said managers were approachable. The home used audits, meetings and feedback to monitor the quality of care.
“People who used the service and staff thought management were approachable and supportive.” from the report
End-of-life wishes were limited
minorThe care plans inspectors reviewed contained little information about people's end-of-life wishes. Inspectors said this should be developed further.
“However, on the care plans we looked at people's end of life wishes were minimal and it would be good practice to develop this further.” from the report
One controlled medicines record had one signature
minorOn one occasion, only one member of staff signed the controlled drugs register. Inspectors found no error, but said a second person should witness the administration as best practice.
“We did see that on one occasion that only one member of staff had signed the controlled drugs register although we could see no error had occurred.” from the report
- 01How do you record and review each person's end-of-life wishes?
- 02What checks are now in place to ensure two staff members sign or witness controlled medicines when required?
- 03How are families involved in best-interest decisions and mental capacity assessments?
- 04How do you make sure activities reflect each person's interests, abilities and choices?
- 05How are complaints and feedback used to make changes to the care provided?
This was an unannounced inspection covering the overall service and all five CQC questions, including care, records, medicines, staffing and management systems. This explanation was written from the published report of 13 April 2017 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 Meadowview Care Home
3 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- March 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 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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