This comprehensive inspection took place on 28 March 2017 and was unannounced. We last inspected Maudes Meadow in December 2015. At that inspection we found breaches of Regulation 12 Safe care and treatment and of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that the provider had complied with the requirement notices in relation to those breaches.

Maudes Meadow is a residential care home that can accommodate up to 28 older people at the time of this inspection there were 14 people living at the home. The property is a two-storey building and accommodation is provided over two floors the upper being accessed by a passenger lift. There are two separate communal and dining areas on the ground floor and one is designated for people who are living with dementia. It is close to the town centre of Kendal.

There was a registered manager in post at the time of the inspection who had been appointed after the last inspection. A registered manager is a person who has registered with the (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were sufficient numbers of suitably qualified staff to meet people’s needs and promote people’s safety.

Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities and we could see records of the actions taken by the home to protect people.

When employing fit and proper persons the recruitment procedures of the provider had not always been followed. We saw for one person recently employed that one of the checks the provider usually completed had not been done in line with the company’s procedures.

The storage and records for medications had improved since the last inspection in December 2015. We saw medicines were being administered and recorded appropriately and were being kept safely. However two people’s medicines had not been reordered in a timely manner.

We have made a recommendation that systems in place were reviewed for the management of reordering medications.

People’s rights were protected. The staff team were knowledgeable about their responsibilities under the Mental Capacity Act 2005. People were only deprived of their liberty if this had been authorised by the appropriate body and was required to maintain their safety and welfare.

Staff had completed training that enabled them to improve their knowledge in order to deliver care and support safely.

People were supported to maintain good health and appropriate referrals to healthcare professionals were made.

There was a clear management structure in place and staff were happy with the level of support they received.

People living in the home were supported to access activities of their choice.

Since the last inspection in December 2015 more formal audits and quality monitoring systems had been implemented that were effective in monitoring the safety and quality of the home.

This comprehensive inspection took place on 21 December 2015 and was unannounced. We last inspected Maudes Meadow in August 2013. At that inspection we found the service met all seven of the essential standards we looked at.

Maudes Meadow is a residential care home that can accommodate up to 28 older people. It is close to the town centre of Kendal. The property is a two-storey building and accommodation is provided over two floors the upper being accessed by a passenger lift. There are two separate communal and dining areas on the ground floor one is designated for people who live with dementia.

There was no registered manager in post at the time of the inspection. A registered manager is a person who has registered with the (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had made arrangements for the home to be supported by a manager that was registered with CQC from another of their homes pending registration of a new manager.

During this inspection we found breaches of Regulation 12 Safe care and treatment and of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Some maintenance of the environment had not been acted upon. Two of the baths in the home required repair or replacement and another was found to be dirty.

The storage arrangements for some medicines in the home were not always in line with current national guidance. Some records for peoples as required medications were not always clear about their needs.

We found that there had been inconsistencies with the numbers of staff on shifts and that there was no process in place to determine the numbers of staff required to meet people’s individual needs. The level of staffing observed on the day of the inspection ensured that people had their needs met in a timely manner.

Information held about people’s care and support was routinely recorded in four different types of records. The information recorded was not always consistent or accurate within these four types of records. The reviews of care plans and records made were not always accurate about the changing needs of people’s health and support required.

People living in the home spoke highly of the staff and were happy with their care and support.

The recruitment procedures demonstrated that the provider operated a safe recruitment procedure to ensure that fit and proper persons had been employed.

Staff told us they had received regular training and supervision to support them in their roles. However records provided relating to staff training indicated that some staff required elements of training to be updated to refresh their skills and knowledge

Where safeguarding concerns or incidents had occurred these had been reported to the appropriate authorities and we saw records of the actions taken by the home to protect people.

We have made a recommendation that the provider review their best interest decision making process to ensure it follows guidance outlined in the Mental Capacity Act 2005.

We have made a recommendation that records relating to care are consistent to provide accurate information.

We have made a recommendation that all staff are refreshed and updated in their skills and knowledge in some specific topics.

‘You can see what action we told the provider to take at the back of the full version of the report.’