Meridian Health and Social Care - Manchester North

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to the governance at the service.

This service scored 57 (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 was in crisis in December 2024 and the service was still focusing on key improvements to ensure it was meeting the required standards. This had impacted significantly on the culture and direction of the service.

The Statement of Purpose, the Mission Statement and the Service User Guide, record the aims and objectives of the organisation and what people could expect from the service.

Most staff did report a marked improvement in culture since the new management team started in January 2025. One staff member told us, “November 2024 was a bad time. Things were upside down. I was thrown in at the deep end. After December 2024 things changed. They have done a brilliant job. Continuity of carers to clients has improved. The rotas have improved. Sickness has reduced. Training has improved. The staff in the community are resistant to change. This is an ongoing issue. There is tension with staff in the community for the time being.”

Policies and procedures along with staff training were provided to guide staff in equality, diversity and human rights, helping to promote good standards of care. However, staff required further support to better support people with a learning disability and autistic people.

There had been a lack of effective oversight of the service throughout 2024. This had impacted on the culture and values of the service. Leaders had not always had the skills, knowledge, experience and credibility to lead effectively, or they had not always done so with integrity, openness and honesty.

The Nominated Individual recognised changes were needed and the management team had been reorganised. The registered manager, and the senior management team in place since January 2025 were experienced and working towards a common goal to ensure the service met the standards required.

Most of the staff we spoke with told us there had been a marked improvement since the new team started. They stated, “We have had a few different managers in recent months. This has been disruptive. No concerns at the moment, we are on the same page and things are going well now.”

Staff told us there was an open culture and they were encouraged to raise concerns. Office staff were available during office hours and there was an on-call system out of hours.

Staff were provided with training and handbooks, which outlined relevant policies and procedures and what was expected of staff working for the service. Information provided outlined the whistleblowing procedure and guided staff on what they should do if they needed to report information or concerns. Staff told us they were confident about raising issues or concerns, including poor practice. One staff member said, “I have raised concerns and yes I felt listened to”.

Staff forums had been introduced to provide more opportunities for staff to participate. Uptake was poor but these will continue to be offered.
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The induction process and training outlined expectations of staff as well as their employment rights including support around staff well-being and flexible working arrangements. Information included the ‘equality, diversity, and inclusion policy’ which promoted equal opportunities for staff and how their protected characteristics would be considered and respected.

All staff had received a one-to-one meeting following the introduction of the new management structure. Managers considered staff work life balance and required working patterns when compiling rotas.

There were a range of appropriate policies and support systems including an employee wellbeing scheme in place to support staff.

The provider had failed to maintain effective governance systems demonstrating clear management and oversight of the service. A schedule of audits and checks had not been in place in 2024 and had only recently been implemented in May 2025.

The provider had worked closely with the local council to start improvements and changes were being implemented. A reorganisation of staff had taken place, including a new registered manager who had started in February 2025.

However, not enough progress had been made, and we found multiple breaches of regulations related to person centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, staffing and good governance.

Provider oversight had not been fully established and there was limited evidence that the provider could consistently and independently self-identify issues of concern through their own monitoring and quality assurance processes.

We could not be assured medicine administration records were accurate and up to date and this put people at risk as detailed in the safe domain of this report.

Visit schedules had not been managed safely. Improvements had been made but further improvement was required. There were still significant shortfalls with punctuality, call duration and a lack of travel time. Poor scheduling impacted negatively on at least half of the people who used the service.

A lack of oversight of care plans in 2024 had exposed people to an increased level of risk. It was acknowledged by the provider they were of poor quality and all of them needed to be reviewed. This had been completed by the end of the assessment.

There was poor oversight of risk related to individual people’s care. The management team did not have a good understanding of people’s needs within the service, and they did not have adequate records to provide them with the information they needed. There had been no oversight of accidents and incidents. None had been recorded in 2025. This is unusual for a service of this size.

The provider had failed to ensure staff maintained an accurate, complete and contemporaneous record. Poor record keeping put people at risk of not receiving care in line with assessed needs. The care records lacked detail and were repetitive and carers had on occasion written the record before providing the care. All the care plans had been reviewed and updated by the end the assessment.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider understood their duty to work in partnership with other agencies, ensuring appropriate referrals were made to external health and social care professionals. Evidence was seen where the provider had attended numerous meetings with other professionals to provide valuable input and help resolve issues for a person.

The provider was working collaboratively with the local authority to help drive improvements within the service. Regular meetings had taken place, where progress with planned actions had been reviewed.

We contacted other professionals, 2 replied and they provided positive feedback of their engagement with the provider.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. A lack of oversight and governance had impacted on their ability to do this.

Staff felt supported and told us they could raise issues to help improve the service where required. Staff were encouraged to share views in meetings. A forum for people and staff had been implemented recently and attendance at these meetings was encouraged.

People and their families were confident they could also contact the office. Office staff made regular calls to people to obtain feedback about their experience of care. We saw actions taken in response to any shortfalls identified.