Meadows Court Care Home is a registered care service providing personal care and support for up to 60 older people. There were 47 people using the service when we visited and some were living with 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.

At this inspection we found the service remained Good.

Assessed risks to people regarding any area of their lives were reduced or eliminated to support the safety of people using the service. Staff understood their responsibilities about reporting any seen or suspected abuse. Staff were employed, after robust recruitment procedures, in sufficient numbers. Medicines were administered by appropriately trained staff. These methods supported the safety of people using the service.

People are supported to have maximum choice and control of their lives and staff do support them in the least restrictive way possible. Policies and systems in the service also support this practice. Staff understood and followed the Mental Capacity Act 2005 guidance. Staff asked for people's consent before providing any support.

Staff had completed required training and this was updated to ensure people's needs were met appropriately. People’s cultural choices were observed in the development of individual support plans.

People we spoke with told us that staff were always caring and respected people’s privacy and dignity at all times. Staff supported people’s choices and fully included and encouraged independent choices to enable full involvement in daily routines and activities.

People’s support plans reflected their individual choices and goals. People were then supported to achieve their aims and potential. People expressed their confidence about raising any concerns, should they have any. People felt that these would be handled correctly and that they had the information they needed to contact external agencies.

There was a registered manager in post. There were audits and spot checks in place to make certain staff worked correctly and that people received the appropriate support at a good standard. People using the service and their relatives had various ways of sharing their views and this was encouraged by staff.

Further information is in the detailed findings below.

The inspection took place on 20 June 2017 and was unannounced.

Meadow's Court provides residential care for up to 60 people many of whom are living with dementia. At the time of our inspection there were 50 people in residence. Meadow's Court has a number of communal areas for people to sit, relax and watch television. In addition the service has a dining room and activities room. There is a garden which is accessible and provides areas of interest, which includes an aviary and seating area.

We carried out an unannounced comprehensive inspection of Meadow’s Court on 20 January 2016. After that inspection we received anonymous concerns in relation to the quality of people’s care during the night. We were informed that staff were getting people out of bed from 5am in the morning. Night staff were not appropriately trained, which compromised people’s safety as staff did not use the appropriate equipment to move people safely. People’s dignity was compromised as their personal care needs were not being met in a timely manner. As a result we undertook a focused inspection to look into these concerns. This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (Meadow’s Court) on our website at www.cqc.org.uk.

The overall rating of good, which was awarded following the CQC's previous inspection of 20 January 2016 was displayed.

Meadow’s Court 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.

We found people’s safety was promoted as staff followed the information provided within people’s records, which included risk assessments and care plans. This ensured the care and support people received was safe and reflective of their needs and wishes. People were regularly checked throughout the night as detailed within their care plan to ensure they were safe and staff completed charts to provide information as to whether people were awake or asleep and what assistance had been provided when required.

Staff implemented the instructions given by the registered manager and management team to promote people’s safety, which were provided on a range of documents, which included policies and procedures. Staff had access to information as to how they should respond to an untoward event or emergency, which included contact details of the management team and relevant external services.

Staff communicated to meet people’s needs, which included their participation in the handing over of information about people and the day to day running of the service. Staff were reminded of the importance of promoting people’s safety and the action to take as a result of the extreme hot weather currently being experienced.

People’s experience as to the care they received was monitored by members of the management team, as part of the overall quality monitoring system. This had included unannounced visits by a manager during the night. These visits were used to ensure people were safe and that the care and support they received met their needs and wishes.

We arrived at Meadow’s Court and entered the service at 5.45am. We found there to be three members of staff on duty, at the time of our arrival there were six people who were up and about. People were observed to be involved in activities of their choosing and a majority of the people we spoke with told us as to why they were up and about. Others who did not speak with us were seen to be supported by staff reflective of their needs and staff we spoke with had a good understanding as to the people living at the service.

People were supported by staff who had received training to keep them

Meadow’s Court provides residential care for up to 60 people many of whom are living with dementia. At the time of our inspection there were 46 people in residence. Meadow’s Court has a number of communal areas for people to sit, relax and watch television. In addition the service has a dining room and activities room. There is a garden which is accessible and provides areas of interest, which includes an aviary and seating area.

This inspection took place on 20 January 2016 and was unannounced.

Meadow’s Court did not have a registered manager in place. A manager has been appointed and they have submitted an application to the Care Quality Commission to become registered. We will monitor this situation to ensure that a registered manager is in post to ensure the service is managed well.

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 who used the service told us they felt safe. Relatives of someone using the service told they believed their relative was safe and well cared for. People were supported by staff in a timely and sensitive manner, which meant people’s needs were met and that there were sufficient staff on duty.

People’s medicines were in the main managed well. Staff had received training and had their competency to manage and administer medicines regularly assessed. However we found there were no written protocols in place for staff to follow with regards to the administration of medicine, which is taken as and when required. The provider agreed to take action in consultation with health care professionals.

Staff were able to tell us what action they would take should they believe somebody was being abused and were aware of the provider’s policies and procedures, which included whistleblowing. Records showed staff had received training to support them in recognising potential abuse and this provided them with guidance as to their role in promoting people’s welfare.

People were supported by staff that had access to training which enabled them to meet people’s needs. All staff within the service were aware of their role in ensuring people received good quality care and their individual role in promoting this.

Potential risks to people were assessed and measures put into place to reduce risk, which included the use of equipment and the provision of personal care which were reflected within people’s plans of care.

People were protected under the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA 2005 DoLS). We found that appropriate referrals had been made to supervisory bodies where people were thought to not have capacity to make decisions themselves about receiving personal care and leaving the service without support.

People we spoke with were complimentary about the meals provided at the service. The dining experience for people was relaxed and calm with people receiving support with their meals where required.

People we spoke with told us they had good access to healthcare and visiting relatives told us that the service contacted health care professionals on behalf of their relative when required. Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. This meant people were supported to maintain good health.

There were positive relationships between people who use the service, their relatives who visited and staff. This created a friendly, calm and welcoming environment for people to live in and visit. People were supported by staff who sought to provide companionship and social interaction in a caring manner. Where people became distressed or anxious staff offered reassurance.

Staff had a good understanding as to t

We spoke with two people who used the service and asked them for their views about the service they received. One person told us they had recently enjoyed watching the film ‘The Sound of Music’ they went onto say it was their favourite film. We asked them for their views about the meals they told us: “They’re really nice.” A second person told us they hadn’t been at Meadow’s Court long and that they were receiving physiotherapy to enable them to return to their home. We asked them about the meals and they told us: “The meals are good they fill me up.”

People had a positive dining experience and those who required assistance to go to the dining room were assisted in a timely manner. People who required support were supported on a one to one basis by a member of staff. People were seen to enjoy their lunchtime meal and we observed that staff were mindful of people's right to choose and were polite and courteous when speaking with them.

We spoke with a visitor who told us their relative had resided at the home for some years until very recently. They spoke positively of the care they had received throughout there residence. The visitors comments included: “She was in the best place she could have been. I can’t fault them to be honest.”

We spoke with three people who used the service. They told us they were happy with the care they received and said that they regularly took part in the activities provided at the home. One person’s comments included: “I’ve lived here for sometime, I’m quite settled and there’s nothing more they could do for me.”

People’s care plans and records were regularly reviewed and their needs were reassessed where changes to their health and welfare had been identified. People had their health care needs met as the service was timely in making referrals to a range of external health care practitioners. We found there to be sufficient staff to meet the needs of people who used the service. Records showed staff had training in a range of topics which promoted the health and welfare of people. However we found some evidence of institutional practices in the delivery of care which impacted on some of the care people received and there daily life experiences.”

We found people received a balanced and nutritious diet, which met their needs and promoted there health. Staff who were involved in the preparation and cooking of food were aware of the specialist diets of people and provided tailored diets to meet people’s individual needs. We found there were sufficient staff to support people in the eating of there meal which was managed in a way that met their needs and promoted their dignity. We observed that the dining experience for some people was not as positive as others in that they were seated in the dining room for a long period of time before the meal was served.

We spoke with eight people who lived at Meadow’s Court. We asked people for their views about the service they received. People told us they were happy living at the service. People spoke to us about their attendance at resident meetings where they were able to express their views; in particular they were able to talk about and plan social activities and events. People told us they took part in organised activities within the service as well as accessing a variety of day trips within the community.

People told us they were satisfied with the care and support they received and that the staff were helpful and kind. People’s comments included: - “I’m happy with the care and the staff are very friendly.” “I like living here, I get the help I need but I’m still independent in most things.”

Records relevant to the management of the service were accurate and fit for purpose and appropriate checks were undertaken before staff began work. Records showed staff had access to a range of training which enabled them to promote the health and welfare of people who used the service.

People we spoke with told us that they were happy with the care and support they received. They said, “”Brilliant, I’m very happy here. I’ve got everything I need. The care is excellent and we have a really good manager Maureen.”

Relatives of people living at Meadows Court told us, “Staff are very attentive.” “Couldn’t have asked for a nicer bunch of people to care for my parents.” “My mum receives the care she needs.” “They keep me informed if anything happens, nothing is too much trouble.”

We asked people how they spent their time and how they influence the service they received. People told us, “I enjoy going on the boat trips and it was really nice to eat out at a pub on the riverside.” “I made the hanging baskets; I’m a very keen gardener. One person told us that they were the chairperson for the residents and several people told us that they attended the resident meetings and talked about events and activities.