Meadowview Care Home

We identified 2 breaches of the legal regulations under this key question: relating to safe care and treatment, and governance. Family members consistently felt informed about changes in their relatives’ needs and expressed confidence that concerns were promptly addressed. Staff demonstrated an understanding of accident reporting and protocols, but lessons learned from incidents were not effectively shared, and some reviews were delayed. The admissions process was generally thorough, but short notice and inconsistent communication with staff affected preparation. Fire safety posed significant risks, with damaged fire doors, obstructed fire exits, and unresolved hazards, despite previous assessments identifying issues. The environment had additional safety concerns, such as damaged flooring and excessive wiring, which sometimes complicated care delivery. Infection prevention and control (IPC) measures were inconsistent, with malodorous rooms, damaged sealant, and gaps in cleaning schedules. The management team were informed about these concerns throughout our visit, and action was taken to escalate and schedule dates for work to commence. Staff were well-trained in safeguarding and familiar with policies. Medication management had notable gaps, including missed doses, insufficient guidance for ‘when required’ medications, and incomplete records for thickened fluids. Audits failed to address medication discrepancies or identify errors. There were enough staff to meet people’s needs, although some staff raised concerns about staffing levels of an evening. Recruitment practices were not always safe, with gaps in employment checks and incomplete inductions for agency staff. Family members and external professionals generally praised the staff’s competence and caring approach, but there were systemic issues in risk management and quality assurance.

Family members felt involved in their relatives' care, participating in reviews and best interest decisions. Staff updated care plans monthly, but plans sometimes lacked details, such as guidance for non-verbal communication or managing specific health conditions. Pre-admission assessments included families and professionals, ensuring thorough evaluations. However, inconsistencies in dietary information and limited specialised training for conditions like diabetes highlighted gaps in care. Staff worked well as a team, with daily handovers and meetings supporting communication. Multidisciplinary team (MDT) meetings effectively engaged external professionals, allowing for regular reviews of people’s care needs and the sharing of necessary information. People were encouraged to stay active and maintain healthy lifestyles through activities and balanced diets. Families were reassured by staff’s quick responses to health concerns, but some care interventions, like repositioning, were not always completed on time. Staff consistently sought consent and understood the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS).

People and their families described the care they received as kind, compassionate, and respectful, with staff creating a welcoming environment for family members who visited. Family members and partner agencies praised the team for their attentiveness. Observations showed positive interactions, with staff demonstrating an understanding of people’s individual preferences, cultural needs, and personal histories. People were encouraged to make choices about their daily routines, meals, and activities. A daily activities timetable included group events like bingo and dancing, as well as one-to-one sessions for those unable or unwilling to participate in groups. Families appreciated prompt updates from staff about their relatives' needs, and mealtime support was provided for those who required it. While some staff felt valued, others noted challenges such as limited break times. The provider maintained a stable team with minimal vacancies, addressing absences using consistent agency staff who were already familiar with people living at the home. Staff policies and practices supported fairness and promoted high-quality care.

People and their families reported that care was personalised, with staff supporting individual preferences in activities, communication, and living spaces. Changing needs were monitored, with timely referrals to specialists such as Speech and Language Therapy (SALT) and mobility experts. Collaboration with external agencies and regular multidisciplinary meetings helped ensure coordinated care. Information about activities and updates were shared through noticeboards, newsletters, and an online application, which enabled families to send updates and photos to their relatives. Families felt confident raising concerns, but the provider lacked proper documentation of complaints, and some issues were not formally addressed. Care plans were reviewed monthly, but for individuals lacking capacity, it was not always clear that family members were involved in the review process. While healthcare access was valued, discussions about future and end-of-life care were inconsistent, and staff had limited training in this area. However, families and people praised the care provided and appreciated the welcoming and supportive environment.

Staff reported low morale, feeling unsupported and not listened to by management. Many were uncomfortable raising concerns and felt their feedback was not valued. While the provider’s vision emphasised compassion and integrity, these values were not consistently reflected, as audits and checks often missed key issues like care plan inaccuracies and unresolved safety concerns. Governance systems were not always effective or robust in monitoring the safety of the service and identifying areas for improvement. Opportunities to raise concerns existed, but staff were hesitant to use them, stating there was little action on feedback. Ongoing issues like damaged flooring, fire doors, and laundry problems remained unresolved despite being raised in meetings. Collaboration with health professionals and community engagement were strong, with external partners praising the service's coordination. However, some staff noted inconsistent support after incidents and a lack of reasonable adjustments for those who needed them. While some staff felt valued, others disagreed, highlighting an overall lack of a positive workplace culture.