Archived: Meadbank Care Home

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. People were safeguarded from abuse and 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. The manager ensured that effective communication was used with staff to monitor and respond to people’s changing needs. Daily clinical meetings and walk arounds were used to share important information with staff in a timely manner. This included learning from accidents, incidents and near misses. When incidents happened a route cause analysis was carried out to determine how they occurred, and the manager shared the findings.

Staff were aware of the importance of learning from incidents. Incidents were documented and investigated, and we saw examples where learning was shared through case studies. Staff were able to describe changes made to reduce risk and prevent reoccurrence. This included reviewing care plans and taking proactive steps to involve health professionals. Staff told us, "When something goes wrong, we talk about it and learn from it." One professional commented that they had "never been concerned discussing any significant events" with staff as they were always receptive and prepared.

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.

The provider ensured that people’s needs were assessed, and their preferences identified before they moved in. This ensured the service was capable of safely meeting their needs.

At the time of our inspection the provider was supporting people with assessments undertaken by prospective providers in advance of the service closing. The provider included families as part of this process. To support this process the provider shared care records and staff knowledge with new providers. This meant that new providers understood people’s needs and had contact details for involved health and social care professionals.

There were safe systems in place to support people during care transitions. Staff worked closely with community health teams to ensure changes in residents' health were identified early and escalated. We were told of examples where prompt referrals were made to physiotherapists and other specialists. One professional said, "I’m not aware of delays in referrals; they are good at managing their own referrals and communicating with community teams promptly."

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.

The manager and staff understood their responsibilities to keep people safe. When required the provider made referrals to the local authority safeguarding team and cooperated with subsequent investigations. Relatives were informed when safeguarding concerns were raised. This was in line with the provider’s duty of candour. The learning from safeguarding events was shared within the staff team to improve care and support and to prevent reoccurrence.
Staff received training in safeguarding and knew how to recognise and report abuse. People told us they felt safe. One resident said, "I always feel comfortable with the carers." Staff demonstrated an understanding of their responsibilities. Safeguarding concerns had been raised appropriately and followed up with the local authority.

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.

People’s risks were identified, assessed and mitigated. Staff assessed people’s known risks where required and made referrals to healthcare specialists to carry out assessments. For example, where there were risks identified to people’s skin integrity, referrals were made to tissue viability nurses who carried out assessments and wrote guidelines for staff to follow to protect people’s skin. These included barrier creams, pressure relieving mattresses and repositioning. This meant that people’s risk of developing pressure sores was reduced. Risk assessments were in place for areas such as choking, nutrition, and pressure care. Managers reviewed these regularly and updated them as people’s needs changed.

People were protected from the risk of choking. How people ate and drank was assessed. Staff followed established protocols and policies that protected individuals during choking incidents. The provider kept these polices up to date through continuous review.

When staff had concerns about the people’s swallow safety, referrals were made to healthcare professionals. Staff followed the guidelines developed by healthcare professionals to keep people safe. For example, when required people had their meals softened and drinks thickened. Kitchen staff had a list of people’s food requirements. This included food textures and allergies, enabling staff to support people to eat and drink safely.

People were involved in decisions about their care. Risk assessments were personalised and regularly reviewed. Where people lacked capacity, decisions were made in their best interests with input from family and professionals.

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

The care environment was safe. Staff ensured that all areas were free of trip hazards and carried out a range of checks to ensure the care home and its equipment were safe for people to use. These checks included hoists and slings to support people’s mobility, and the call bell alarm system used by people to summon assistance when needed. The provider had a fire risk assessment. There were fire doors and window restrictors in place.

The home was clean and well maintained. Staff responded promptly to any environmental concerns. One professional shared, "When I raised a concern about a resident’s room being too warm and a broken piece of furniture, the management immediately arranged for a fan, reviewed the ventilation, and replaced the furniture."

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. Each floor at the service had a dedicated team led by a unit manager. They were supported by 2 nurses and 8 care staff. This meant there were enough staff available to support people safely.

Staff were recruited safely. The provider interviewed applicants and took up the employment references of successful candidates. Criminal records checks were carried out as well as checks against lists of individuals barred from working with vulnerable adults. The provider confirmed the identities of potential staff as well as their eligibility to work in the UK. This meant the provider assured themselves of the safety and suitability of staff to provide care and support.

Staff received regular supervision and annual appraisals. These processes enabled staff to receive formal feedback on their performances and to plan their professional development. Staff received training in a wide range of areas. The provider supported nurses to maintain the competencies required as a condition of their continued professional registration.

Some residents told us they were familiar with staff, while others noted a mixture of longstanding and new faces. A professional told us that although there had been some new staff, the experienced nurses "manage situations like end of life care very well."

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 were protected from the risk and spread of infection. Staff wore personal protective equipment such as gloves, masks and aprons when providing personal care. These were single use items which prevented the risk of cross contamination. Staff followed a programme of cleaning the environment and equipment to keep people safe.

The provider’s food hygiene practices ensured food safety. Food storage and preparation areas were regularly cleaned, and a colour coded scheme was used to separate the equipment used for different food types such as cooked and uncooked meats. The temperatures of stored, refrigerated and cooked foods were checked and recorded. There were reporting protocols in place if temperatures were not in range. Kitchen staff received food safety training.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received their medicines safely and as prescribed. Nurses administered people’s medicines as prescribed. Medicines records contained photographs of people to ensure the right person received the right medicines. Staff had clear guidance in care records for the administration of ‘when required’ medicines. This included when to administer and the maximum number of doses to be administered before seeking advice from the GP.

Medicines were stored safely. Locked medicines trollies were stored in locked clinical rooms. This prevented unauthorised access. The temperature at which medicines were stored were monitored and recorded to ensure they remained safe.

Staff were trained and assessed as competent. One professional told us, "They notify the doctors when there are changes in condition, for example if they are struggling with their medicines." Medicines were stored securely, and audits were carried out to check for any missed doses or errors.