The Meadow

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 good. At this assessment the rating has remained 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 service maintained 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.

Staff followed a clear process for recording accidents, incidents and near misses, which the managers closely monitored. Managers responded to issues by gathering relevant information and facilitating debrief sessions with the team, during which they shared lessons learned and guidance. They implemented the necessary measures to minimise risks and improve safety.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

Staff understood their responsibility to safeguard people. They knew how to recognise abuse and neglect, and report concerns through the appropriate channel. A staff member told us, “Safeguarding means protecting all people from getting harmed. To protect their dignity and protect them from abuse and neglect. If I see anything, I have to report to senior management, record on [system] and report to the police or local authority if needed.”

People felt safe at the service. A person told us, “It’s a safe place to be.” A relative said, “[Person] is certainly safe.”

For people whose freedom was restricted, the service sought the appropriate legal authorisations when needed.

The service identified risks to people’s health, care and support and implemented control measures to mitigate those risks. Staff provided care to meet people’s needs that was safe and supportive.

People’s care plans contained clear instructions on how to support them safely. Guidance reflected people’s individual needs and demonstrated how the staff team worked in collaboration with other health and social care professionals to support people safely. Senior staff regularly reviewed care plans and risk assessments, including after any incidents, and ensured updates were communicated to the rest of the team effectively. Staff showed a clear understanding of the risks to people and the measures in place to minimise them.

People who had swallowing difficulties were offered their meals according to specialist guidance. We observed staff using appropriate techniques when supporting people to mobilise. Feedback from relatives included, “They [staff] use a hoist [to transfer person] and they seem competent in doing it” and “The care they’re getting keeps them safe.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service 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.

The service conducted the necessary checks to ensure staff were recruited safely. Recruitment records included proof of identity, employment histories, employment references, right to work in the UK checks and DBS checks. DBS checks provide details of convictions and cautions to help employers make safer recruitment decisions.

Staff completed regular refresher training across a range of areas, including training related to people’s identified needs. A relative described the staff as “well trained and very patient”.

We observed brief periods during which staff were not consistently available to supervise people at lunchtime. However, the service was in the process of reviewing lunchtime arrangements and told us the measures implemented had improved people’s mealtime experiences and the level of staff supervision at mealtimes. A relative told us, “There’s a lot of people and carers around. Very happy with the ratio [of staff] to residents.”

Some people and their relatives expressed concerns about the high number of new staff. The managers acknowledged this and explained the reasons behind it, outlining the steps they were taking to reassure people and relatives while maintaining safety in the service.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service operated a safe medicines management system. This ensured people received their medicines on time, safely and as prescribed.

Staff were trained and assessed as competent to manage and administer medicines. Medicines, including high risk medicines and controlled drugs, were stored securely. Medicines administration records contained clear instructions for staff, including personalised notes on how people preferred to take their medicines. Staff recorded the administration of patches and topical creams appropriately. There was guidance in place to support the administration of ‘when required’ (PRN) medicines.

The service had a robust auditing and stock management process. Staff addressed errors promptly, with learning embedded into practice. People received regular health checks to ensure their medicines remained safe and appropriate.