Archived: Meridan House

We found the following examples of good practice.

The home had responded to people’s choices and individual needs during the pandemic, to help them carry out activities outside the home safely. For example, they had provided people with information and training about the pandemic and had provided support packages of sanitiser and masks.

When the provider admitted people to the home, they recognised and responded to people’s individual needs whilst ensuring they followed the proper government guidelines.

The provider was following the current Government National Guidance regarding care home visiting. People had three named visitors and an essential care giver. Information was available for visitors to follow. Visitors were supported to test for COVID 19 prior to entering the home and instructed how to use PPE.

The provider had adapted the home entrances to accommodate PPE and testing stations for people living at the home and their visitors to use before entering.

The home had alternative methods to support social contact for visitors who were not named. For example, video calling.

The home had sufficient supplies of personal protective equipment (PPE). There were PPE stations available throughout the premises. Staff had received training in infection prevention and control and how to don and doff PPE.

The provider had a system in place to ensure staff had the necessary vaccinations and had completed the necessary COVID 19 testing prior to working in the home.

The layout of the service and communal areas supported social distancing. The premises looked clean and hygienic throughout. There were cleaning schedules in place and adequate ventilation.

The staff were aware of who to contact should they have a outbreak of COVID 19 and the protocols to follow.

Meridan House is a purpose built care home in a complex of supported housing services for people with mental health needs. Meridan House is registered to accommodate a maximum of 12 people. On the day of this inspection there were six people using the service.

People’s experience of using this service and what we found

At this inspection we found that the service was outstanding in empowering people to have as much control over their lives as possible and to achieve their maximum potential.

People’s care was highly personalised, and staff had excellent understanding of people’s needs and interests to deliver an excellent level of care. We found multiple examples to demonstrate the staff and management team went above and beyond and were passionate about providing an innovative, responsive and excellent service to people.

People told us they felt safe using the service. Medicines were managed safely. Appropriate numbers of suitably skilled staff were deployed to meet people's needs in a timely manner. Staff followed appropriate infection control practices. Accident and incidents were recorded and acted upon. Any lessons learnt were used as opportunities to improve the quality of service.

Assessments were carried out prior to people joining the service to ensure their needs could be met. Where risks were identified, management plans were in place to manage these safely. Staff had the training, knowledge and experience to support people's needs. People were supported to maintain good health and had access to a range of healthcare services when needed. People were encouraged to eat a healthy well balanced diet for their wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's privacy, dignity and independence was promoted. People told us staff were kind and caring.

There were procedures in place to respond to complaints. The provider had investigated and responded promptly to any concerns received.

There were effective systems in place to assess and monitor the quality of the service provided.

The provider worked in partnership with healthcare services and professionals to plan and deliver an effective service.

Rating at the last inspection:

The last rating for this service was requires improvement (published 13 September 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

This was a planned inspection based on the previous rating.

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 any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At our last comprehensive inspection on 14 January 2016 the service met the regulations we inspected and was rated Good. At this inspection we found the service to be deficient in some areas and have rated it as Requires Improvement. Following the inspection we received concerns in relation to the care of people who used the service and the management of care workers. We therefore made further enquiries with the registered manager and provider.

People who used the service informed us that they had been treated with respect and dignity. The service had arrangements to protect people from harm and abuse. Care workers were knowledgeable regarding types of abuse and were aware of the procedure to follow when reporting abuse.

Risks assessments had been carried out and risk management plans were in place to ensure the safety of people. The service followed safe recruitment practices and sufficient staff were deployed to ensure people’s needs were met. There were suitable arrangements for the administration of medicines and medicines administration record charts (MAR) had been properly completed.

With one exception, the premises were kept clean and tidy. One bedroom had not been fully cleaned and there was litter on the floor. The state of the bedroom posed a fire and health and safety risk as the person who used the service had smoked in their bedroom. There was a record of essential maintenance and inspections by specialist contractors. Fire safety arrangements were in place. These included weekly alarm checks, a fire risk assessment, drills and training. Personal emergency and evacuation plans (PEEPs) were prepared for people to ensure their safety in an emergency.

The service worked with healthcare professionals and ensured that people’s healthcare needs were met. The dietary needs of people had been assessed and arrangements were in place to ensure that people received adequate nutrition.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted are regularly reviewed to make sure it is still in the person’s best interests. We noted that the home had suitable arrangements in place to comply with the Mental Capacity Act 2005 and DoLS.

Care workers had received a comprehensive induction and training programme. There were arrangements for staff support, supervision and appraisals.

Care workers prepared appropriate and up to date care plans which involved people and their representatives. People were encouraged to be as independent as possible and to engage in various activities within the home and in the local community. Some people had made progress and their mental health had improved.

The service listened to people who used the service and responded appropriately. There were opportunities for people to express their views and experiences regarding the care and management of the home. One complaint made had been recorded and promptly responded to.

Comprehensive checks and audits of the service had been carried out by the registered manager and the team manager to ensure that the service provided care of a good quality. We however, noted that there continued to be issues related to cleanliness of a person’s bedroom. We also noted that an allegation of abuse was not notified to the Care Quality Commission (CQC). This came up after the inspection and we followed this up with the provider. We accepted the explanation given by the provider.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.

One person said, 'The staff are ok. They are respectful. They give me choices. They help me to cook and also cook for me sometimes.'

People felt that they got on well with their key workers. One person said, 'My keyworker keeps me informed. We have meetings. We talk about things, about how I feel. Staff are very helpful.' This was echoed by another person who said, 'We have meetings. We discuss shopping and activities.' Another person said, 'My key worker is great. The staff are all very good and supportive.'

We found that refurbishment work was in progress to improve the premises, including people's en suite bedroom facilities and the decor in the communal rooms.

We noted that care plans were well maintained and confidential records, including electronic records, had been kept securely.

The service had followed the provider's complaints policy and procedures and complaints had been responded to within 28 days.

People took part in a range of activities and further education classes which helped develop their independent living skills. People said that both their physical health and mental health needs were addressed by staff. Everyone told us they felt safe using the service. Staff demonstrated the knowledge and skills needed to protect people from possible abuse.

The service worked with a multidisciplinary team of professionals to ensure that people's needs were met. Appropriate checks were carried out on staff before they started working in the service. The provider regularly monitored the service to make sure that an appropriate standard of care and support was provided to people who use the service.