Meridian Health and Social Care - Nottingham

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

We assessed 4 quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good.

People and those important to them were supported to raise concerns when they did not feel safe. Staff assessed and reviewed safety risks to people and made sure people, and those important to them, participated in making decisions about how they wished to be supported to stay safe.

The provider ensured any mistakes were acted on quickly and provided staff with the ability to reflect on their practice to improve outcomes for people.

Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers checked the suitability of staff to ensure they were suitable and fit to provide care.

People’s medicines were well managed. Staff attended most calls on time.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us they felt able to speak up if they had a concern. Most told us when they had raised an issue about their care swift action had been taken. One person said, “I did need to raise a concern a while ago and it was sorted almost straight away which was good.”

People and relatives spoke positively about the approach of office-based staff and felt concerns were acted on. A relative said, “The company do all they say they will which helps me no end.”

Staff told us they had regular supervision sessions to review what was working well, and what could be improved in their role and also at the service. Staff felt listened to and valued. A staff member said, “We have regular supervision every 3 months and I feel very supported.”

There were processes in place to act on concerns, review accidents and incidents and make improvements where required. Staff were provided with the opportunity to reflect after incidents, to ensure learning and improvement could occur. Staff meetings encouraged staff to reflect on what was working well, and what could be improved at the service. The registered manager said, “If there has been a mistake we reflect, review, it doesn’t matter if it is an error with care staff, the management, or all of us.”

The provider ran a number of workshops to support staff learning and to ensure staff have the most up to date information to carry out their role safely. Recent workshops included food safety, medication, and a session on Huntington’s Disease.

There was a policy on the duty of candour. This policy guided staff to tell the person (or, where appropriate their advocate) when something had gone wrong. We reviewed complaints that had been made and saw this policy had been followed.

People told us that staff supported them with health and social care appointments when required. Some people told us staff helped them to attend appointments with their GP.

A relative said, “They (staff) helped us with pressure sores – they called the District Nurse for us and arranged all that.”

Staff had good knowledge of which health and social care professionals supported which people.

Staff knew how to monitor people’s health conditions and to ensure timely referrals were made to other services. For example, should a person require a district nurse to attend to provide insulin or support with pressure sores. Where required, staff supported people to visit their dentist or GP.

The provider had a contract with the local authority which assessed people referred to them to receive care within their own homes. No concerns had been raised by the Local Authority in relation to the care provided.

Staff kept clear summary documentation on people’s holistic needs. If the person required a hospital admission, this document could go with them to the hospital. This meant hospital staff would have clear guidance on how the person liked to be supported.

Where people required external health and social care support, documentation showed that suitable referrals had been made. Records showed referrals had been made to a District Nurse and nurses specialised in pressure care to treat pressure sores.

Staff kept clear records on how they had supported people and at what time. This allowed changes in a person’s needs to be identified, and improvements made to their planned care.

There were clear processes in place for how to respond to an emergency. Staff followed these processes to ensure people were safe in an emergency. This took into account people’s individual needs such as their mobility and mental health. This helped to keep people safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Most people and relatives told us staff arrived on time and stayed for the length of time for each call. A small number did raise concerns about the consistency of the staff that attended and said they sometimes did not know the staff member who attended the call. However, people and relatives said this did not affect the quality of the care provided. The majority of people and relatives told us that if the staff member was going to be late, they received a call to notify them.

A person said, “My carers are very good and always phone if they are going to be late or early.” A relative said, “The car broke down one week and they phoned straight away and said they would be an hour late.” Another relative said, “We can’t fault the service; staff come when they should and do what they should, and the carers are all brilliant. They are so kind and caring and nothing is a trouble.”

Most people and relatives told us staff were well trained and knew how to meet their needs. One person said, “They are trained well. One day they called the doctor for me when I couldn’t get hold of them. They are really good at what they do.”

The staff felt well trained and supported. They felt they had the skills needed to provide safe and effective care for people. They felt they had sufficient time to get to each call and to provide the care and support people needed.

Staff told us they were encouraged and supported to complete their diplomas in adult social care (sometimes referred to as NVQ’s). This helped to develop staff knowledge and understanding of current best practice processes resulting in high quality and safe care for people.

We asked the provider to produce a report which analysed the arrival times of the staff for the three months prior to the inspection. The report showed that the majority of calls were completed on time. The provider had prioritised time critical calls for people that required medicines at specific times of the day. The majority of these calls had also been completed on time.

There was an ‘on-call’ process in place. This was available for people and relatives to speak with someone should there be an issue outside of normal office hours. The registered manager told us this process worked well.

Staff had received training the provider had deemed required for their role. Most training for staff was up to date. Once staff were trained, there was a process to assess their competency. If needed, further support and training was then given to improve staff skills.

Regular supervisions and observation of practice were completed. If staff were not providing the expected level of care, there were clear processes to monitor and improve their performance.

Safe recruitment processes were followed. For example, previous employers were contacted to give references on the staff member. Staff also had regular Disclosure and Barring Service (DBS) checks. These check the police database for convictions or warnings that may impact the staff members ability to work with people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The majority of people and relatives told us they or their family members received the support they needed with their prescribed medicines. Most said staff understood what medicines were to be given, when they were to be given and how to do so safely.

A person said, “The carers do my medication and it’s fine. With the paracetamol they ask me if I want it.” A relative said, “[Family member] doesn’t have many medicines but the carers do the medicines, and they are good. [Name of staff member] is very good and will check all the medicines and phone if it is running low to let me know.”

Staff were able to explain how they supported people to take their medicines safely. Staff told us they had the required information needed to know what medicines to give, the correct dosage and how to record when it had been taken.

Staff knew who to report medicine concerns to. For example, if they felt a person’s medicine was no longer effective; they understood where to document this, and which health professionals to contact.

The registered manager told us they felt people’s medicines were well managed. Any issues with staff were addressed during supervisions.

Staff completed medicine administration records which they updated at each call. This was monitored by staff and any errors were quickly acted on to reduce the impact on people’s health and safety. We did note a small number of these records did not include the dosage to be given to people. The registered manager acted on this immediately.

Staff had received training on how to administer medicines safely. The management team had regularly assessed the staff’s competency, to ensure they were following best practice.

We asked the provider to produce a report that showed how many ‘time critical’ calls were late. (These are calls that needed to be completed on time due to specific medicines being needed). This report showed that the majority of people received their time critical medicines at the time they needed them. This helped to keep people safe.