Merecroft

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.

Staff understood how to report and record safety events. The registered manager and senior leaders reviewed events regularly to identify themes, trends and patterns, understand why they had occurred, and establish lessons to reduce the risk of recurrence. One staff member gave an example of an event which had been discussed as a team and explained how the discussion had helped staff identify learning and actions to prevent a similar event from happening again.

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.

Some people had lived at Merecroft for many years. Their needs had been assessed before they moved into the service to ensure staff could provide safe and effective support. However, the management team was open and honest and told us, in some cases, limited information had been available at the point of admission, particularly during emergency placements. In these circumstances, staff assessed people’s needs and developed their care plans as they got to know them.

The provider worked with commissioners and the multidisciplinary team to reduce risks, promote positive outcomes and plan a move to a service better suited to a person’s needs. The registered manager explained how any transition would be carefully planned to reassure the person, maintain continuity of care and support a positive experience.

The registered manager maintained effective working relationships with health and social care professionals, including GPs, psychiatrists, social workers and advocates. Coordinated reviews, timely referrals and the prompt sharing of relevant information helped ensure changes in people’s needs were communicated and acted on, supporting safe, consistent care and continuity between services. One professional said, “[Registered manager name] responds promptly and provides information when requested.”

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 demonstrated a good understanding of individuals' needs and how to keep them safe. They could clearly explain the practical steps taken to minimise risks to people's safety and worked collaboratively to identify and address potential triggers or behaviours of concern. One staff member said, “Any incident is recorded in people’s notes, and the manager and head office go through it. Then we have a handover and we discuss what happened during the day, what happened during the night.”

Staff had received safeguarding training and told us they would be comfortable to raise any concerns. One relative said, “I think [person’s name] is pretty safe, as they are quite happy to go back. [Person] has tea with us when they come to visit and is ready to go back home to Merecroft.” Another relative told us, “They’re (staff) very good with [person] and have fantastic a relationship. If there was anything [person] was concerned about [person] would talk to me because we have regular contact on WhatsApp or [person] would speak to [registered manager name].”

The provider had reported safeguarding concerns to the appropriate authorities and took action to safeguarding the people living at the service. Relatives confirmed they were informed of any concerns. One relative said, “Safeguarding always contact me but the home contact me first with full details about what they do for example there was a recent medication error, and they retrained the carer and safeguarding were notified. That was fine.”

Leaders demonstrated an understanding of the legal framework relating to restrictive practice and Deprivation of Liberty Safeguards (DoLS). Where people were subject to restrictions, appropriate legal authorisations had been sought to support people’s safety whilst protecting their rights. The team had also discussed the new framework for DoLS during governance meetings.

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.

Care plans and risk assessments were in place for people. Staff involved people in managing risks and tailored support to their individual needs. For example, where fire alarm noise caused anxiety for a person, staff helped them become familiar with it by involving them in routine alarm tests. This approach reduced distress, increased the person's confidence in responding to alarms, and helped minimise behaviours which could place them or others at risk during an emergency.

The registered manager promoted a least restrictive approach to risk management, balancing people’s safety with their right to make choices over their lives. For example, when managing risks related to food-related behaviours, environmental hazards and accessing public spaces in the community.

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 personalised their living spaces to reflect their individual preferences and interests. They also had access to a communal kitchen, a lounge, and a large outdoor space to enjoy. A relative said, “The place suits him and I like the environment as it’s the biggest thing that’s helped. When [person] was in a previous place, they were with others and was stressed and wanted their own space and they gave [person] this.”

Environmental risks were appropriately managed. Window restrictors were fitted, and wardrobes were secured to walls to minimise the risk of avoidable harm.

Records showed fire safety checks were regularly carried out. People had personal emergency evacuation plans (PEEPs) in place to guide staff on how to safely evacuate them from their home in the event of an emergency. Staff had completed fire safety and health and safety training, ensuring they understood how to maintain a safe environment and keep people safe.

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.

We observed sufficient staffing levels to support people safely. People were receiving their funded hours during our visit. Staff told us they felt overall there were enough staff however, one staff member felt they could benefit from an additional staff member to, ‘just be around’ to support when challenging situations occur. However, all staff we spoke with told us the registered manager was always available and supported them when needed.

One relative said, “Merecroft has had this year quite a high turnover of staff. Some carers I like a lot and they’re the ones who really get [person].” Another relative told us, “I do like staff. Care staff come and go, and [person’s name] has been there many years, but they’re (staff) all very good and I see them regularly.”

Staff were recruited safely. Recruitment records confirmed appropriate pre-employment checks had been completed, including full employment histories, explanations for any gaps, references and Disclosure and Barring Service (DBS) checks. DBS checks provide information about relevant convictions and cautions to support safer recruitment decisions. These checks helped ensure staff were suitable to work with people who may be vulnerable.

Staff confirmed they received regular supervision and relevant training, including communication, learning disability, autism, mental health, and moving and handling. However, one staff member felt mental health training would be beneficial for all staff, not only a core team of staff.

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.

The home was clean and tidy. One relative said, “The cleanliness is spot on and when [person] comes here, they use that time to deep clean their room, and it always looks nice.”

Staff received training in infection prevention and control (IPC). Staff supported people to keep their environment clean and tidy and, where they were able and chose to participate, involved them in routine household tasks such as doing their laundry. We observed this during our visit.

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.

Medicines were managed safely. Staff had detailed guidance of how and when to administer prescribed medicines, including 'as and when' PRN medicines. The management team understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured people's medicines were reviewed in line with these principles. A relative told us, “I don’t know what medication [person] is on, but they are generally more settled at the moment.” Another relative shared, “We have no concerns with medicines because the psychiatrist is in control.”