About the service: Tendring Meadows is a residential care home for older people situated in the village of Tendring. The accommodation is located over two floors. There were 42 people living at the service on the day of inspection.

People’s experience of using this service:

People's medicines were not always managed safely.

Personal emergency evacuation plans were not always detailed for staff to follow.

We have made a recommendation about personal emergency evacuation plans

Systems were in place to monitor the quality of the service; however, these were not effective and did not highlight concerns raised during the inspection

The registered manager was not aware of the legal requirement to notify the Commission of any authorised DoLs, safeguards or significant injuries to people using the service.

The environment was not always clean and required improvement. We have made a recommendation about the environment of the service.

Information was not available in other formats to aid people’s understanding where required. We have made a recommendation for the service to improve knowledge of the Accessible Information Standards.

People received effective care from staff who understood how to recognise potential abuse. However not all concerns were appropriately through safeguarding procedures.

People and their relatives were complimentary about the care provided at Tendring Meadows.

People were supported by sufficient and competent staff who knew people well and cared for them

according to their needs and preferences.

The registered manager and staff were encouraged to maintain and develop their knowledge and skills.

Staff respected people's privacy and dignity and interacted with people in a caring and compassionate way.

People's health was well managed and staff had positive relationships with professionals which promoted people's wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were encouraged to maintain their independence and to make their own choices about where they spent their time and how. People were offered activities which they had the opportunity to join in.

The owners of the service had a visible presence and provided good support to the registered manager.

Rating at last inspection: Good (10 August 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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 we receive any information of concern, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 18 May 2016 and was unannounced. Tendring Meadows is owned by Archangel Healthcare Ltd and is registered to provide accommodation and personal care for up to 53 people. The service was divided into four separate areas (one of which was of a more secure nature and had keypad entry facilities). People using the service had conditions related to old age or dementia and some people had physical disabilities. The service has recently undergone extensive refurbishment. Due to the on going reconfiguration of the service only 44 rooms were being used. On the day of our inspection 33 people were using the service.

The service had an application in progress to register a new manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

Staff had received training in regard to how to protect people using the service from abuse or harm. Staff we spoke with were knowledgeable about the types of potential abuse people may be exposed to and understood how to report any concerns. Records showed, and staff and the manager which confirmed, that all staff, including newly appointed staff had received the expected level of training required to ensure competence in their role.

Recruitment had taken place and there were sufficient staff available on the day of inspection, however thought should be given to staff availability at busier times of the day. This is because the service was not yet at full capacity and we saw that sometimes two staff were needed to work together. An extra member of staff to float between units would ensure staff were readily available to support people and maintain their safety in the different areas of the service, when another member of staff required support.

Medicines were stored, handled and administered safely. Guidance was available for staff to ensure that medicines were provided for people in line with instructions from the prescribing GP.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Some people at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s nutritional needs were monitored regularly and reassessed when changes in their needs arose. Staff supported people in line with their care plan and risk assessments in order to maintain adequate nutrition and hydration.

Staff were responsive to people when they needed assistance. Staff interacted with people in a positive manner and used encouraging language whilst maintaining their privacy and dignity. People told us they were encouraged to remain as independent as possible. Activities that were on offer to people considered people’s interests and hobbies; through consultation with the individual and their relatives.

People and their relatives told us they were provided with information about the service and their care and treatment. People were supported to continue to maintain their cultural and religious preferences. Information was readily available for people or their relatives about local advocacy services.

P