We carried out a review of the data available to us about Meylan House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Meylan House, you can give feedback on this service.
Meylan House is a residential care home registered to provide personal care and accommodation to up to 7 people. At the time of inspection 5 people were living at Meylan House.
The site comprises of a 6-bedded building and a 1-bedroomed independent annex in the property’s garden equipped with a living/kitchen area and bathroom.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
Risks to people were assessed and mitigating strategies implemented. People had detailed care plans to ensure staff had the information required to support them safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the service had policies and systems to support this.
The provider made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go.
Staff were recruited safely and were supported within their roles. People were protected against abuse.
Right Care:
People were supported by staff who knew them well and who had the relevant training and skills to meet their individual needs.
Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
People were supported to maintain relationships. Staff supported people to stay in contact with friends and family and involved any significant people in the care planning process as appropriate.
Right Culture:
Some improvements were required to ensure the registered manager and provider had good oversight of the service. Some systems and processes were ineffective in identifying missing or conflicting information. The registered manager immediately implemented changes and new systems.
Staff felt valued and empowered to suggest improvements and question poor practice. Staff told us they were confident to raise concerns and complaints.
Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 11 June 2021).
At our last inspection we recommended the provider referred to best practice guidance on infection control and supporting people who may display behaviour that may challenge. At this inspection we found the provider had made improvements.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe, caring and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meylan House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Meylan House is a residential care home registered to provide personal care and accommodation to up to seven people aged 18 and over. The service was fully occupied at the time of our inspection.
The site comprises of a six-bedded building and a one-bedroomed independent annexe in the property’s garden equipped with a living/kitchen area and bathroom.
People’s experience of using this service and what we found
We carried out a focused inspection of the key questions ‘safe’, ‘caring’ and ‘well-led’.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. The service was not fully reflecting the principles and values of ‘Right support; Right care; Right culture’. This statutory guidance supports Care Quality Commission to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. Providers of existing services are expected to demonstrate principles and values including the environment meeting people’s sensory needs and preferences.
There were six people living in the main house and four of these people had autism. There was also one autistic person living in the annexe. The main house had little evidence of an autism-friendly layout in line with best practice guidance (such as appropriate quiet spaces to ensure people’s sensory needs and preferences were optimised). There was one open plan communal space but with the number of people and staffing levels required, the environment could be noisy with little opportunity for people to use other areas, other than their bedrooms.
We have made a recommendation the provider seeks and implements the values and principles of the current guidance.
The staff team were relatively new and beginning to work well together and in a collaborative way to ensure people received the support they needed. However, some staff did not have prior experience working in social care and we found the induction and training programme did not always reflect this. This meant the training provided did not fully ensure staff felt skilled and confident to support people with behaviours that could challenge. We also found that improvements were needed to ensure people’s preferred communication methods were effectively met in order to be able to express their views and choices.
We have made a recommendation about the provider seeking and implementing up to date best practice in respect of effective communication to meet people’s preferences and needs.
We observed many caring interactions and people and relatives we spoke with felt staff were caring and wanted the best outcomes for people.
Medicines were administered and managed in a safe way. Risk management plans were detailed. The home was clean and tidy, and there were mostly safe infection control practices in place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were auditing systems in place and the registered manager had an oversight of the day to day running of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was Good (published 6 June 2019).
Why we inspected
We received concerns in relation to the care people were receiving. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Meylan House on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Why we inspected: We undertook an unannounced focused inspection of Meylan House on 30 April 2019. We had received concerns from an anonymous whistle-blower about the practice of a member of staff. Alongside this we had received a high level of notifications of incidents between people who lived in the service. As a result, we undertook the focused inspection to investigate these concerns to ensure that risks were being managed safely. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity, so we did not inspect the Key Questions of Effective, Caring or Responsive. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.
People’s experience of using this service:
People were protected from abuse and avoidable harm. The provider had reported any concerns or allegations to safeguarding when it was identified. Where required, investigations were thorough.
The service shared information about risks consistently and reliably with staff and relevant others, including in handover meetings when staff changed over and other meetings.
Staff had received training and support was provided from a positive behaviour support team. This helped staff to identify and manage any risks that could result from behaviours that challenge.
Staff performance relating to unsafe care was recognised and responded to appropriately and quickly. Where concerns were brought to the provider’s attention, there was an appropriate thorough investigation involving all relevant staff and others.
Medicines systems were organised, and people were receiving their medicines when they should. The provider was following safe protocols for the receipt, storage, administration and disposal of medicines.
The provider and registered manager had an understanding of prioritising safe and high-quality care. There was evidence to demonstrate what action had taken place in response to concerns and incidents and in planning to prevent similar incidents in the future.
The service had effective governance, management and accountability arrangements. Where necessary, management had accounted for the actions, behaviours and performance of staff. Concerns are investigated in a sensitive and confidential way, and lessons are shared and acted on.
Rating at last inspection: At the last inspection the service was rated Good (published on 14 November 2017).
Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk. The report from our last comprehensive inspection, can be found by selecting the 'all reports' link for Meylan House on our website at www.cqc.org.uk.
Meylan House is required to have a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The new manager was present and assisted us during this inspection. The registered manager for the service left in May 2017. Another manager had applied for the registered manager post; however, left their post in August 2017 before registration was completed. At the time of the inspection a new manager was in place who had applied to be registered with the Care Quality Commission (CQC). Their CQC application is currently being processed. The manager is being supported by the assistant area director.
People were kept safe by staff that had received training on safeguarding adults and understood their responsibilities to report concerns. Risks had been appropriately assessed and control measures were in place to minimise the risks.
People received their medicines as prescribed. Staff had training and were checked to ensure they continued to be competent when administering medicines.
Recruitment processes were designed to ensure only suitable staff were selected to work with people. There were sufficient numbers of staff to meet the needs of people who currently used the service. New staff were supported with an induction when they commenced work in the service, including shadowing opportunities. Relevant training had been received such as managing medicines, food hygiene, health and safety and first aid.
Staff were supported through annual appraisals and a number of supervisions throughout the year. Staff told us that they felt supported by the manager and that communication was effective.
Staff were aware of their duties under the Mental Capacity Act 2005. They obtained people's consent before carrying out care tasks and followed legal requirements where people did not have the capacity to consent.
We saw people were cared for and their dignity upheld. Relatives confirmed staff encouraged people to retain their independence on a day-to-day basis.
Care plans were personalised and centred on people's preferences, views and experiences as well as their care and support needs.
Measures were in place to assist people to raise concerns with staff. Complaints were investigated and responses given.
Auditing and quality assurance systems were in place to identify any actions required to ensure the safety and quality of the service.