This inspection took place on 28 November 2018. The inspection was unannounced.

The Meadows Care Home provides personal and nursing care for up to 70 people. People are accommodated in two separate buildings. The service provides care for younger and older people, people living with dementia, and people living with physical disabilities and nursing care needs. Rose Court has 40 beds for people who need nursing care. Lavender Court has 30 beds for people who need residential care. At the time of our inspection, there were a total of 57 people living at the service.

At the previous inspection in February 2017, we identified some improvements were required in two key areas we inspected; ‘Safe’ and ‘Responsive’. This resulted in the service having an overall rating of 'Requires Improvement'. People were not always kept safe from risks associated with the risk of infection. People experienced varying levels of support to maintain interests and hobbies.

During this inspection we checked to see whether improvements had been made, we found improvements had been made and this contributed to the service receiving a rating of ‘Good’ in all the key areas.

The service had a registered manager 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Improvements had been made to infection control practice. The environment and equipment was found to be clean and staff followed best practice guidance, in the prevention and control of infections. Improvements had also been made to social activities and opportunities available to people, included community involvement.

Risks associated with people’s needs were assessed and managed. Staff had received additional training and guidance in how to mitigate risks. There were sufficient numbers of staff to meet people's needs and staff skill mix and competency was considered. Safe staff recruitment procedures were in place and followed.

People's medicines were managed and administered safely. Accidents and incidents were reviewed and action was taken to reduce further reoccurrence.

Staff were aware of their responsibilities to protect people from abuse and avoidable harm. The management team had worked with the local authority safeguarding team to investigate safeguarding incidents and concerns.

Staff received an induction and ongoing training and support. Staff were knowledgeable about people’s health conditions.

People received a choice of meals and drinks and were assisted to eat and drink where required. People’s health care needs were assessed and monitored, and staff worked with external healthcare professionals in meeting people’s 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 supported this practice.

Independence was encouraged and supported. Information about independent advocacy services was available. People were involved in opportunities to discuss and review how their care and treatment was provided.

Staff had information to support them to understand people’s needs, preferences and diverse needs. People received opportunities to participate in social activities. The provider’s complaint policy and procedure had been made available to people who used the service, relatives and visitors. People’s end of life wishes had been discussed and planned with them.

The systems, audits and checks on quality and safety had improved and the provider had an ongoing action plan to make further improvements. People received opportunities to feedback their experience of the service.

This inspection took place on 1 and 7 February 2017. The first day of our inspection visit was unannounced.

The Meadows Care Home provides personal and nursing care for up to 70 people. People are accommodated in two separate buildings. Rose Court has 40 beds for people who need nursing care. Lavender Court has 30 beds for people who need residential care. At the time of our inspection, there were 55 people living there: 24 people in Lavender Court and 31 people in Rose Court. The service provides care for younger and older people, people living with dementia, and people living with physical disabilities.

The service had a registered manager at the time of our inspection visit. 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 were not consistently kept safe from the risk of infection. The overall system to ensure equipment was kept clean was not effective. We discussed this with the registered manager, and immediate action was taken to resolve these concerns.

People experienced varying levels of support to maintain interests and hobbies. The provider employed two activity coordinators, but one had been off work for an extended period of time. This meant there was one staff member responsible for organising and coordinating activities for 55 people across two buildings. Although the provider had taken steps to cover this absence, there had been an impact on people’s ability to take part in activities that were meaningful to them.

People’s care needs were assessed and recorded and risks identified. Risk assessments and care plans identified steps staff should take to reduce the risk of avoidable harm. Accidents and incidents were monitored and reviewed, and action taken to reduce the risk of harm occurring. There were enough staff to ensure people received their personal and nursing care.

People were happy with staff who provided their personal care, and felt safe living at The Meadows Care Home. People had medicines available when they needed them and were given these in accordance with prescribing instructions. They were cared for by sufficient staff who were suitably skilled, experienced and knowledgeable about people’s needs. Staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner. People were supported to have sufficient to eat and drink, and people who needed assistance to eat were provided with support.

The provider took steps to ensure potential staff were suitable to work with people needing care. Staff received supervision and had checks on their knowledge and skills. They also received an induction and training in a range of skills the provider felt necessary to meet the needs of people at the service.

People and their relatives confirmed that staff sought permission before offering personal care. Appropriate arrangements were in place to assess whether people were able to consent to their care. The provider met the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS).

People felt cared for by staff who treated them with kindness, dignity and respect. The support people received was tailored to meet their individual needs. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care. The provider had a complaints procedure to ensure that issues with quality of care were addressed. The provider also sought people, relatives’ and staff views in order to take action to improve the quality of the service.

The service was well-led. The provider had systems to monitor and review all aspects of the service. These were u