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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Systems and processes ensured safety incidents were recorded and responded to appropriately. Staff told us they were encouraged to report safety events, and stated they received good support from the office staff and the registered manager when they did so.

There was a clear escalation procedure in place and regular contact with the local authority to report safety concerns. A health and social care professional told us, “They know their service user's well, they are able to quickly provide a chronology of concerns over the phone (likely due to good record keeping) therefore information is passed on quickly and effectively for next actions to be taken.”

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.

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

Hospital passports were introduced as an option for people to consider during the assessment. A hospital passport is an essential tool that helps health professionals understand an individual’s needs quickly and accurately, particularly in emergency or unplanned hospital admissions. For people with a learning disability for example, communication challenges, sensory needs, anxieties, or difficulties expressing pain or symptoms can significantly impact the safety and quality of their care. A hospital passport helps to reduce these risks by clearly outlining how the person communicates, their medical history, conditions, medication and any reasonable adjustments they need.

We requested feedback from 5 health and social care professionals. We received 1 response. The response was positive. They told us, “They raise concerns promptly by raising a contact to adult social care.” We received no concerns from health and social care professionals prior to the assessment.

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 carers made people feel safe. People told us, “I like them all and feel safe and trust them” and “I feel very safe with [staff] as [staff] is so vigilant and well trained.”

Staff had access to policies and procedures on safeguarding and received the necessary training to help keep people safe. We spoke to 10 staff, during the onsite visit and telephone calls with them, 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 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.

Risks related to people were assessed and managed appropriately, with the involvement of people and their families.

Staff had the appropriate level of training to understand and support people’s individual risks.

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

Environmental risk assessments 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. Fire safety measures were improved during the assessment to support people whose individual circumstances increased their level of risk.

Staff told us they felt safe working in the community and their needs had been considered.

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 received positive feedback about staff training. People told us, “The carers are well trained as they know my routine and just get on with the job” and “They are well trained and manual handling is safe.”

Staff were recruited safely and had the appropriate pre-employment checks in place before employment commenced. Staff received good support. They told us, “Supervision is regular as well as spot checks. This is actually quite useful. They take time to consider well-being” and “Yes, the training gives me the confidence, and we get refresher training too.”

The organisation of people’s visitswere more effective and punctuality had improved since the last assessment.

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.

Staff received infection, prevention and control training and regular spot checks took place to support compliance.

The staff we spoke with 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. They told us, “The carers wear their gloves and aprons, and they do wash their hands” and “Personal Protective Equipment is worn during personal care.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Staff had effective processes in place to obtain medicines, seek advice, and confirm stock availability so they could resolve any issues promptly. They ordered medicines in a timely manner to ensure people had their medicines when needed, with prompts in place for anticipated shortages, including weekends and holidays. The service also had arrangements to access advice outside of normal working hours.

Medication Administration Records (MARs) were available and staff used them appropriately. When staff supported people with their medicines, they completed the corresponding MAR entries. Staff did not always document the use of thickener on the MAR charts, including the amount used. This meant the service could not demonstrate that people received their thickener as prescribed or that it was administered safely. The reason for non- administration was unclear; we saw examples of missed critical medicines with no rationale recorded.

Medication lists were reconciled correctly with GP records. Protocols for “when required medicines” (PRNs) were in place for people who required PRN medicines; however, they did not always provide sufficient information to guide staff in administering these medicines safely.

Catheter care planning was detailed and person-centred. Care plans set out clear protocols for staff to follow, and staff documented evidence demonstrating that they followed this guidance.Care plans for other conditions were not always maintained accurately, up to date, or person‑centred.

However, some service users had detailed task‑planning entries and prompts that guided staff on how to manage specific conditions such as diabetes and epilepsy.

There was a system in place for reporting incidents. Staff described how medicines incidents were reported, investigated, and managed. However, it was unclear how learning from medicine related incidents was shared.