This assessment was carried out between 1July and 7 July 2025. We visited the service on 1 and 2 July 2025. Meadow Court is a domiciliary agency which provides care and support to people living in their own accommodation in a supported living complex on the outskirts of Taunton. At the time of the inspection visits 5 people were using the service. The service specialised in the care of people with a learning disability and autistic people. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. At the last inspection the service was in breach of regulation relating to good governance. At this inspection we found improvements had been made and the service was no longer in breach of this regulation. There were now effective systems in place to monitor quality and plan ongoing improvements. There was a clear staffing structure which made sure there was always senior staff available to people and to support less experienced staff. People were safe at the service and staff knew how to report any concerns. The registered manager liaised with appropriate professionals when issues arose to make sure people were protected from avoidable harm. Staff were safely recruited and received training appropriate to their role. Staff felt well supported. Risks were assessed to ensure people could receive care and support safely and take part in activities with minimum risk to themselves or others. People had their needs fully assessed and staff provided care and support in line with their assessed needs. The registered manager tried to involve people in their care as much as possible. At the time of the inspection, they were working with outside professionals to look at ways to further seek people’s views and make sure they were involved in decisions. The staff worked well with other professionals to make sure people’s needs, including their healthcare needs, were met. Professionals who worked with the people [OG1][JP2]who used the service told us the staff always provided care and support in accordance with their recommendations.
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Meadow Court, a supported living domiciliary care agency in Taunton serving 13 people with mental health and/or learning disabilities, was rated Requires Improvement overall following a focused inspection in January 2023. A breach of Regulation 17 (Good Governance) was identified due to ineffective quality assurance systems, alongside concerns about incomplete risk assessments, absence of 'as required' medication protocols, and inadequate records of personal finances and incident learning.
Concerns (7)
criticalGovernance: “Quality assurance systems were not always effective in identifying shortfalls and planning improvements...This is a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008.”
moderateMedication management: “some people were prescribed pain relief when needed. There were no instructions for staff to identify pain in people who may not be able to express the need for these medicines verbally.”
moderateCare planning: “risk assessments and care plans did not always give clear information about how to manage individual risks. For example, one risk assessment stated that staff should be aware of triggers, but these were not identified.”
moderateRecord keeping: “records relating to people's personal monies were not always clear. There was no evidence of audits carried out of personal finance which was being managed by the provider.”
moderateIncident learning: “All incidents and accidents were recorded and analysed on a monthly basis...but these actions were not formally recorded.”
moderateSafeguarding: “Before the inspection we received concerns about how personal finances were managed by the provider...Improvements were needed to ensure clear records were available to identify the reasons for transactions.”
minorComplaints handling: “Complaints were recorded and there was evidence they had been discussed with the complainant. However, actions taken were not always recorded.”
Strengths
· People were supported by a consistent staff group who knew them well, enabling trusting relationships to develop.
· Staff completed specific training including the Care Certificate and received competency assessments for medication administration.
· People were supported in the least restrictive way possible with appropriate Mental Capacity Act authorisations in place.
· Open and inclusive culture with people and staff feeling comfortable to raise concerns with management.
· Staff worked effectively with external professionals to meet people's health and social care needs.
Quality-Statement breakdown (14)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced diet
Mr Frederick John Eaton's supported living service in Taunton received a Good rating across all five key questions at its January 2016 inspection, demonstrating person-centred, flexible care for 14 people with learning difficulties and mental health needs. The sole minor shortcoming identified was that daily records did not capture time spent with individuals, making it impossible to evidence delivery of allocated support hours.
Concerns (1)
minorRecord keeping: “daily records showed what support people received it did not detail the time spent with individuals which made it impossible to evidence that people were receiving their allocated support hours”
Strengths
· People felt safe and comfortable with staff, with 24-hour staff presence in the building
· Robust recruitment procedures including DBS checks and references for all new staff
· Staff received training in safeguarding, medicines administration, MCA, and relevant care subjects
· Person-centred care with flexible support hours tailored to individual needs and preferences
· People fully involved in writing and reviewing their care plans and setting personal goals
Meadow Court is a supported living service for people with mental health and/or learning difficulties, rated Good across all five key questions at its March 2018 inspection. The service demonstrated personalised, person-centred care delivered by a well-supported staff team under experienced leadership, with no concerns or regulatory breaches identified.
Strengths
· People felt safe with staff and there were adequate numbers of staff available 24 hours a day to meet individual needs.
· Staff received comprehensive induction and ongoing training, including nationally recognised care qualifications.
· Care was highly personalised, taking account of people's wishes, culture, beliefs and individual communication needs.
· People were fully involved in planning their care and could make choices about who supported them.
· The service was flexible and responsive to changing needs, liaising with external professionals effectively.
Good
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersGood