Meritum Integrated Care LLP (Folkestone)

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

People were protected from the risk of potential abuse. Staff had appropriate skills and experience and knew how to report any concerns and who to report them to. Any potential concerns had been appropriately reported and investigated. The management team worked in partnership with external health care professionals to ensure people remained as healthy as possible and protected from the potential risk of harm. Potential risks to people’s health care and environment had been assessed and mitigated. Staff had received training to meet people’s needs including any specialist needs. Staff had been recruited safely. People were provided with consistency and continuity of care by staff who knew them well. Staff had been trained and followed guidance to reduce the risk of infection. People received their medicines safely as prescribed by staff who had been trained and had their competency assessed.

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.

There was a culture of learning and continually improving the service. People spoke positively about the staff who they felt were well trained and knew how to meet their needs. Comments from people included, “I give them (staff) top marks. They come in and say good morning, smiling. I feel safe with them around me” and, “They come in and they do what they do every day, and I feel safe with them doing it.” The management team were committed to promoting a positive open culture where lessons were acted on when things went wrong to prevent a reoccurrence. The registered manager gave examples of changes that had been made following incidents and complaints. For example, as a result of the latest incidents, the importance of clear documentation, clear communication and having a robust audit trail was discussed with the care team. Staff knew how to report and escalate concerns and where to find the organisations policies. Staff felt confident that the management team would deal with any concerns raised in a timely and appropriate manner. Accidents and incidents were reported and reviewed. One staff member told us, “I would report to the office, we complete incident and accidents forms, they would then be picked up by management who would take it from there. If there is an incident or accident that is time critical, they are handled straight away.” Health care professionals spoke positively about the joined up working with the management team following any identified concern. One health care professional said, “Meritum has been a very responsive, proactive and flexible provider, always trying to find solutions and they communicate any issues or concerns that need to be resolved.”

The management team worked closely and collaboratively with health care professionals, to solve identified concerns and make improvements to people’s health and wellbeing. The service maintained regular contact with the local authority and several health care professionals. This enabled the provider to establish and maintain safe systems of care. A health care professional complimented the management and care team working within Summer Court. They said any referrals were made in a timely way and that the team were always respectful, polite and accommodating when they visited Summer Court. People’s needs were assessed with them to ensure staff had the skills and knowledge to meet these needs. Staff were aware of how to support people when their needs changed, or they had an accident. Comments from staff included, “(Name) will call us and let us know if there are any issues with clients, therefore I am already aware of any risks. I then look at their risk assessment. I know how to report accidents or incidents in the incidents book. I have not had to report any” and “I report everything to my manager, I record my comments in the clients note sheets. I explain what has happened (summary).”

People felt safe with the care staff, comments included, “They’re very good carers. They give me confidence and they’re always cheery”, “They’re all nice girls, they make sure they hold onto me, and they wash my back” and, “Absolutely (safe). They are just comforting and welcoming. To be fair every single member of staff I have had has been exceptional.” Whilst visiting the supported living setting, we observed people were familiar with staff and appeared to be relaxed and safe. When people were going out into the community, staff ensured people had everything they needed to help maintain their safety. Staff had been trained, understood the potential signs of abuse and knew the action to take if they had any concerns. One member of staff said, “Safeguarding is protecting adults and children who are at risk of harm and abuse. Working for (supported living setting), if I notice something I go to the manager.” Staff felt confident that any concerns would be taken seriously and acted on. Records showed concerns had been reported to the local authority, investigations had taken place, and any actions had been completed. Staff had access to the providers policy and procedure in relation to safeguarding and whistleblowing.

People and their loved ones had been involved in the development and review of their risk assessments. Whilst visiting Summer Court, we observed people had their own equipment in place which appeared to be well maintained and safely stored. We observed that people were able to manage their community risks well. Staff knew people well and had worked with people at the service for many years. Staff knew the triggers for poor health and recognised the signs of people’s health risks. Staff told us that people’s care plans and risk assessments were clear and easy to understand to keep people safe. The registered manager emphasised the importance of keeping people involved at all stages of their care and supporting people to take positive risks. They said, “The care plans and risk assessments were bespoke to the needs of the person.” This was evident within the care records we viewed which were outcome focused and were person centred.

People lived in their own flats within the building and communal areas were managed by an external housing provider at Summer Court. Systems were in place to ensure the environment remained safe and fit for purpose. Observation showed that fire doors, exits, corridors and stairways were clearly marked with signage and were clear from obstruction, clean and well lit. People had been involved in fire drills and knew where to evacuate to if needed. The internal and external building was maintained to ensure people’s safety and security. The registered manager told us they had a good working relationship with the housing manager who ensured any reported repairs were quickly rectified. Feedback from the recent survey and residents meeting showed that people felt that any repairs were carried out in a timely manner. Regular liaison meetings were held between the registered manager, the manager of Summer Court, the local authority and the housing provider. Environmental risks had been assessed and mitigated. Changes were made when people’s needs had changed for example, their mobility needs increased.

People spoke highly of the staff saying staff arrived on time and that they never felt rushed. Comments included, “The staff are very nice. I’ve got to know them”, “Very friendly. I just get on with them really well” and “Well, they know everything I like to drink and how I like my tea.” Observation within the supported living service showed there were enough staff deployed to meet people’s commissioned needs. Staff told us they received a comprehensive induction including working alongside experienced staff and undertaking essential training before working on their own. Staff felt the training they had received covered their role and people’s needs. Staff received email reminders from the management team when further training and updates were due. The registered manager told us, “We have no reliance on bank or agency staff. All the office staff have backgrounds in social care or nursing care, so if there was a shortage of carers, we step in. We all have four-wheel drive vehicles in case of snow or bad weather, to pick staff up if needed.” We viewed staffing rotas at Summer Court and could see there were enough staff allocated to support people. These were almost always the same staff, ensuring continuity of care for people. Staff had been recruited safely; all recruitment files viewed contained the necessary documents to reduce the risk of unsuitable staff being employed. Records showed investigations had taken place when required following the providers disciplinary procedure.

People did not comment on infection prevention and control specifically or the use of personal protective equipment (PPE) however, no concerns were raised or identified. During the visit to Summer Court, we observed staff using PPE effectively and safely. The environment was clean, and PPE was accessible throughout the building. Staff had been trained in infection prevention and control and were familiar with the processes to mitigate infection risks. Waste was disposed of safely in different coloured bins daily within the building and weekly from the main bins outside of Summer Court. Care staff supported people to carry out daily cleaning tasks to keep their rooms hygienic. Infection control audits were completed regularly, and actions taken if any issues were found.

People told us that if it was required, staff administered their medicines safely. We observed within people’s care records, body maps were in place for those prescribed topical treatments and for any injuries, skin tears or concerns. People’s care plans included information about any health professional’s involvement, medication prescribed and the use of any ‘As and When Required’ PRN medication. Staff had been trained and had their competency assessed by a member of the management team to support safe administration of medicines. Any medication errors were investigated and discussed during staff meetings to identify any changes that could be made. The registered manager said, “When there has been a medication error, we undertake an investigation, facilitate reflective practice, look for patterns, trends and lessons learned.” Staff carried out a monthly medication audit which included reviewing the electronic medication administration record for each person being supported by the service to take their medication. Records were viewed and no concerns were found.