CQC report explained · a residential care home
What the CQC found at Meylan House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had risk assessments and staff had information about how to support them safely. Inspectors found one conflicting choking-risk record and one incomplete set of safety checks, which were updated after the inspection.
- Effective?
- Good
- This key question was not inspected during this focused visit, so no rating was given in this report.
- Caring?
- Good
- Staff supported people to communicate, make decisions and maintain important relationships. People were treated with kindness, dignity and respect, although not all relatives felt involved in care planning.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so no rating was given in this report.
- Well-led?
- Requires improvement
- Management oversight did not always identify missing or conflicting information. The manager made immediate changes and introduced new systems, but this rating remained Requires Improvement.
What inspectors found, June 2023
Meylan House was rated Good overall, but inspectors found weaknesses in management checks and record-keeping.
This was an unannounced, focused inspection on 18 May 2023. One inspector spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
Inspectors found people were safe and treated with kindness and respect. Staff knew people's needs, supported their choices, used the least restrictive options and helped people keep in touch with family and friends.
The home was rated Good for Safe and Caring. It Requires Improvement for Well-led because some checks did not identify conflicting or missing records, including a choking-risk record, safety checks and a month of medicine audits. The overall rating improved from Requires Improvement at the previous inspection, published in June 2021.
Kind and respectful staff
People and relatives said staff were kind and respectful. Staff understood people's emotional, sensory and personal support needs.
“People were supported by staff who knew them well and treated them with dignity and respect.” from the report
Safe support and restraint practice
Staff tried to avoid restraint and used it only when necessary after other approaches had failed. Restrictions were recorded and reviewed.
“Staff made every attempt to avoid restraining people and did so only when de-escalation techniques had failed and when necessary to keep the person or others safe.” from the report
Consistent staff team
Staff turnover was very low. This meant people were usually supported by staff who knew them well.
“Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.” from the report
Medicines generally managed safely
Medicine records were up to date, administration was signed for, and reasons were recorded for medicines given when needed.
“Medicine administration records were kept up to date.” from the report
Conflicting and incomplete safety records
needs fixingOne person's choking-risk information conflicted across records, and safety checks for another person were not fully completed. The manager updated the documents after the inspection.
“1 person had conflicting information recorded regarding their choking risk and 1 person's records were not fully completed for safety checks.” from the report
Missed medicine audits
needs fixingWeekly medicine audits had not been completed for one month. The manager introduced new systems to ensure these audits were completed.
“Systems and processes had not identified the weekly medicine audits had not been completed for 1 month.” from the report
Some relatives not involved in care planning
minorPeople were involved in their care, but inspectors found that not all relatives felt involved in care planning.
“However, not all relatives felt involved in the care planning process.” from the report
- 01How do you now check that care plans and risk assessments do not contain conflicting information, especially about choking risks?
- 02Can you show how safety checks and weekly medicine audits are recorded and reviewed since the inspection?
- 03How will you make sure relatives who want to be involved are included in care planning?
- 04What evidence can you share that the new management checks have continued since the inspection?
This was a focused inspection of Safe, Caring and Well-led only; Effective and Responsive were not inspected and the overall rating used the available ratings from this and the previous inspection. This explanation was written from the published report of 16 June 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2021
Meylan House was rated Requires Improvement; inspectors found kind care and safe medicines, but gaps in behaviour support, communication and the environment.
Inspectors made unannounced visits on 31 March and 14 April 2021. They spoke with people using the home, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The inspection focused on Safe, Caring and Well-led because concerns had been received about people's care. All three areas were rated Requires Improvement. Effective and Responsive were not inspected, so their previous ratings were used in the overall result.
Inspectors found medicines were managed safely, the home was clean and there were many kind interactions. However, staff did not always follow behaviour support plans, and the home did not always meet people's communication, privacy, sensory and environmental needs.
The overall rating fell from Good at the previous comprehensive inspection, published on 6 June 2019, to Requires Improvement. The provider had action plans and was being monitored by the CQC, which said it would inspect again under its re-inspection programme.
Medicines were managed safely
Medicines were stored securely, recorded and checked. Staff responsible for medicines had training and competency checks.
“Medicines were ordered, stored securely within temperature limits and managed safely.” from the report
Safeguarding systems
Staff understood how to report concerns, and people and relatives told inspectors they felt safe.
“The provider continued to have effective safeguarding systems in place to protect people from the risk of abuse.” from the report
Kind interactions
Inspectors observed caring interactions. People and relatives said staff were caring and wanted good outcomes for people.
“We observed caring and kind interactions, where people showed they appreciated the support from the staff.” from the report
Management checks
The manager and staff carried out regular checks and acted when issues were identified. The manager also worked with local authority professionals.
“Regular checks were completed by the registered manager and staff to ensure the service was safe and any actions taken where identified, such as cleaning audits.” from the report
Behaviour support was not always followed
seriousInspectors saw a person become upset and agitated after staff did not follow their support plan. Staff also said some behaviour could be very difficult to manage.
“People were not always effectively supported when their behaviour challenged and presented a risk to themselves or others.” from the report
Communication needs were not consistently met
needs fixingStaff did not consistently use signing, pictures, objects or electronic devices set out in people's care plans. Only 26% of staff had Makaton training.
“This meant the service was not taking all steps to maximise people's communication style which could contribute to lack of involvement, choice and frustration.” from the report
The environment could be unsuitable
needs fixingThe main house had little evidence of an autism-friendly layout. The shared space could be noisy, with limited access to quieter areas apart from bedrooms.
“There was one open plan communal space but with the number of people and staffing levels required, the environment could be noisy with little opportunity for people to use other areas, other than their bedrooms.” from the report
Privacy and dignity
minorMost staff supported people discreetly, but inspectors saw two occasions when privacy and dignity were not handled as expected.
“However, we noted two occasions during the inspection where people's privacy and dignity were not dealt with as expected.” from the report
- 01How do you ensure staff follow each person's positive behaviour support plan, especially when routines change or someone becomes distressed?
- 02How many current staff are trained in each person's preferred communication method, including Makaton, signing, pictures or electronic devices?
- 03What changes have been made to provide quieter spaces and better meet people's sensory needs?
- 04What additional checks are now made to protect people's privacy and dignity?
- 05What progress has been made since the action plans and recommendations in this report?
This was an unannounced focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 11 June 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Meylan House
4 rated inspections over 6 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2021Requires improvementdown from GoodSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- June 2019Goodstayed GoodSafe: GoodWell-led: Good
- November 2017GoodSafe: GoodCaring: GoodWell-led: Good
- October 2016
Registered with the Care Quality Commission on 10 October 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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