CQC report explained · a residential care home
What the CQC found at The Mead
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risk assessments, safeguarding systems, medicines records, staffing arrangements and infection control measures were found to be effective.
- Effective?
- Good
- Staff had training, supervision and support. People were helped to develop skills, prepare food, access health services and make their own decisions.
- Caring?
- Requires improvement
- This key question was not covered by this focused inspection. The report says ratings from the previous comprehensive inspection for areas not looked at were used in calculating the overall rating.
- Responsive?
- Good
- People had detailed, personalised support plans with goals and regular reviews. They were supported with communication, activities, relationships and complaints.
- Well-led?
- Good
- Inspectors found consistent leadership and effective checks on care records, medicines, staff records and quality surveys. The provider used these checks to plan and review improvements.
What inspectors found, July 2021
The Mead is rated Good; inspectors found people were safe, supported to become more independent and cared for by a well-run service.
This was a focused inspection on 16 and 17 June 2021. One inspector spoke with three people living at the home, the manager and two support workers. They also checked care records, medicines records, staff files and management records.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Inspectors found people felt safe, medicines were managed safely, staff had suitable training and support plans gave clear information about people's needs.
The home had improved since its previous inspection, which was rated Requires Improvement in March 2018. The provider had completed an action plan, and inspectors found it was no longer in breach of the regulations identified at that inspection.
This was not a full inspection of every area of care. The inspection checked the areas linked to the previous legal requirements, while other ratings from the earlier comprehensive inspection were carried forward.
Safety planning
Risk assessments covered issues such as self-neglect, self-harm and staying safe when socialising. They were updated when people's needs changed.
“Risk assessments and management plans had been reviewed and updated as people's needs changed.” from the report
Support for independence
People were supported to set goals, build skills and work towards living in a more independent setting.
“People were supported to set goals to help them develop their skills and become more independent.” from the report
Medicines
Medicines records were complete, and there were clear instructions for medicines taken only when needed. Some people were supported to manage their own medicines where safe.
“Medicines administration records had been fully completed.” from the report
Personalised support
Support plans gave staff detailed information about each person's needs, preferences and goals. People met regularly with their keyworker to review them.
“People had been supported to develop clear support plans, which set out how their individual needs should be met.” from the report
Quality checks
The provider checked support plans, medicines records, staff records and people's views. Actions from these checks were reviewed to make sure they were completed.
“The provider had effective quality assurance systems in place.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and review my relative's risks, including any risk of self-neglect or self-harm?
- 02What independence goals would you set with my relative, and how would you measure progress towards them?
- 03Would my relative manage their own medicines, and how would you check that this remained safe?
- 04How would you support my relative to access doctors, mental health services and other health professionals?
- 05How would you keep my relative in contact with family and involved in activities if restrictions were introduced again?
This was a focused inspection of Safe, Effective, Responsive and Well-led; the report says ratings for key questions not looked at were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 22 July 2021 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
Rated Requires Improvement; inspectors found kind staff and some safe systems, but serious gaps in risk management, safeguarding, training and leadership.
The inspection took place on 24, 25 and 31 January 2018. One inspector spoke with two people, three staff and managers, and reviewed care records, training, medicines, rotas, policies and quality checks. Five people were living in the home, which can accommodate six.
The home was rated Requires Improvement in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were generally treated respectfully and said they felt safe, but important systems did not consistently protect people or meet their complex mental health needs.
There was no registered manager in post, and staff reported five manager changes in 12 months. Inspectors found breaches involving person-centred care, safe care and treatment, safeguarding, good governance and staffing. The provider had improvement plans, but progress was not being properly checked.
Respectful support
Inspectors saw staff respond sensitively when people were distressed or asked for help. Staff knew people's preferences and how to approach them.
“The staff response to people was respectful and sensitive to their requests.” from the report
Privacy
People had lockable bedrooms and were given keys. Staff knocked and waited before entering bedrooms.
“A member of staff explained that to ensure people's privacy they knocked on bedroom doors and waited for an invitation to enter.” from the report
Medicine records
Records showed staff signed when medicines were given. People's ability to self-administer medicines was assessed and reviewed.
“Medication Administration Records (MAR) were signed by staff when medicines were administered and indicated they had administered these medicines according to the prescribed directions.” from the report
Staff teamwork
Staff said the team was stable and worked well together, despite changes in management. New improvement plans and regular staff meetings were being introduced.
“Another member of staff said the team "worked well together" and there was a "common purpose" between staff.” from the report
Risk management
seriousPlans did not clearly explain how staff should respond to risks including self-harm and deteriorating mental health. Staff were not always aware of agreed actions.
“There were no clear guidelines or strategies for staff to follow to consistently manage incidents of self-harm.” from the report
Safeguarding
seriousStaff did not report allegations of abuse to the local authority safeguarding team when a person asked them not to. This meant opportunities for support and protection were missed.
“Staff had failed to report allegations of abuse when asked not to reported abuse.” from the report
Staff training
seriousSeveral staff had not received recent mental health training. Training in eating disorders and drug and alcohol addiction was not provided, despite people's complex needs.
“Specific eating disorder training, addiction to drugs and alcohol training was not provided to staff although people were accommodated with complex mental health care needs.” from the report
Care plans and activities
needs fixingSupport plans did not cover all identified needs. Some people were not supported to access meaningful activities, community facilities or independent living skills.
“Support plans were not in place on how people were to access community facilities, participate in meaningful activities and on the support needed with independent living skills.” from the report
Management stability
needs fixingThere was no registered manager, and staff reported five manager changes in one year. Quality systems had not ensured that known problems were put right.
“A member of staff told us there had been five changes of managers in 12 months.” from the report
PRN medicines
needs fixingThe home had not followed its own policy by creating plans for medicines taken when needed. Inspectors recommended that this policy be reviewed and implemented.
“We recommend that the provider reviews the policy for the use of PRN medication and to ensure that it is implemented.” from the report
- 01What has changed in the risk plans for self-harm, deteriorating mental health, addiction and poor nutrition?
- 02Have all staff completed up-to-date mental health training, including training about eating disorders and drug and alcohol addiction?
- 03Is a registered manager now in post, and how will you prevent further disruption from management changes?
- 04How are you ensuring safeguarding concerns are reported correctly, even when a person asks staff not to report them?
- 05How are people now supported to access meaningful activities, community facilities and independent living skills?
This was a comprehensive inspection covering all five CQC questions, with the overall rating and each question rating assessed during the visit. This explanation was written from the published report of 22 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 The Mead
3 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 1 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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