About the service:

Meadow House Nursing Home is a service that provides accommodation and nursing care for up to 38 people who are living with neurological condition such as multiple sclerosis, cerebral palsy or acquired brain injury. At the time of our inspection there were 37 people living in the home.

People’s experience of using this service:

• Staff continued to be extremely kind, caring and compassionate. They knew people extraordinarily well and frequently spoke of them as being an ‘extended family’.

• Staff often went above and beyond what was expected of them to ensure people were comfortable, well cared for and content.

• Staff and management worked well together to ensure that people received care that was totally focused on them as individuals based on their own needs, goals and aspirations. This had resulted in some people experiencing extremely positive outcomes in terms of their independence.

• People had a voice that was listened to and respected. Where people had communication needs or lacked capacity to make their own decisions, staff were knowledgeable about how best to communicate with them and always acted in their best interests.

• Staff advocated for people where necessary to ensure that their views were heard. People’s opinions mattered and they were actively involved in the running of the home which gave them a sense of empowerment and pride.

• Staff had the appropriate knowledge and skills to provide people with effective care.

• People were given total choice and control over their care where this was possible. They had been fully involved in developing and planning their care.

• There was good leadership at the service that promoted an open and inclusive culture.

• The management had a clear focus that people should be put first, treated as individuals and receive support that enabled them to live fulfilling lives.

• Staff demonstrated great pride at working in Meadow House. They worked well as a team and felt valued and supported.

• There were robust systems in place to monitor the quality of care people received and to ensure the values, aims and objectives of the service were met.

• The registered manager and staff were keen to continuously improve the quality of care people received.

• People and relatives were extremely satisfied with the care and support provided.

• There were clear systems and processes in place to protect people from the risk of abuse and avoidable harm.

• The home, people’s rooms and communal areas were clean.

• People received their medicines when they needed them.

• When things went wrong, lessons had been learnt to try to reduce incidents or accidents from happening again.

• There were enough staff working in Meadow House to keep people safe and to provide them with care that met their needs. This included having time to spend with people to enhance their wellbeing.

Rating at last inspection:

Outstanding (Published July 2016).

Why we inspected:

This was a planned inspection based on the period since the last report was published by CQC.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 10 and 11 May 2016. The first day was unannounced.

Meadow House Nursing Home is a service that provides accommodation and nursing care for up to 38 people who are living with neurological conditions such as multiple sclerosis, cerebral palsy and acquired brain injury. On the day of the inspection, there were a total of 37 people living at the home.

There was a registered manager employed at the home. 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 and associated Regulations about how the service is run.

People were supported by very kind, caring and compassionate staff who often went the extra mile to provide them with excellent, high quality care. This high standard of care enhanced people’s quality of life and wellbeing. The staff were extremely passionate about providing people with support that was based on their individual needs, goals and aspirations.

There was a strong culture within the home of treating people with respect. The staff and the registered manager listened to people, offered them choice and made them feel that they mattered. People and the staff knew each other well and these relationships were valued.

People were able to make decisions about the support they received and to live their lives as they wished. People’s diverse needs were met and respected.

People were safe living at Meadow House Nursing Home. There were enough staff to meet people’s care needs safely and people received their medicines when they needed them. The staff had received appropriate training and supervision to provide them with the necessary skills and knowledge to provide people with effective care.

People had access to activities that complemented their individual hobbies and interests. Links with the local community had been established and people were supported to participate in community events and other events that were important and meaningful to them. This provided them with a sense of purpose and wellbeing.

People received enough to eat and drink to meet their individual needs and timely action was taken by the staff when they were concerned about people’s health.

The staff were happy working in the home and felt supported in their role. They were clear about their individual roles and responsibilities and the majority of them felt valued by the registered manager and the wider senior management team. Good leadership was demonstrated at all levels and there were effective systems in place to monitor the quality and safety of the care provided.

During our inspection on 23 May 2013 we found that the Medication Administration Records (MARS) we saw did not evidence accurate documentation to ensure that people were protected against the misuse of medication. During this inspection on 30 August 2013, we found that the provider had made the required improvements to the recording of medication administration.

During our inspection visit to Meadow House Nursing Home we spoke with two people who used the service, three relatives and three members of staff.

Staff had access to detailed care plans to ensure that they provided people with safe, appropriate, individual care and support. A person who used the service who we spoke with told us that, “We are all treated individually and everyone feels special.” A relative also told us that, “(Staff) are caring and they look after them (people who used the service). Things are done properly.”

People were protected from the risk of dehydration and poor nutrition because nutritional needs were assessed ensuring that any such risks were identified and eliminated.

When reviewing medication administration records (MAR charts) we did not see evidence of accurate documentation to ensure that people were protected against the misuse of medication.

Effective staff recruitment was in place to make sure that people received support and safe care from suitable, skilled, and knowledgeable staff.

We spoke with people who use services at Meadow House Nursing Home who told us they were always asked to consent before care and treatment was provided to them by staff members. One person we spoke with told us, "I am never asked to do something I would not want to. The staff here are very friendly and always ask me what I want".

We saw that people received care and support which was planned with them according to their own personal needs and requirements. People's needs were regularly reviewed with them to ensure care and treatment was delivered in a way which ensured their safety and welfare.

People were cared for in a clean, hygienic environment and were protected from the risk of infection.

Staff members were supported to deliver care to people that met their needs. Staff were also supported to undertake professional training to help them provide care and support to people living at the Meadow House Nursing Home.

There was an effective complaints system available and people living at the home were provided with appropriate information on how to make a complaint should they want to.

People told us that they felt involved in all aspects of their care and treatment and made decisions about anything that affected them. People attended group meetings where they could put forward suggestions for change.

We were told that the staff promoted people's dignity and treated them with respect. More than one person described Meadow House as a happy place and one person commented that there was a good balance between professionalism and friendliness.

All of the people we spoke with during our inspection were very positive about the care they received at Meadow House. People told us that staff understood their individual needs and supported them in accordance with their wishes. We were told that the staff team were skilled at providing the right care.

People told us that there was a good range of therapies and activities that they could join if they wished. The service had transport and people went out frequently to places of their choice.

We heard positive comments about the meals. We spent some time in the dining room at lunchtime and found that people had a good mealtime experience, with everyone receiving the individual support they needed.