Moorland House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning; and promoted an open, fair culture. At our last ratings inspection we rated this key question requires improvement. At this assessment the rating has changed to good and all legal requirements were met. This meant the service was consistently managed effectively, and was well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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.

The service had a shared vision, strategy and culture. Staff and leaders told us this was based on transparency, equity, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. Staff felt they were consulted, and their feedback was considered when making improvements to the service.

We found there was a highly person focused culture and a positive approach to ensuring continuous development of the service. There was a range of policies and procedures to guide staff on what was expected of them in their roles. Leaders were clear about their expectations of staff and closely monitored the service improvement plan to ensure the service objectives were met. The staff and leaders celebrated the improvements they had made following our previous inspection and were proud of the good quality care they were providing people.

Staff confirmed there had been leadership changes following our previous inspection. They felt the registered manager, deputy manager and provider showed, through their actions, they had the experience, capacity, capability and integrity to ensure the service could deliver safe and effective care, with risks being well managed. Staff described a caring working environment with the provider and managers sensitive to staff’s personal and professional needs. Comments included, “Lots of management support, not just in terms of career development and progression, but also on a personal level’’, ‘‘They listen to us if we feel things can improve. For example, the music here, we wanted some more CDs, and they did that, some decorating, some activities for Halloween and Christmas’’ and ‘‘If we ever have any worries for the residents, they sort it out very quickly.’’

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. The improvements that had been made following our previous inspection demonstrated leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty through regular team meetings, supervisions and working alongside staff. The provider and registered manager had a clear commitment to providing person centred care and valuing people, and the staff team.

The service fostered a positive culture where staff felt they could speak up and their voice would be heard. Staff told us they were encouraged to speak up and were able to raise any concerns. They were positive about the provider and registered manager and how the service was run. One staff member said, “Has been good working here, very confident that I can speak up if any concerns.’’ The registered manager was able to detail examples where they had acted on concerns raised by staff and how they evidenced this.

Staff were encouraged to speak up through daily shift handover meetings, regular team meetings and supervision meetings. Leaders also worked alongside staff and took prompt action when staff shared concerns with them. We saw information posters on display for both people and staff in relation to how to raise concerns, both internally within the organisation, and externally to other agencies, such as CQC.

Staff told us they felt valued and listened to by managers at the service. They gave examples of how they had been supported to develop their skills and progress their career, including support to improve their English language skills. All staff felt they were treated equally and that leaders had a strong focus on them as individuals and worked hard to understand their unique cultures. Staff felt they received support from colleagues, appreciated each other’s differences and felt their common goal to care for people created a shared culture and focus. They felt the stability of the staff team enabled relationships to develop as they knew each other well.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Leaders identified if staff needed any additional support and responded flexibly. The provider’s systems and processes supported this.

The service had clear responsibilities, roles, systems of accountability and effective governance. They used these to manage and deliver good quality, sustainable care, treatment and support. The registered manager told us they had implemented many changes since the last inspection. They said, “We have a new system in place for care plans and risk assessments… we have internal audits, and we have a good online system that tells us when reviews are needed… we are so much better than before. We have meetings to review people’s care plans and we involve the Power of Attorney and other family members and professionals.”

The effectiveness of risk and quality monitoring systems had improved following our previous inspection. The registered manager produced a weekly governance report which helped the provider monitor quality and safety within the service. This included reports on issues such as falls, pressure ulcers, infections, complaints, and the actions taken should staffing levels fall below planned levels. Regular spot checks were carried out by leaders to make sure staff were following policies and procedures. Overall quality assurance audits were being used more effectively to review the performance of the service. For example, an infection prevention control audit conducted in March 2024 identified concerns with the cleanliness of some areas of the service and external waste storage. The provider had a ‘home improvement plan’ in place which was being actively worked on. Recent completed improvements included the introduction of a digital social care record, the update and review of care plans and risk assessments with input from the Integrated Care Board to plan for seizure and dysphasia management. A new deputy manager had recently been appointed and arrangements made for them and the registered manager to work alternate weekends to provide visible leadership and management support across the full week. There were regular meetings for people living at the service and their relatives. Records were kept on what was discussed and updates given on actions taken.

Staff and relatives told us they were supported well by staff to engage with all agencies in planning people’s care and treatment.

Staff understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement, particularly in relation to people’s health needs. The registered manager shared examples which illustrated the strong working relationships they had developed with stakeholders. The registered manager told us how they had worked with a community social organisation to adapt an activity for 1 person, enabling them to continue engaging in the activity following a change in their support needs.

Healthcare professionals worked in partnership with the service to pro-actively develop staff skills, so that people at the end of their life could remain in the home and prevent unnecessary hospital admission when people’s health deteriorated.

The registered manager had made significant improvements to establish effective working relationships with other agencies to ensure people's needs were met. This included setting up regular communication with professionals and relatives to agree people’s plan of care.

The provider had taken learning from our previous inspection and made the required improvements to the service. Leaders told us about the further improvements planned. For example, for the outside space to ensure people could enjoy the back garden. Activities available to people were also being reviewed to ensure they met people’s needs and preferences. Staff had a good understanding of the improvements the service was working towards and their role in achieving these objectives. There was a strong emphasis on staff development and several examples shared with us of how staff had been actively supported to develop skills and provided with support and encouragement to progress professionally.

The service focused on continuous learning, and improvement across the organisation and local system. They encouraged creative ways of delivering quality of life for people, particularly in relation to people’s health needs. They actively contributed to safe, effective practice and had invested in technology to support risk monitoring, communication and staff development. The provider and registered manager were responsive to feedback from external agencies and could demonstrate learning taking place and being shared following external input and support.