This inspection took place on 27 November 2018 and was unannounced.

Meadowfields 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.

Meadowfields Care Home accommodates up to 65 people in one building. At the time of the inspection, the service supported 62 people.

At the last inspection in 2017 we rated the service as requires improvement. We asked the provider to complete an action plan to show what they would do and by when to make improvements to how people’s risks were managed. At this inspection we found that these improvements had been made, although improvements were still required to ensure a consistently safe and well-led service.

The service had a registered manager. 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.

Some improvements were required to ensure that systems in place to monitor the quality of services were effective in identifying areas for improvement and ensuring that action was taken. Improvements were needed to ensure systems for protecting people from potential abuse and avoidable harm were effective.

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

People received their medicines as prescribed, however improvements were needed to the management of medicines to ensure they were consistently safe.

People’s risks were assessed and managed to help keep them safe. There were enough suitably skilled staff to meet people’s needs. People were protected from the risk of infection.

People’s needs were suitably assessed before they moved to the service and care plans were developed in line with best practice guidance. Staff were trained and suitably skilled. People had their nutritional needs met and there were systems in place to ensure people received consistent care and support. People were supported to have healthier lifestyles by having timely access to healthcare services and professionals.

People had their consent sought in line with the principles of the Mental Capacity Act 2005. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People received support that was delivered in a caring and compassionate way and people were treated with dignity and respect. People, where possible were consulted about how their care was provided and were given choices in their day to day lives. People’s communication needs were met.

Staff knew people well including their likes, dislikes and preferences. People had access to activities. There was a complaints procedure available to people and their relatives and people were supported at the end of their life to have a dignified and comfortable death.

People, relatives and staff felt the management team and provider were approachable and supportive. People and relatives’ feedback was requested and responded to.

The service worked in partnership with other organisations to improve outcomes for people.

This inspection took place on 3 May 2017 and was unannounced. At our last inspection in October 2015 we rated the service as Good overall but some improvements were required in how the service was managed. At this inspection some improvements had been made in relation to the management of the service however further improvements were required.

Meadowfields Care Home provides support and care for up to 65 people, some of whom may be living with dementia. At the time of this inspection 61 people used the service.

The service had a registered manager. 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.

Risks to people's health and wellbeing were not managed to keep them safe from harm. Some situations which could be harmful to people were risk assessed but staff did not always follow the plans put in place to reduce risks. People's medicines were not always managed safely.

There were sufficient numbers of suitably trained staff to provide people with the support they required. However, there were occasions when people experienced delays in receiving the support they required because of the lack of organisation of staff.

People were supported by staff that had been recruited using safe recruitment procedures to ensure they were of good character and fit to work with people who used the service. People were supported by staff who knew how to recognise and report potential abuse to safeguard them from harm and abuse.

People's rights were protected as the provider followed the principles of the Mental Capacity Act 2005 (MCA). People were offered and supported to make choices about their care and support.

Staff had been recruited using safe recruitment procedures to ensure they were of good character and fit to work with people who used the service.

People were not always provided with the appropriate support to eat their meals. People told us the quality of the food was good however they were not always given their preferred choice of food.

People’s privacy and dignity was upheld but there were occasions when staff did not support people consistently in a caring or sympathetic way.

People received regular health care support and were referred to other health care agencies for support and advice if they became unwell or their needs changed.

People were provided with a varied recreational and leisure activity programme.

People and their representatives (where appropriate) were involved in the planning and review of their care. The provider had a complaints procedure and people knew how and to complain when they had concerns.

The provider had made improvements to the systems in place to assess, monitor and improve the quality of care. However, some further improvements were needed to ensure all areas of care were assessed and monitored to mitigate potential risks to people and to improve the quality and consistency of the service.

This inspection took place on 20 October 2015 and was unannounced. This is the first inspection since the service changed ownership. Meadowfields Care Home provides accommodation and personal care for up to 65 people. At the time of this inspection 33 people used the service. The service was undergoing refurbishment, one of the units was closed and in the process of redecoration.

The service had a registered manager. 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 felt safe and comfortable. Staffing levels were sufficient to support people individually and in their preferred way. Recruitment for additional care staff was on-going to reduce the need and use of agency workers. The provider had a recruitment process in place. Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed.

People’s medicines were administered to them by staff; staff were knowledgeable and supported people with their medicines as required. Arrangements were in place for the safe storage, administration and management of medicines.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs) and to report on what we find. The Mental Capacity Act (MCA) is designed to protect people who can't make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty safeguards ensures that people are not unlawfully restricted. People were consulted with making decisions and offered choices and options regarding their daily lives. The registered manager told us that they had raised several DoLS referrals with the local authority.

People told us they enjoyed the food, had plenty to eat and drink and lots of choice. Where people needed help with their nutritional requirements, staff provided the level of support that each individual person required.

Health care professionals were contacted when additional support and help was required to ensure people’s health care needs were met.

People were treated with respect and approached in a kind and caring way. People told us they found the staff caring, friendly and helpful. People were able to see their friends and families as they wanted. There were no restrictions on when people could visit the home. Visitors we spoke with told us they were made welcome by the staff in the home.

Leisure and recreational activities were provided in house; these were either on a one to one basis or in groups. People could choose whether they wished to participate or not and staff respected their choices. The activity programme was being reviewed.

People were aware of the complaints procedure and knew how and to whom they could raise their concerns.

The home had a registered manager but a new person has been recruited to take over this position. The registered manager had planned to work closely with the new person to ensure continuity and stability of the service.

There were some quality assurance audits and checks in place but these did not give a comprehensive overview of the quality and safety of the service. Some records were not in sufficient detail to ensure care was provided in a consistent and reliable way. However, staff were knowledgeable regarding people’s individual care and support needs.