The Meath Epilepsy Charity

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

For example, when a person had sustained a fracture due to living with osteoporosis (a condition where bones become weak, porous, and fragile, increasing the risk of fractures), the managers had compiled a list of people who had this particular physical vulnerability and at risk of fractures. They were working with the GP on a project around mitigating this risk.

The managers had regular quality assurance monitoring meetings to share good practice, what worked well, and to identify trends and analyse where improvements were needed.

People told us they were happy living at the service and felt safe and well cared for. Relatives agreed. One relative told us, “It is a lovely, lovely place. I wouldn’t want [family member] to be anywhere else. I consider myself extremely lucky for [them] to be there. It’s just like a little family. It’s lovely. They all care about each other.”

Incidents and accidents, safeguarding concerns and complaints were recorded on the provider’s system. These were reviewed, discussed and analysed to determine any underlying causes or trends and to identify any actions required to improve the service.

The registered managers understood their responsibilities under the duty of candour and were able to demonstrate this. For example, a letter of apology had been sent to relatives following a medicines error. The duty of candour is a general duty to be open and transparent with people receiving care from services.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People told us they felt safe at the service. They told us the staff were available if they needed support. Relatives stated they were informed when their family members required support or treatment from different agencies.

The staff team and managers told us they worked well with other professionals to ensure continuity of care, including when people moved between different services. Healthcare professionals told us they had a good working relationship with the service and communication was good. Healthcare professionals regularly visited people and provided the support they required, such as the GP and epilepsy specialists.

Staff told us they received good information about a person before they were admitted to the home. A manager told us, “A member of staff is sent to where the person lived previously. We meet the family and have a lot of communication with the previous service. We sit down with the family and the person and adapt how to work with them here. For all staff, a small summary is provided before the person moves in.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People said they felt safe from harm and abuse. Their comments included, “Yes, I do feel safe, “Staff are good, everyone is good” and “I can talk to staff about my worries, and they listen to me.” Relatives agreed and said, “I feel [family member] is absolutely safe there”, “I have 100% faith in all of the staff” and “[Family member] is absolutely safe. It’s been [their] home all [their] adult life.”

Staff were aware of their responsibility to safeguard people and who to contact in the event of any safeguarding concerns. One staff member told us, “If I saw a person in danger, I would contact 999 for police assistance or paramedics… if there were repeated concerns, I would raise this with my manager. If not taken seriously, I would escalate to senior managers.”

The staff received safeguarding training and regular refresher training to ensure they kept their knowledge up to date. A staff member told us, “We have annual training in relation to safeguarding both face to face and online.” Staff were able to describe how they would recognise signs that someone was being abused, and what actions they would take. A staff member explained, “We would look for withdrawal, not acting themselves around a certain individual. Look for physical signs such as unexplained bruising. I would inform the registered manager, the local authority and CQC.”

The provider was proactive in raising safeguarding concerns with the local authority. They worked with the relevant professionals to investigate concerns when incidents occurred. For example, where a person using the service had displayed inappropriate behaviour towards another person, the provider had taken appropriate action, including contacting appropriate agencies, and putting a plan in place to mitigate the risk of recurrence.

The provider understood their responsibilities under the Mental Capacity Act 2005 in ensuring Deprivation of Liberty safeguards (DoLS) applications were submitted as required. DoLS are a legal framework designed to protect vulnerable adults lacking mental capacity who require continuous supervision, control, and restriction of freedom in care homes or hospitals.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The provider had made improvements since our last inspection.

People said staff knew their needs and met these safely. Relatives agreed and said, “[Family member] suffers from pressure sores. They are very fast at noticing things and telling me and getting the nurse. Any problems at all they are fast to respond.”

There were effective processes in place to help ensure risks to people were assessed and mitigated. Risk assessments were detailed and included a score to determine the severity of the risk, and how to manage this. For example, a person at high risk of choking had been referred to the Speech and Language Therapy team and as a result, was a on pureed diet to reduce this risk. We saw at lunchtime the correct food consistency was offered.

People living at the service had high and complex needs. Most people were living with epilepsy, and some were at high risk of harm during seizures. An epilepsy nurse was involved with people’s care and support and provided advice to staff on how to support people with their individual needs. For example, because of the increased risk of suffocation for some people living with epilepsy, some had been provided with special pillows to reduce this risk. A healthcare professional involved with the care of people told us, “Protocols are in place for seizure management, and I see daily evidence of reasonable adjustments being made to support the residents’ needs.”

Some people experienced emotional distress in certain situations. This was well supported by staff who were well trained in this area of care. One of the registered managers told us, “Some individuals we support have positive behaviour support plans that include de-escalation strategies. These may involve supporting individuals to relax in their bedrooms, for example by listening to music. Where individuals are alone in their bedrooms during such periods, audio monitoring is in place to ensure their safety.”

Incidents and accidents were recorded and contained details such as a description of events leading up to the incident, action and response and post incident analysis. Each report also highlighted what had been put in place to prevent re-occurrence. Following the incident, an action plan was put in place and care plans, and risk assessments were reviewed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were supported in a safe and well-maintained environment that met their needs. Relatives told us the environment was safe for their family members. One relative stated, “My family member doesn’t have particularly good vision. They could trip over things. The staff keep everything clear for them.”

There were effective systems in place to monitor and regularly check the safety and upkeep of the premises. The management team and staff worked together to help ensure any potential risks were identified and addressed promptly such as faulty equipment or trip hazards. Safety checks were completed daily and weekly in all areas of the home to ensure safe systems were in place. These included water temperatures, fire safety checks and kitchen equipment. They also responded promptly to any reports from the staff where repairs were required.

Equipment used to support people was suitable, well maintained and stored securely. The provider had an up-to-date emergency plan in place to help ensure people were supported in the event of an adverse event.

A member of staff who was had long service with the provider said, , “Being able to put up a photograph or fix a television for a resident may seem small to someoneelse butcan makea huge differenceto them. I like coming to work and feel like everyone works well together as a team.”

Personal emergency evacuation plans were in place for each person. These contained detailed information about each person and the support they required to safely evacuate the building in the event of a fire or other emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Relatives told us, “Generally, there’s enough staff – we all want more don’t we”, “I would say most of the time 99% there’s enough staff”, “There’s no shortage of staff, and they’re also well trained” and “Most of the time there’s enough staff but occasional problems, like anywhere else. All care homes have problems with staff, but they’ve made a real effort over the last few years, and everything is stabilised.”

The provider carried out checks on the suitability of staff before they started working at the service. Systems in place included checks on new staff’s identity, eligibility to work in the United Kingdom and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

Staff told us they were happy working at the home, felt supported and listened to. They said they received training that equipped them to do their job well and care for people who used the service. A staff member stated, “The training has been robust and there is a lot to do in person and online. There is a lot of time to prepare.”

Newly recruited staff received an induction which included a welcome and introduction to the different services and people who lived there, health and safety and training the provider identified as mandatory, such as safeguarding, infection control, moving and positioning, communication and health and safety.

Throughout the induction process, new staff were introduced to training specific to the needs of people using the service, such as dysphagia (dysphagia is a medical term for difficulty swallowing), learning disability and epilepsy. Staff had completed level 1 Oliver McGowan training and level 2 was being rolled out commencing 27/1/26. This is a specialised training course to assist health and care staff caring and supporting people with a learning disability and autistic people.

The new staff undertook a period of shadowing more experienced members of staff and were assessed to ensure they were ready to work unsupervised. A staff member told us, “When I started, every unit went through the residents’ care plans and let us know about how they want us to get to know residents, epilepsy care plans and any other health conditions. They went through fire safety, and I have been included in fire tests. I like the staff, they are good and I love working with them.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us they felt safe from the risk of infection because premises and equipment were kept clean and hygienic, and relatives confirmed they did not have any issues with cleanliness of the service. One relative told us, “It’s very clean and tidy there. There’s a cleaning team. [Family member’s] room gets a top to tail once a week.”

Each of the properties we visited was kept clean, tidy and well maintained. Staff wore appropriate protective personal equipment (PPE) when supporting people to help protect them from avoidable infections.

Safe systems were in place in relation to infection control. The provider ensured staff had access to PPE and were trained in its use. The provider’s infection prevention and control policy was up to date. Information about the risk of infection was shared appropriately with people using the service and visitors. The registered managers and staff carried out audits to ensure high standards of cleanliness.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Some people were prescribed medicines to be administered on a when-required basis for health conditions such as constipation, pain, and anxiety. The service used specialist assessments to support them to identify if someone was distressed or in pain. These assessments help staff to provide the best support for people who do not communicate verbally. Following our feedback the service made improvements to the content of guidance for staff to ensure it was always person-centred.

The staff carried out assessments when medicines were administered covertly. Covert administration of medicines is when it is given in a disguised form without the knowledge or consent of the person mixing it in food or drink. The service employed a medicines officer who was working to ensure that all guidelines with respect to any covert medicines being mixed with any food or drinks, were clearly documented in people’s written covert instruction which was signed by the GP. This was also included in monthly medicines audits.

The service had implemented a medicines review tracking spreadsheet to facilitate quarterly psychotropic medicines (drugs that alter brain chemistry to affect mood, thoughts, perception, and behaviour), including high risk medicines, with the GP and in line with best practice STOMP guidelines. STOMP stands for ‘Stopping Over Medication of People with a learning disability and autistic people’.

Medicines, including controlled drugs and over the counter medicines, were stored securely and at correct temperatures. Following the last inspection, improvements had been made to record keeping for these medicines. There was an adequate stock of prescribed medicines.

Our observations and records showed people were having their medicines administered as prescribed. An electronic medicines administration (eMAR) system had been recently implemented at the home. There were adequate devices to use the eMAR system, and the staff received training to use it.

There was a medicines policy in place. There was a process in place to report and investigate medicines errors and incidents. Staff carried out medicines management audits to identify gaps and make improvements. There was a process in place to receive and act on medicines alerts. The staff received training and had their competency assessed to handle medicines safely.