Meridian 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

Meridian House is a private outpatient doctors’ consultation and treatment centre, seeing patients via referral or self-referral on a private basis and via health insurance. The hospital provides a range of elective surgery treatments for NHS and other funded (insured and self-pay) adults in a range of surgery specialties. At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. Incident reporting systems and process were robust and effective. Mandatory training was suitable for all staff and the service demonstrated that all staff were now compliant with no outstanding training requirements observed. Environmental and safety audits had been improved with appropriate oversight from management. We saw examples of these in practice and all were suitable and appropriate completed. The service had introduced a new RAG rated training matrix for safeguarding training to ensure that all staff completed the required level of training as determined by their role. We also saw improvements with in house safeguarding training. We saw that all appropriate risk assessments and policy were in place to reflect national guidance. We also noted that all policies had been recently reviewed. All environmental concerns raised previously had been addressed or changes were still being implemented at the time of inspection. We observed all equipment included hazardous chemicals were stored appropriately and securely. We saw improvements in governance systems and process relating to safe recruitment of staff. We saw improvements in the management and storage of medicines including controlled medicines. We saw a newly implemented process to maintain this improvement.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. The registered manager provided assurance that safety is a top priority that involves everyone, including staff as well as people using the service. There is a culture of safety and learning. This is based on openness, transparency and learning from events that have either put people and staff at risk of harm, or that have caused them harm. The service incident policy had been revised in January 2024. Risks are not overlooked or ignored. They are dealt with willingly as an opportunity to put things right, learn and improve. Incidents and complaints are appropriately investigated and reported. The registered manager clearly articulated the incident investigation process and demonstrated how they worked with neighbouring NHS trusts. Lessons are learned from safety incidents or complaints, resulting in changes that improve care for others. The service had improved their process for registered nurses and consultant anaesthetists to complete pre-assessment checks. The registered manager provided an example to demonstrate actions had been taken following a recent incident within a clinical area.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. Safety and continuity of care is a priority throughout people’s care journey. This happens through a collaborative, joined-up approach to safety that involves them along with staff and other partners in their care. This includes referrals, admissions and discharge, and where people are moving between services. There is a strong awareness of the risks to people across their care journeys. The approach to identifying and managing these risks is proactive and effective. The effectiveness of these processes is monitored and managed to keep people safe. New environmental and safety audit checks were in place. These were comprehensive and detailed. This included WHO check lists and resuscitation machine checks. Records showed staff were using these audit checks effectively and there was appropriate oversight from managers. Policies and processes about safety are aligned with other key partners who are involved in people’s care journey to enable shared learning and drive improvement. Policies were aligned closely to neighbouring hospital trusts.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. There is a strong understanding of safeguarding and how to take appropriate action. There are effective systems, processes and practices to make sure people are protected from abuse and neglect. The service had introduced a new RAG rated training matrix and ensured all staff completed safeguarding training relevant to their role. Safeguarding level 3 adult training was completed as an interactive group session which was also followed by a question and answer session. There is a commitment to taking immediate action to keep people safe from abuse and neglect. Safeguarding systems, processes and practices mean that people’s human rights are upheld and they are protected from discrimination.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. People are informed about any risks and how to keep themselves safe. Electronic consent was gained at the initial consultation at the time of any pre-operative discussions. This included a cooling off period. Electronic consent was also taken on the day of the operation. The service were moving to a new digital consent form system to ensure further compliance and oversight. Risks are assessed, and people and staff understand them. There is a balanced and proportionate approach to risk that supports people and respects the choices they make about their care. Risk assessments about care are person-centred, proportionate, and regularly reviewed with the person, where possible. Appropriate risk assessments and policies were in place to reflect national guidance. All policies had been recently revised. This included the identification and management of suspected sepsis (deterioration of patient policy), falls risk assessment, COSHH policy and transfer policy for patients to NHS wards, intensive care unit and high dependency unit. All staff had been asked to read and sign all newly revised policies. All eligible staff had completed sepsis refresher training in January 2024.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. All medical gasses / oxygen cylinders were safely and secured stored. All trollies had oxygen cylinders. All COSHH items were safely and secured stored in a locked cupboard within a locked room. Environmental audits had been completed and showed full compliance.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. We detect and control potential risks in the care environment. We make sure that the equipment, facilities and technology support the delivery of safe care. People are cared for in safe environments that are designed to meet their needs. Facilities, equipment and technology are well-maintained and consistently support staff to deliver safe and effective care. The registered manager had requested a full stock check which meant all equipment had been safety checked and was in good working order. There are effective arrangements to monitor the safety and upkeep of the premises. Leaders and staff consider how environments can keep people safe from psychological harm as well as physical harm, for example in relation to sensory needs. The registered manager provided examples to demonstrate how they took account of individual needs within a clinical area. Equipment used to deliver care and treatment is suitable for the intended purpose, stored securely and used properly. This included equipment on the resuscitation trollies All eligible staff had been trained to ensure all theatre and recovery equipment was set up at all times.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. There are robust and safe recruitment practices to make sure that all staff, including agency staff and volunteers, are suitably experienced, competent and able to carry out their role. New safe recruitment audit checks were in place. These were RAG rated, comprehensive and detailed. Recruitment records were up to date for each staff member. This included professional registration checks and practicing privilege checks. DBS enhanced checks had been repeated for all staff. Personnel records showed DBS had been provided or had been requested. The registered manager had requested an external review of consultant's practicing privileges. All policies relating to recruitment had been recently revised. Staff receive training appropriate and relevant to their role. New specialist training audit checks were in place for all eligible staff who had been trained to provide specialist support such as requiring high dependency care. These were RAG rated, comprehensive and detailed. Staff rota's were planned to ensure there was at least one member of staff who was appropriately trained in providing specialist support. Training records were up to date for each staff member. Inhouse training sessions had completed with staff to provide additional assurance. Staff receive the support they need to deliver safe care. This includes supervision, appraisal and support to develop, improve services and where needed, professional revalidation. Staff at all levels have opportunities to learn, and poor performance is managed appropriately.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. Cleaning audits showed 100% compliance.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. The environment supports the standard of care described in the quality statement. The service was visibly clean in the majority of areas . Cleaning audits showed 100% compliance. We observed some ongoing issues that the registered manager was aware of and they were able to assure us that there were action plans to demonstrate improvements.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. The registered manager employed domestic workers and a supervisor to undertake scheduled cleaning including deep cleaning duties. The theatre manager had a dedicated one day a week to complete managerial duties such as quality assurance checks on completed audits and controlled medication logs. The registered manager had recently recruited a non-executive director (NED) who has a background in estates development. They will be commissioned with redesigning the environment to comply with all IPC related concerns.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. The approach to medicines reflects current and relevant best practice and professional guidance. Staff provided assurance that second checks would be recorded for controlled medicine records. Additional processes had been implemented for further safe medicine management. To take out (TTO) medicine packs were prepared by pharmacy staff and a second check was completed before delivering medication to patient. Staff were also guided with a flowchart. This system is yet to be fully embedded due to there being no patient surgical activity during the suspension period. There are appropriate arrangements for the safe management, use and oversight of controlled drugs.

At this inspection the registered manager responded positively to the concerns raised as part of the last inspection and suspension period. They have taken immediate actions and made significant improvements to the service. All medicines were stored appropriately. Medicine audits had been completed for resuscitation trollies, anaphylaxis emergency bags, spinal trolleys, recovery and theatre 1 and 2.