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.
What inspectors found, October 2023
The Meadows was rated Requires Improvement because inspectors found weaknesses in risk management, infection control and quality checks, although care was effective in several areas.
This was an unannounced inspection on 25 and 26 May 2023. Two inspectors and an expert by experience spoke with people, relatives, staff and professionals. They reviewed care, medicines, recruitment and management records.
The home was rated Requires Improvement overall. Safe and Well-led were both Requires Improvement. Effective remained Good. The report did not give separate ratings for Caring or Responsive.
Inspectors found that some risk assessments were not reviewed regularly or did not give staff enough guidance. Some staff wore painted or gel nails, which did not follow infection control guidance. Records about consent and mental capacity were also incomplete.
There were enough staff, medicines were managed safely, and people received support with food, drink and healthcare. The management team corrected several issues during the inspection, but the home's monitoring systems had not found them beforehand.
Enough staff
Inspectors found enough staff on duty and saw staff respond quickly to people. Recruitment checks were also in line with government guidance.
“There were enough staff on duty to meet people's needs. We observed staff around the building and saw they responded quickly to people.” from the report
Medicines
Medicines were administered by trained staff who had regular competency checks. Administration records showed medicines had been given as prescribed.
“We looked at medicine administration records (MARs) which had all been signed to indicate people had received their medicines as prescribed.” from the report
Food and healthcare
People were supported with food and drink, including modified or enriched diets where needed. Staff sought advice from health professionals when people's health or weight changed.
“People were supported to maintain their nutritional needs and referred to appropriate health professionals when needed” from the report
Positive staff culture
Staff and relatives were positive about the culture. Staff said managers listened, supported them and encouraged teamwork.
“The registered manager had developed a positive staff culture. Staff said they worked well as a team.” from the report
Risk assessments
seriousSome risk assessments were not reviewed regularly and did not give staff clear instructions. This included risks linked to falls, poor nutrition, skin damage and distressed behaviour.
“Some risk assessments had not been routinely reviewed and were not robust.” from the report
Bedrail safety
seriousTwo people's bedrails did not have covers and had gaps that created a risk of entrapment. The management team said this was corrected during the inspection.
“Two people's bedrails had no covers on them. There were gaps in the rails and a risk of entrapment.” from the report
Infection control
needs fixingInspectors saw at least five staff wearing nail varnish or gel nails. They were not always assured that the home was supporting people to minimise infection spread.
“We observed at least five staff members wearing nail varnish and/or gel nails.” from the report
Incomplete records and checks
seriousConsent and mental capacity records did not always show who had been involved in decisions. Quality checks had not identified these problems before the inspection.
“The systems for quality assurance and monitoring were not always effective and had not identified the shortfalls we encountered during the inspection.” from the report
As-needed medicines
needs fixingSome instructions for medicines used when people were anxious or distressed were too limited. They did not explain what staff should try before giving the medicine.
“PRN protocols were in place, but they lacked detailed personalised information for staff who administered medicines.” from the report
- 01How are risk assessments now reviewed, and how will you make sure staff have clear guidance for falls, skin damage, nutrition and distressed behaviour?
- 02What changes have been made to the bedrail checks, and how often are they now monitored?
- 03How do you check that staff follow the rules about nail varnish and gel nails?
- 04How are consent and mental capacity records checked to show who was involved in each decision?
- 05What action has been taken on the limited instructions for as-needed medicines used when people are anxious or distressed?
This was an unannounced planned inspection that rated Safe, Effective and Well-led; the report did not give separate ratings for Caring or Responsive. This explanation was written from the published report of 20 October 2023 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 2019
Rated Good overall, with Outstanding caring; inspectors found kind, personalised care and a few recording and planned-check issues.
Inspectors visited the home without warning on 10 and 11 January 2019. They spoke with people living there, relatives, staff and health and social care professionals. They observed care and checked care records, staff files, medicines, policies, audits and other records.
The home was rated Good for Safe, Effective, Responsive and Well-led. It was rated Outstanding for Caring. Inspectors found people were safe, staff were trained, medicines were managed safely and care plans reflected people's needs.
Inspectors found especially kind and respectful care. People were supported to make choices, maintain relationships, take part in activities and use the local community. A few checks needed better recording or updating, but the report did not identify any breaches of regulations.
Kind and dignified care
Inspectors saw staff treating people with warmth, respect and kindness. Staff knew people's preferences and protected their privacy.
“People were always treated in a kind, loving and dignified manner.” from the report
Personalised support
Care was tailored to people's histories, communication needs, health and interests. Staff supported people to regain skills and reach their potential.
“The care team responded well to changes in people's needs and also supported people to regain life skills and reach their full potential” from the report
Safe care
Safeguarding, risk assessments, staffing, recruitment and medicines systems were found to protect people from avoidable harm.
“Risks to people's health and welfare were assessed and well managed to reduce or eliminate the risk.” from the report
Meaningful activities
People took part in activities linked to their interests and past lives. The home also supported visits, outings and links with local children and community groups.
“Care staff were able to respond and 'go the extra mile' to address people's needs in relation to their preferred activities” from the report
Effective leadership
Managers were visible and knew people well. Audits, meetings and feedback were used to monitor the service.
“The programme of quality checks and audits ensured the quality and safety of the service was maintained and identified if any improvements were required.” from the report
Hot-water checks not recorded
minorThe maintenance team checked that water temperatures were safe, but these checks were not recorded. Ask to see how this is now documented.
“whilst the maintenance team was randomly checking temperatures were not above 43 degrees centigrade, the checks were not recorded.” from the report
Fire risk assessment due
minorA new fire risk assessment was due as the building moved into ongoing maintenance. Ask whether this was completed and whether any actions were identified.
“A fire risk assessment was due to be repeated now the building was 'being handed over' to the provider for ongoing maintenance.” from the report
Some refresher training due
minorA small number of staff were due refresher training in safeguarding, moving and handling, and fire safety. The report says this was already planned.
“a small number of staff were due to repeat their safeguarding, moving and handling and fire training but this was already planned.” from the report
- 01Have the hot-water temperature checks been recorded consistently since the inspection?
- 02Was the fire risk assessment repeated, and were any follow-up actions needed?
- 03Have all staff who were due safeguarding, moving and handling, and fire refresher training now completed it?
- 04How will you keep my relative's care plan updated if their needs or preferences change?
- 05What activities and community visits would be suitable for my relative's interests and abilities?
This was the first comprehensive inspection since registration and covered all five CQC questions; an additional 30 beds operated by a community health service were outside the home's registration and inspection remit. This explanation was written from the published report of 11 May 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 The Meadows
2 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- October 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- May 2019GoodSafe: GoodEffective: GoodWell-led: Good
- January 2018
Registered with the Care Quality Commission on 19 January 2018.
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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39 live-in carers within about an hour of South Gloucestershire
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 £1,280 a week. 32 can care for a couple. 11 years' experience on average.
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