Meadowcroft Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Meadowcroft Residential Care Home is a care home without nursing, which can accommodate up to 17 people. At the time of our inspection 15 people were using the service and these included older people; some who may have a diagnosis of dementia.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection visit took place on 14 November 2018 and was unannounced.

There was a registered manager in post and they were present during the inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

People received medicines as required, although some small changes were needed to ensure that the number of medicines coming into the home were recorded adequately. People continued to receive care that made them feel safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and guidance about how to manage these was available for staff to refer to/follow. Safe recruitment of staff was carried out and adequate numbers of staff were available to people.

People continued to receive effective support from staff with a sufficient level of skills and knowledge to meet their specific needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were assisted to access appropriate healthcare support and received an adequate diet and hydration.

The care people received was provided with kindness, compassion and dignity. People were supported to express their views and be involved as much as possible in making decisions. Staff supported people to have choices and independence, wherever possible. People’s diverse needs were recognised and staff enabled people to access activities should they so wish.

The provider had effective systems in place to regularly review people’s care provision, with their involvement. People’s care was personalised and care plans contained information about the person and their needs, choices and cultural needs. Care staff knew people’s needs and respected them. People were able to speak openly with staff and understood how to make a complaint.

The service continued to be well-led, including making detailed checks and monitoring of the quality of the service. People and staff were positive about the leadership skills of the registered manager.

Our inspection took place on 27 April 2006 and was unannounced. We last inspected the service on 12 October 2013 where we found the provider was meeting regulations.

Meadowcroft residential care home provides accommodation and care for up to 17 older people who may be living with dementia. The service does not provide nursing care

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

People told us they felt safe although we saw some occasions where staff used equipment to help people stand that may not have been appropriate. People said staff responded to their requests for assistance and there was sufficient staff available to keep them safe. Staff were knowledgeable about how to escalate any concerns about people’s safety. People said they had their medicines when needed, with support from staff if required. Staff new to the service were appropriately checked by the provider before commencing work.

People’s rights were promoted, and their best interests considered. People expressed confidence in staff who they felt were skilled, competent and able to look after them well. People had a choice of nutritious food and drink they said they enjoyed, and we saw any risks to people due to weight loss or eating were well managed. People’s health care needs were monitored and promoted by staff.

People said staff were kind, caring and compassionate. People were treated respectfully and their dignity promoted. People’s privacy was promoted by staff. People were able to make choices with the support of staff were needed, this in respect of their care and how they spent their day. People’s independence was promoted.

People had involvement in planning their care and staff were knowledgeable about people’s individual preferences. People were able to spend their time involved in activities they enjoyed with support from staff to do so. People felt able to complain and were confident issues raised would be addressed, but said they had no complaints.

People were confident in the provider, registered manager and staff, and told us the service was well led. There were systems to in place to ensure people were actively encouraged to share their views, and where specific requests were made these were responded to. The provider had systems in place to monitor the quality of the service. Staff felt well supported by the provider, this meaning they enjoyed their job and were able to do it well.

We spoke with four people who lived at the home. We also observed how care was provided to people who were not able to easily share their views with us. We spoke with two members of staff, the manager and provider during the course of the inspection.

We saw and heard from people we spoke with that their choices were listened to by staff and considered when they were provided with care and support. An example of this was food choices with one person telling us, “There are lots of foods I can’t eat but they will find something else”.

People told us that they consented to the care they received. Where people were unable to clearly express consent staff were aware of how to understand when they did not want assistance or expressed a preference in respect of such as food choices.

We saw people received care that was planned and delivered in a way that was intended to ensure people's needs were met and their safety and welfare was promoted. People told us that they were able to access external healthcare as needed with one person saying, “Anything wrong a doctor comes”.

We saw that people were supported with their nutritional needs and the home had sought advice from healthcare professionals when needed to ensure people’s nutritional needs were met.

People’s views were taken into account as to how the service was provided and any complaints made were acted upon.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of an inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practicing professional.

Some of the people living in this home were unable to tell us about the care and support they receive. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three people, a relative and two professionals from health or social care backgrounds. We observed the breakfast and lunch time meals. We spoke to two care staff the cook and the deputy manager and reported our findings to the manager.

The three people we spoke with told us that they were treated kindly and felt safe in the home. We observed that when staff supported people they did this in a sensitive way and told people how they were going to help them. However there were times where people with dementia did not have much interaction with care staff.

Whilst people were observed to have enough to eat and were offered a choice of food that met their nutritional needs, the menus did not detail all choices available at all meals. We saw that most people, in line with their own wishes, were assisted to rise early however they had to wait a long time for breakfast to be served. Some people were observed to physically manage feeding themselves but needed prompting to do so. There were enough care staff to provide the support people needed but sometimes this did not happen. Some staff were new and needed further training.

There were good records of people's contact with health professionals, their previous life histories and their current care plan.

People living at Meadowcroft told us that they’re very satisfied with the care and support they received from the service, this reflected in the comments they made to us:

“Lovely atmosphere”

“Very good here”

“‘We all feel we can make decisions and know staff care for you”.

“‘Very good all the way around”

“Staff very helpful”

“Day to day life is as we want it to be”

“It’s very good here”.

They also told us that they felt involved and told us about activities that were put on for them that included music and movement, singing, chatting and going out to places.

We have also heard from social services that reviews of care they have carried out with people living at the home have presented positive outcomes.

People told us that they “Feel safe at the home” and “‘any faults they get mentioned” and “any complaints manageress sorts out”.

People told us that they do not feel restricted and staff listen to concerns that are raised.

People told us that they are “Looked after, beds always spotless and clean” and “We are kept clean as well”.

We saw that people are consulted through the homes quality monitoring system and have chance to comment on the service provided to them.