20 November 2020
During an inspection looking at part of the service
The Meadows is a residential care home providing personal care and support care to 10 people who have a learning disability and or mental health conditions. The service can support up to 14 people. The Meadows accommodates people in one adapted building. Accommodation is set over two floors with a lift to access the first floor. Communal space is on the ground floor. The home is set back off the road with easy access to the local village.
People’s experience of using this service and what we found
People said they enjoyed living at The Meadows and felt safe. One person said, “I feel safe here as the staff are approachable even the agency staff, feels like a family even more so since the lockdowns.” Another said, “The staff here are a lovely team, some residents say they hate living here but they don’t, they just like to moan.” Two people said they would like to move on. One person told us “I want to move on to somewhere else as I have been here long enough, it’s not that I am unsafe, but I would like to live in Taunton.” One person said they were unhappy with the restrictions placed on them and would like to move. They were being supported with an independent advocate and restrictions were part of their agreed plan and Deprivation of Liberty safeguard process.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service this practice. Some people had previously lived in more secure settings and through careful person-centred planning were being enabling to lead less restrictive lives.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they are working towards meeting the underpinning principles of Right support, right care, right culture. Although the service is larger than recommended, the use of positive support plans and individualised activities meant people were enabled to follow their interests’ hobbies and passions as far as possible. This had been curtailed by the pandemic and lockdown restrictions. Future planning was taking place to look at development of move on flats on site and developing more communal space so people could choose to be in smaller groups. In addition, people’s needs were being reviewed and two people had moved on to other settings as a result of this. Compatibility of people living together was being reviewed as was the skill mix of staff supporting them. Staff training had been enhanced since the last inspection to enable staff to consider a more person-centred approach for each individual living at The Meadows. Investment in enhancing the environment was ongoing and people were being enabled to influence choice of decoration and how they wished to develop their garden space.
Since the last inspection we found medicines were being managed safely. Risks were being clearly identified, assessed and monitored in a more timely way.
Staff reported there had been a lot more training support and guidance available to them. The team felt positive about the new management team and the direction they were working towards to enable people to live fulfilling lives. Most staff said there had been a definite improvement in staff numbers on shift, in skills and in staff morale.
Work had commenced on improving the environment. For example the entrance hall had been refurbished and people who live at the service had chosen a calming Forrest décor. Some of this work had unfortunately been delayed due to the pandemic and lockdown, but it was clear investment and plans to improve the building and grounds were taking place.
We made one good practice recommendation in respect of medicines.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (report published 7 May 2020)
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned focussed inspection based on the previous rating. We looked at the key areas where breaches had been identified.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We carried out an unannounced comprehensive inspection of this service on 11 March 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Meadows on our website at www.cqc.org.uk.