Meadow Bank Care Home

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Lessons were learnt to continually identify and embed good practice.

Staff were aware of the incident recording process and recorded incidents on the electronic system. Managers reviewed these and discussed themes at regular governance meetings to make sure concerns were addressed and monitored. The incident recording process prompted leaders to notify relevant organisations and escalate where required, for example referrals to falls teams or to seek medical assistance.

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.

There was a thorough pre-admission process, and we saw examples of pre-admission assessments which captured information about people’s needs. There were good referral pathways between the home and external organisations such as the hospice and local authority. Information was shared effectively between the 4 units within the service.

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.

Staff completed safeguarding training and compliance rates were high. Staff knew how to report any safeguarding concerns and there was information about what to do available in staff areas. There was an appropriate and up to date policy. The registered manager collated safeguarding issues and worked alongside the local authority to make sure safeguarding concerns were investigated, and any recommendations were implemented. The registered manager applied to the local authority if someone was at risk of being deprived of their liberty. There was a system to monitor and review these.

Some risks had not been accounted for, and written documents required reviewing to make sure information was accurate.

Staff had good knowledge about how to manage people’s risks, however there were some gaps in written documentation, for example incorrect information in a person’s personal evacuation plan in the event of a fire.

An individual required close observation due to their risk of falls and the risk of picking up other people’s food items. Although the level of harm experienced was low, the person was able to enter another individual’s bedroom and had an unwitnessed fall. Following our feedback, it was confirmed there was enough staff to meet this person’s needs since the incident.

However, we observed staff managing people’s needs and risks well during the assessment. For example, 1 person experienced regular periods of distress, and we observed staff responding appropriately during the assessment. They knew how to support the person well in a calm and professional manner. The individual’s care plan contained thorough detail to guide staff in respect of safe holds. Safe holds are a physical method used by staff as a last resort to reduce the risk of people causing themselves or others harm, and other methods such as distraction should be used first. We saw from records that following incidents, staff escalated concerns and continuous care from 1 member of staff was arranged for the person to help manage 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.

Health and safety checks had been made, and we saw compliance certificates for gas and electrical safety, water testing and fire safety.

The home was free of hazards, and the service employed full time maintenance staff to make sure issues were identified and resolved in a timely manner. Equipment such as hoists had been serviced recently. Staff completed visual safety checks of items such as bed rails.

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.

Staff were recruited using safe processes. The registered manager used a dependency tool to make sure enough staff were on the rota for each shift. At times the service used agency staff to cover shifts, and the same staff were used to provide consistency.

Training compliance rates were high, and staff told us they completed a wide range of training and thorough inductions. Some periods of the day were more challenging, and people and relatives told us they had to wait longer for assistance at these times.

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.

All 4 units were clean and tidy. There were dedicated domestic staff on each unit and cleaning schedules were in place. Sometimes care staff were required to clean spillages. The home had recently experienced a flu outbreak and followed guidance to manage this. We saw staff wearing appropriate clothing to protect against infection for example at mealtimes.

The provider made sure people received their medicines as prescribed however some improvements were required around written information and scheduling reviews.

There were some gaps in the written documentation regarding assessment of risk, for example around the use of prescribed oxygen and use of flammable emollient creams. However, we checked the storage of the oxygen, and it was being stored according to guidance. We did not see a specific care plan for someone that had epilepsy to guide staff what to do following a seizure. The registered manager reviewed these following our feedback and updated people’s care plans.

For 3 people who were at risk of choking and had modified diets, the provider had not requested a GP review to make sure their medicines were in line with their dietary guidelines. This was not consistent with the provider’s own policy. We did not identify any harm and the provider put measures in place to review people’s risk assessments and care plans immediately after we fed this back.

Medicines were administered according to people’s prescriptions and there was guidance for staff regarding ‘as and when required’ medicines.

Medicines were stored according to guidance. The stock control system was effective, and no-one missed their medicines. Staff administered thickener to the drinks of people who were at risk of choking, and recorded information in daily notes about this. People said they received their medicines when they needed it and had no concerns about how it was managed.