Moorland House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted quality of life, based on best available evidence. At our last ratings inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 their relatives told us an assessment had been completed before they started using the service and staff had a comprehensive understanding of their needs.

Staff told us they had access to people’s care plans which helped ensure they understood people’s needs. For example, 1 staff member told us, “I get to know the residents because I talk to the residents and go through the care plans” and another said, “Care plans and risk assessments are good, they help me understand people.” The registered manager told us that since the last inspection a new system for care plans and risk assessments had been introduced. They explained meetings were held with people and their family to review care plans. The registered manager told us, and demonstrated, how they ensured staff were kept updated and informed of any changes relevant to people's care and support in a secure and timely way. They told us how they were made aware of any changes to ensure people's care planning documentation remained current and relevant to the person. Staff and the registered manager knew people and were able to detail people’s preferences and support needs. The registered manager told us how they worked alongside staff to get to know people, this enabled them to ensure people received support in line with their individualised care plans.

People’s needs were assessed prior to moving into the service and kept under regular review. Changes were made in partnership with people and those important to them when needed. Care plans and risk assessments were detailed, personalised and provided useful and accurate information. Best practice guidance was used in relation to people’s support needs. For example, in relation to dementia and diet. The registered manager had implemented effective systems and processes to ensure changes to people’s care planning documentation was securely and promptly shared with staff. This helped to ensure people received safe and consistent support which met their needs and preferences.

People confirmed they had access to food and drink when they wished and confirmed they were offered choices. We saw this in practice throughout the assessment. One relative told us how their family member had not been eating well. They said, “They were wonderful here. They changed her diet to encourage her to eat. They gave her soft food, fortified drinks, soup etc and she is back to eating well now.” Another relative told us, “They are always very quick in identifying changes and are very proactive.”

Staff were confident appropriate action would be taken in response to any changes to people's support needs, including eating or drinking difficulties or poor nutrition and fluid intake. The registered manager described how they would become aware of any concerns relating to people's fluid or nutrition intake and what action they would take in response. They were able to demonstrate how they had done this in practice.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. People’s nutrition and hydration needs were met in line with current guidance. The provider had systems and processes in place to monitor people's fluid intake. We saw evidence of how concerns relating to a person were being monitored and had been escalated to external healthcare services. There was information visible in the kitchen identifying people's preferences, allergies and any modified dietary requirements. Staff confirmed the information was regularly reviewed and updated to include new admissions into the service. We saw evidence of people's dietary needs being effectively communicated to staff. Universally recognised tools were used to ensure people received care and support which was evidence-based and in line with good practice standards.

People and their relatives told us the service worked effectively across teams and services to support people. One relative told us how positively the service worked with external services and how they were included in this. They told us, “[Registered manager] is excellent and will always message me when the doctor has to go out and they will talk about my thoughts and include that when liaising with doctor about [person’s] care needs…They take my input into consideration.”

The registered manager told us how they worked collaboratively with people, relatives and other professionals to meet people's needs in ways they wanted. The registered manager described the processes and systems in place to refer people to the appropriate health and social care services and how they ensured effective information sharing. They told us how they ensured staff were aware of any guidance or advice from external professionals, how this information was reflected in people's care planning documentation to ensure consistency in care for people. Staff told us they worked closely with other agencies and were involved in reviews of people’s care.

Health professionals explained how all relevant staff, teams and services were involved in assessing, planning and delivering people's care and treatment. Staff worked collaboratively to understand and meet people's needs.

The service made sure people only needed to tell their story once by sharing their assessment of needs and information about people’s care arrangements when people moved between different services. We saw evidence of information being shared with staff and how guidelines from a professional had been implemented for a person in relation to skin integrity support.

People were supported to access a range of health care professionals. Comments from relatives included, “She [person] had opticians there the other week and got new glasses…they do contact the GP if needed” and “Moorland House will contact them all hours of day and night, getting support from specialists and paramedics.” Another relative told us, “They do always contact me whenever contacting health professionals and the treatment is always discussed with me first. There is no trouble or issues in contacting the GPs and dentist.”

Staff described how they supported people to manage their health and wellbeing to maximise their independence, choice and control. They worked with appropriate agencies to support people to live healthier lives and where possible, reduce their future needs for care and support. The registered manager told us they utilised external resources from the local authority to support staff training and development to promote positive outcomes and to support people to live healthier lives.

Care plans described people’s health needs and the support they needed to remain well. Records showed when people became unwell medical support was promptly sought and people were treated in the service where appropriate. The provider had developed effective close links with healthcare services and professionals.

People and their relatives were confident the service routinely monitored people’s care and treatment to continuously improve it. One relative told us how proactive the service was in supporting their family member’s health condition. They told us, “They measure [person’s] stats and if they see it change then they are straight onto the doctor.”

The registered manager told us how outcomes for people formed part of their care planning and approaches to designing their activities programme and menus, with a focus on improving people's quality of life. Staff worked with stakeholders to support people experience positive outcomes and ensured relevant guidance and advice was implemented.

People had personalised care plans which reflected their preferences, likes and dislikes. The provider had systems and processes in place to monitor outcomes for people in relation to their health conditions. For example, 1 person was supported with regular blood tests to monitor the management of their condition. Although the provider did not have any formal goal setting in place for people, we found people's care planning documentation and health conditions were regularly reviewed and monitored with any indications of deterioration or concern promptly responded to. This meant the provider’s systems and processes ensured people’s care, support and outcomes were effectively monitored and responded to.

Whilst we didn't seek specific feedback from people regarding consent, people confirmed to us they felt their choices and wishes were respected by staff and the service, and they felt listened to. We viewed feedback people had given to the provider through the provider's own surveys which demonstrated they felt involved in decisions about their care.

Staff were able to articulate an understanding of the Mental Capacity Act 2005 and we observed staff involving people to make choices about their care and support. The registered manager told us, “Staff understand the mental capacity and we have done a lot more work on that in terms of paperwork.” Staff understood the need to follow the best interest decision making process if people were assessed not to have capacity to consent to a specific decision.

Understanding of the Mental Capacity Act had improved since our previous inspection. Staff had completed training in the Mental Capacity Act and the provider had relevant policies and procedures in place. Mental capacity assessments were now being completed where necessary and best interests’ consultation had been undertaken where people lacked capacity to consent to a decision. Copies of Lasting Powers of Attorney were now being retained to evidence that consent was being obtained in line with legal frameworks.