Meridan House

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 was the first assessment for this newly registered service after the provider made changes to their registration. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was sometimes limited assurance about safety.

This service scored 59 (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 did not always have a proactive and positive culture of safety. The provider did not check lessons had always been learnt following safety events.

A significant safety event had happened some time ago which involved a person who was living at the home at that time. Some actions had been taken to respond to this. But there had been no work completed to review if lessons had been learnt. Whether all necessary actions had been completed to promote people’s safety regarding this matter and if best practice is now embedded into staff/management practice. No one came to harm as a result of this shortfall, but it demonstrated the provider oversight and culture to respond to safety events was not effective.

The registered manager worked with people and staff to maintain safe systems of care, in which safety was managed. But they did not always make sure there was continuity of care, including when people moved between different services.

There were safe systems of care which included an incident process, which was followed when an incident occurred for the person the service supported. This person also moved services from the provider’s other service. Their health care support plans transferred with them. However, they did not have a review of their care needs and associated risks until a month after moving to the home, which was prompted by this assessment. Even though staff and managers had identified changes to their needs before this point. Staff were not recording the care provided to assist the monitoring of this person’s care needs. We fed this back to the registered manager who updated this person’s care plan and risk assessments.

The provider worked with staff 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 and abuse.

Staff were aware of the potential risks to some people experiencing abuse, especially financial abuse due to their vulnerabilities connected to their mental health needs. Staff said they would report these concerns to a manager or the registered manager. Staff were aware the provider had a whistle blowing number to call if they felt the need to alert the provider. However, most staff did not know about the other professional bodies they could also report their concerns to outside of the provider and home, such as the local authority. Some further work was needed to promote this knowledge.

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

The person’s risk assessment was not updated when their needs changed following moving to the home. Staff and the registered manager knew of the changes, but they had not updated the risk assessment and created new care plans as part of the process to continually assess, review and meet these new needs. This person was known to become anxious about the management of an important part of their life. There was no risk assessment and care plan for this. They had not been involved in the management of this. A staff member was also not supporting this person to manage this risk and need. We fed this back and the registered manager who took action to correct these shortfalls.

The provider had detected and controlled potential risks in the care environment. They made sure equipment and facilities supported the delivery of safe care. But there were shortfalls in consistently ensuring the environment was safe.

There were various fire safety checks taking place at the home. Some people chose to smoke outside in the garden, but there was a known risk they may smoke inside sometimes. The provider and managers were monitoring this risk and had taken appropriate actions to reduce any potential risk to people in the home. However, when the specialist fire safety company had identified actions were needed with the building, there were shortfalls with how these were managed and checked. The provider asked the managers to seek advice from the maintenance team if another fire risk assessment was needed once the actions had been completed, but the managers did not do this. Managers had not created a specific emergency evacuation plan for the person the service supported. This was not within best guidance practice. We asked the registered manager to correct this as soon as possible.

The provider made sure there were enough qualified, skilled and experienced staff, who received supervision and development. Staff worked together well to provide safe care that met people’s individual needs.

There was enough staff to meet the needs of the person receiving care. We saw appropriate staff presence to respond to issues and requests for help and support, from other people. Staff had been safely recruited. Staff received training in response to the person’s needs in receipt of care. Staff spoke well of the training, management presence/support, and the supervisions they received.

The provider did not always assess or manage the risks of infection effectively. They did not always detect and control the risk of it spreading.

The communal parts of the home looked and smelt clean. However, We found shortfalls with the management of one aspect of infection protection control (IPC) at the home. The registered manager and staff were not following best practice guidelines in regards to this issue. The provider had not established records or ways of evidencing some of the actions staff took to manage the spread of infection. Some aspects of the person’s room was not clean. The registered manager took action to address some of these issues creating an IPC process to evidence the cleaning regime of the laundry room.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

We completed a check on the person’s medicines and found they had received their medicines as prescribed. The registered manager had ensured the person’s medicine was being checked and audited to identify any issues. This person’s medicines were kept secure.