About the service: The Meadows provides accommodation for older people, some of whom may live with dementia. The service can accommodate up to 55 people. On the day of our inspection visit 48 people were accommodated.

People’s experience of using this service:

Improvements had been made to the service following our last inspection on 19 April 2018. At the last inspection we identified issues with unclean environment, lack of processes and understanding of the Deprivation of Liberty Safeguards and governance. At this inspection we found the provider and registered manager had driven improvement and made positive changes. The issues identified at the last inspection with records and environment had been addressed. Systems for overseeing the service were more effective. The changes had enabled staff to address the issues noted at previous inspections.

People told us they felt safe and happy living at the home. Staff knew how to safeguard people from abuse. Staff were recruited using systems to reduce the risk of unsuitable candidates being employed. Risks to people and for tasks carried out by staff were identified and actions were taken to mitigate these. Medicines management was effective.

Staff had the skills and knowledge to deliver care and support in a person-centred way. They received the appropriate training, supervision and appraisal.

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.

People were cared for in a respectful manner and good relationships between people and staff had been formed.

People could access a wide range of activities.

People’s health needs were met. The service worked with a range of professionals to best meet people’s needs.

Staff said they felt supported by the management team. Governance systems and processes were in place to monitor and improve the quality of the service.

Rating at last inspection: We rated The Meadows Care Home as requires improvement and published our report on 11 June 2018.

Why we inspected: This was a scheduled inspection based on previous rating.

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.

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

The Meadows Care Home provides accommodation and personal care for up to 55 older people some of whom may be living with dementia. This comprehensive inspection took place on 19 April and was unannounced. At the time of our visit there were 55 people using the service however one person had recently been admitted to hospital unwell. The home was situated on the periphery of the town of Haverhill in Suffolk.

The Meadows Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

At our last comprehensive inspection in February 2016 we rated the home Good overall and in four of the key questions we ask. In the key question of Responsive we were concerned that people's care plans were not always up to date. We also found there were gaps in records which meant we were not always confident that people needs were responded to appropriately. We found at that improvements were need to the opportunities for social activity. We also found that whilst there was a well-established complaints procedure the registered manager’s actions in response to concerns were not always recorded. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Meadows Care Home on our website at www.cqc.org.uk

At this inspection in April 2018 we have rated the home Requires Improvement overall. Whilst the necessary improvements have been made to the key question of Responsive we found additional concerns in the key questions we ask.

People had not always been protected from avoidable harm as actions in place to minimise risks to people had not always been followed.

The provider had not always ensured they carried out their responsibilities to comply with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Where people could not always make decisions themselves, mental capacity assessments had not been completed and best interest’s decisions made.

Sufficient staff were on duty and were deployed effectively to meet the needs of people. Staff were competent in their roles and received support and guidance from management.

Systems were in place to help ensure people's health and nutritional needs were met. People at risk of malnutrition had their weight, food and fluid intake monitored. Measures to reduce risks such as fortified foods, and referrals to a GP were in place.

Staff provided people with care in a friendly and relaxed manner, treating people with respect. Staff promoted and maintained people's dignity and provided encouragement to people to retain their independence wherever possible.

People were given the opportunity to participate in social activities both inside and outside the home. People had access to a complaints procedure. Where people received end of life care this was planned in conjunction with people.

There were systems in place to monitor the quality of the service, which included seeking feedback from people, relatives and staff. However, the quality monitoring systems had not identified the shortfalls found during the inspection.

We found two breaches of the legal requirements and regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.