CQC report explained · a residential care home
What the CQC found at The Meadows
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were generally protected from avoidable harm. Inspectors found improved staffing and training, clearer risk assessments, secure medicines storage and suitable infection control arrangements, although some medicines information and audits needed improvement.
- Effective?
- Requires improvement
- This key question was not assessed during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found a new management team, clearer accountability, regular audits and better communication with people and staff. The service was found to be consistently managed and well-led.
What inspectors found, January 2021
The Meadows rated Good; inspectors found clear improvements in safety and management, with some medicines records still needing attention.
This was an unannounced, focused inspection on 20 and 23 November 2020. Inspectors checked the areas linked to the previous problems, including staffing, medicines, risk management, infection control and management systems. They spoke with people, staff and other professionals and reviewed care records, medicines records, staff files, rotas and audits.
The home was rated Good overall and Good for Safe and Well-led. Inspectors found better staffing, training, risk assessments, medicines management and management oversight. People generally said they felt safe and liked the staff. Infection control arrangements were also found to be suitable.
There were still some areas to improve. Information for staff about some medicines taken when needed was not always complete, medicines audits had been delayed by a computer problem, and one-to-one support was not clearly shown on rotas. The home received a good-practice recommendation about medicines.
Improved staffing and training
Staff said staffing numbers, training and support had improved. Inspectors found safer recruitment and better staff skills for supporting people with complex needs.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 18.” from the report
Clearer risk management
Risks were being identified, assessed and reviewed more promptly. Care and positive support plans clearly told staff what actions were needed to keep people safe.
“At this inspection we found risks were being clearly identified, assessed and actions being taken to mitigate any risks.” from the report
Better management and communication
The new management team had introduced clearer checks and responsibilities. People and staff said communication had improved and their views were being listened to.
“At this inspection it was clear that staff and people felt communication had significantly improved.” from the report
People generally felt safe
Most people spoken with said they felt safe and could raise concerns with staff or managers. People also said they liked the staff.
“People told us they liked the staff who worked with them and felt safe.” from the report
Some medicines information was incomplete
needs fixingSome plans for medicines taken when needed did not contain all the information staff needed. Inspectors recommended reviewing these plans.
“Some of the plans in place to support the use of "when required" medicines did not always contain all the information to help staff support the person.” from the report
Medicines audits had been delayed
needs fixingRegular medicines audits had not been completed after the electronic medicines system was introduced. The home was working with the supplier on a technical problem.
“Regular medicines audits had not been completed since the recent introduction of the electronic medicine's administration record.” from the report
One-to-one support was not clear on rotas
needs fixingThe number of staff was based on people's assessed needs, but the rotas did not clearly show one-to-one support. Managers said shift leaders allocated this support during the day.
“The one to one support for individuals was still not clearly defined within the rota.” from the report
- 01How are medicines taken when needed described in each person's care plan, and how do you make sure staff have all the information they need?
- 02Has the electronic medicines system problem been fixed, and are regular medicines audits now being completed?
- 03How is one-to-one support allocated on each shift, and how can the family check that it has been provided?
- 04How are people's wishes about moving on, living arrangements and smaller group spaces being reviewed?
- 05What changes to the building and garden have been completed since the inspection, and which planned improvements remain delayed?
This was a focused inspection of Safe and Well-led, with infection control also checked; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 8 January 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, May 2020
Rated Requires Improvement; inspectors found kind and responsive care, but ongoing problems with staffing, medicines, risks and management.
This was an unannounced planned inspection because the previous rating was Requires Improvement. Inspectors spoke with people, staff, managers and health professionals. They observed people and checked medicines, care plans, risk assessments, recruitment records and audits.
The home was rated Good for Caring and Responsive. People were treated with dignity, their preferences were recorded, and staff supported activities, healthcare and contact with the community. People also had advocates and were involved in weekly meetings.
The home was rated Requires Improvement overall, as well as for Safe, Effective and Well-led. Inspectors found gaps in staffing and training, incomplete follow-up of medicine problems, an outdated risk assessment and delays with cleaning and refurbishment. The home remained in breach of Regulations 12, 17 and 18, despite an earlier action plan.
Safer recruitment
Recruitment had improved. Checks and references were completed before staff started work.
“Staff were only employed once all their checks and references were back.” from the report
Kind and respectful care
People said staff were kind and caring. Inspectors found that staff promoted dignity, privacy and respect.
“People confirmed staff were always respectful and ensured dignity and privacy was upheld.” from the report
Personalised support
Care plans described people's needs, preferences and communication requirements. Staff tried to match support to people's interests and wishes.
“People received care and support in a way that was responsive to their needs.” from the report
Some medicine improvements
Emergency medicines were available and in date. Storage and disposal arrangements had improved, and staff had received updated training.
“There had been some improvements to the management of rescue medicines.” from the report
Staffing and training gaps
seriousThe home did not always have enough staff with the right skills. Some shifts had fewer staff than the provider's preferred level, and only nine of 20 staff had completed the relevant behaviour training.
“Staffing rotas showed there were some gaps where staffing levels had not met the preferred levels as determined by the providers tool for assessing levels.” from the report
Medicine problems not fully followed up
seriousAudits found incorrect stock levels for two people's medicines, but the home had not recorded robust actions to investigate and resolve this.
“However, robust actions had not been completed or recorded in order to fully investigate the issues found.” from the report
Risk assessment not updated
seriousAfter an incident that could have put staff at risk of scalding, guidance for managing the risk was not clear and the risk assessment was still being updated.
“Lack of clear guidance for staff about how to manage significant risks is a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Building and cleanliness
needs fixingParts of the home were tired, shabby and needed deep cleaning and refurbishment. Inspectors also found dust on some kitchen sills.
“Not all areas of the home were as clean as they should be.” from the report
People affected by the mix of residents
needs fixingThe home was larger than recommended by best practice guidance. Inspectors said some people's behaviours significantly affected other people's quality of life, and not everyone was happy with who they lived with.
“Other people's behaviours impacted significantly on people's quality of life at times.” from the report
- 01How many support workers are planned for each shift, and what happens when staffing falls below the preferred level of eight?
- 02Which staff have completed training in managing expressive behaviours, epilepsy and emergency rescue medicines?
- 03What action has been taken to investigate and prevent the medicine stock discrepancies found by inspectors?
- 04Has the risk assessment linked to the scalding incident been updated, and how are staff now told to manage the risk?
- 05What refurbishment, deep cleaning and improvements to communal areas have been completed since the inspection?
This was an unannounced planned inspection covering all five key questions, with checks of care, medicines, records, staffing, the building and governance. This explanation was written from the published report of 6 May 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.
Every inspection of The Meadows
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- January 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 17 November 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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17 live-in carers within about an hour of Devon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.