Meridian Health and Social Care - Manchester North

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.

This is the first assessment for this service. This key question has been rated requires improvement. This meant people were not safe and were at risk of avoidable harm.

The service was in breach of legal regulations in relation to safe care and treatment and the way people’s medicines were managed, staffing, as people’s visit schedules were not safe and safeguarding, as people were at risk of neglect.

This service scored 41 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

Systems had not been effectively established to ensure safety incidents were recorded and responded to appropriately. There had been no incidents or accidents recorded in 2025. However, we identified some in the records we reviewed. They had not been escalated by care staff, so no action was taken to respond to the incidents and no learning was implemented as a result.

Staff told us they knew how to escalate accidents and incidents, although we saw no evidence of this during the assessment.

As part of the on-going development of governance systems, accidents and incident records needed further review to identify any themes and patterns, helping to inform and embed areas of learning and development across the team.

The service worked in partnership with a range of health and social care professionals, so people’s current and changing needs were met. Staff were clear who to report concerns to and there was a process in place to follow up referrals.

New referrals were assessed face to face to ensure people’s needs could be met. Staff said they had access to relevant information about people’s care and support needs, which they could read on electronic handheld devices. If they had a concern about people’s changing needs, staff could report back to office staff so that appropriate referrals could be made to the relevant agencies, where necessary.

Poor records in some care plans increased the risk of care pathways and transitions not being safe as the information being shared may not be accurate.

We requested feedback from 10 health and social care professionals. We received 2 responses. Both were positive and reported good relationships with the office staff and told us they were responsive to any requests made.

The provider did not operate systems and process to ensure people were kept safe. The provider did not share concerns quickly and appropriately.

We identified safety incidents where concerns had not been escalated appropriately by staff, and this put people at risk. There was no specific escalation policy in place to ensure people who were at risk of self-neglect were highlighted and referred to the local council. This was implemented by the end of the assessment.

Systems and process were not sufficiently robust to help identify potential safeguarding concerns. The provider introduced a new system during the assessment to ensure branch level incidents and accidents were recorded and actioned in future.

Staff understood safeguarding when we spoke to them and reported no concerns about people's safety during the onsite visit and during telephone calls with them. However, people’s needs were at risk of being neglected as call durations were too short to enable their needs to be met. For example, the local authority would allocate a 30-minute visit and staff would only be in attendance for 5-10 minutes.

Staff had access to policies and procedures in safeguarding. Records also evidenced training had been undertaken and staff told us they had received the necessary training and were able to describe what might constitute a safeguarding concern. We spoke to 22 staff to check their learning in practice. They all understood their responsibilities and how to report concerns. They were confident managers would respond appropriately.
 

The provider did not always work well with people to understand and manage risks.

It had been identified prior to the assessment that care plans and risk assessments were out of date and were of poor quality. We reviewed records for 13 people. Some people’s risk assessments were detailed and person centred and evidenced involvement of the person and their families. Others were lacking in detail and did not always give clear guidance to carers. Records lacked pertinent information on the support people required with catheter care, personal care, self-neglect, communication, and distressed behaviours. We could not be assured all the people supported were being provided with the correct level of care to keep them safe. All the care plans and risk assessments had been updated by the end of the assessment.

The provider detected and controlled potential risks in the care environment. Risk assessments were in place to ensure the environment was safe for people and staff.

This included information on smoke alarms, fire risk, escape routes, risk mitigation and how to switch off the electricity, water, and gas supply in an emergency.

We spoke to 15 members of staff who worked in the community. They told us they were suitably trained to use moving and handling equipment and they felt safe working in the community and their needs had been considered.

The organisation of people’s visits was not managed effectively. This resulted in calls that were too early, too late and too short. This put people at increased risk of unsafe care.

8 out of 24 responses, in telephone interviews with people and their families, told us about concerns related to early visits, late visits, duration of the visits, staff being rushed and irregular carers. Comments included, “They don’t turn up on time and it has happened in the past that they just don’t turn up at all and they don’t stay long enough” and “I have no problem with my regular carer, but this week [carer] was off, and they are just sending anybody. The carer was supposed to be here at 10am and its now 11.20am.”

A high number of calls were either more than 45 minutes early or late. Many people did not get their allocated time for visits. A high number of calls were scheduled with no travel time which could result in staff needing to rush between visits. Some visits required two staff members to attend together to ensure the care was delivered safely. There were issues with almost half of these visits as staff were either not present at the same time or they were only present at the same time for a short period. The provider and the commissioning team from the local authority had identified this prior to the assessment and had taken some actions to address this. However, it was still ongoing, and a large number of visits were affected. This put people at risk of not receiving safe care.

Training records we reviewed showed staff were up to date with their essential training and attended regular updates to ensure their knowledge and skills were maintained. A review was carried out by the new management team when they started in January 2025 to ensure all staff training was up to date. Most of the staff we spoke to told us they received sufficient training to support people. All staff had been provided with one-to-one supervision. Spot checks on staff occurred on a regular basis and new staff had additional support and checks to support their learning and development.

Staff were recruited safely and had the appropriate pre-employment checks in place before employment commenced.

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.

There was evidence of up to date and ongoing infection, prevention and control training and regular spot checks on staff to ensure compliance.

We spoke to 15 staff about infection control, and they understood what infection, prevention and control was and could explain how they used their training in practice. Experts by Experience contacted people and their families and there were no concerns raised about staff practice.

Medicines were not always managed safely. Systems and processes were not robust and put people at risk of unsafe care.

There was no effective system in place to check the accuracy of people’s medicines when a care package was commenced. There was also no effective system in place to accurately verify changes to peoples’ medicines.

There was no effective system in place to identify which medicines needed to be given at specific times with regard to food, or on an empty stomach or with a safe time interval between doses. This meant there was not enough information to ensure that peoples’ calls could be scheduled in order to administer the medicines at the times they were needed.

When people regularly refused their medicines or cancelled their visits and medicines were not administered there no system in place to ensure where relevant timely communication with relevant health care professionals to assess the risk.

Information to support staff to safely give ‘when required’ medicines was not always in place and did not adhere to the service’s medicines policy. This meant there was a risk people might not have their medicines when they needed them.

The medicines policy needed updating to reflect the use of an electronic system and it did not cover all the required areas from national guidance.