Meridian Health and Social Care - Leeds

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 newly registered provider. This key question has been rated 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.

Lessons were not always learnt to continually identify and embed good practice.

Whilst incidents, complaints and safeguarding concerns were recorded, there were limited evidence to demonstrate how information was reviewed, analysed and used to identify learning. Records did not consistently show evidence of trend analysis, reflective review or how learning was consistently shared with staff to improve practice.This is reported on further in the well led domain.

Staff demonstrated an awareness of the importance of reporting concerns and described clear processes for escalation. One staff member told us, “Everything gets documented on the system and followed up with a phone call.”

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.

Systems were in place to assess, monitor and manage risks to people’s safety and support safe transitions between services.

People and relatives described transitions into the service as smooth and well-coordinated. One person said, “GP to start with and then a social worker. It worked well,” and another told us, “From hospital there were no issues.” A relative stated, “Good transition. Came to the house and spoke to us as a family. Really good.”

Staff described processes to ensure safety in people’s homes. One staff member told us, “When I go in, I remove the key safely, lock the door and make sure everything is in order.”

There were mixed responses from staff regarding travel time between visits. One staff member explained, “We can be expected to travel long distances in a short time which is not always possible.” Another staff member told us, “I have enough time. No issues.”

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.

People and their relatives consistently told us they felt safe receiving care. One person said, “I feel safe. Very trustworthy,” and another commented, “I feel safe just having them here helps.” A relative confirmed, “All very good. 100% safe.” People also knew how to raise concerns. One person told us, “I would ring the office,” and another explained, “I have telecare round my neck, I would contact them.”

Staff demonstrated a clear understanding of safeguarding responsibilities. They could recognise potential signs of abuse, including changes in behaviour and unexplained injuries. One staff member said, “We look out for bruises or if someone becomes withdrawn or not themselves,” and another told us, “If anything unusual is noticed, we report it straight away.”

Staff confirmed they had received safeguarding training and understood reporting procedures.

The manager confirmed safeguarding concerns would be escalated appropriately and in line with local procedures. Records reviewed showed no safeguarding concerns at the time of inspection, and systems were in place to support escalation where required.

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 to people’s safety were assessed, monitored and managed effectively, with people involved in decisions.

Care records demonstrated that risks relating to falls, skin integrity, choking, Parkinson’s disease and reduced mobility were identified and documented. A falls risk assessment identified people at high risk and provided clear guidance for staff, including escalation to healthcare professionals or emergency services.

Skin integrity risks were managed through preventative approaches, including repositioning, monitoring and the use of pressure-relieving equipment. This supported people to maintain skin health and reduce the risk of pressure damage.

People and relatives described how risks were managed in practice. One person said, “No trip hazards,” and another told us, “Safe as possible.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had completed an environmental risk assessment on pre-assessment. These were reviewed when any changes occurred.

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.

People and relatives were positive about staff and described them as kind and respectful. One person said, “They are lovely, smashing,” and a relative commented, “They treat [name] with respect.” Continuity of care was good. One person told us, “Continuity yes. I have built up a rapport,” and a relative said, “Weekly rota, rarely changes.”

Staff had access to training and supervision. One staff member told us, “We have supervision every six months.” Training covered key areas including safeguarding, medicines, nutrition and long-term conditions. Staff demonstrated knowledge in practice, for example one staff member explained, “With dementia you have to be calm, not argue and go along with people.”

There was evidence of competency checks in some areas, particularly medicines. One staff member said, “They come out and check our competency.”

We saw evidence that some staff had completed face-to-face training, including moving and handling and medication. The provider had identified the need to strengthen this approach and had plans in place to expand face-to-face provision, particularly for practical skills. The manager acknowledged this and confirmed that improvements to training delivery were already being implemented.

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.

Infection prevention and control measures were in place and followed in practice. People confirmed staff used appropriate personal protective equipment during care. One person told us staff “always use gloves and aprons.”

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.

Medication Administration Records (MAR) evidenced that medicines were administered as prescribed. Where medicines were prescribed on an ’as required ‘(PRN) basis, clear guidance was in place to support staff in making safe and appropriate decisions about administration.

Staff demonstrated a good understanding of medicines management and confirmed training and competency checks.

Staff understood how to manage medicines safely, including recording refusals. One staff member explained, “We record refusals on the MAR chart and inform the office.”

These processes supported the safe administration and management of medicines.