Moorhead Rest Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People and their relatives were not always aware of a care plan being in place and did not know they had access to this. Care plans did not always identify people’s specific communication needs and staff had a lack of understanding of the Accessible Information Standards. Relatives felt staff did not always have time to sit and have a conversation with their loved ones and said they were not always kept informed when their health declined and required the intervention of other healthcare professionals. There was no evidence of recent feedback forms being completed by people or their relatives to check they were happy with the care they received.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were not always aware they had a care plan in place and relatives told us they were asked to review their loved one’s care plan, but they had never seen a care plan before this. Relatives felt staff did not always have time to sit and talk to people. One relative said, “Sometimes they don’t have the time to have a conversation.” People also agreed staff didn’t have the time to spend with them but felt staff understood their needs.

Staff told us they understood how to deliver person-centred care. One staff member said, “Everyone is unique, no two people are the same.” However, staff did tell us there was not always enough time to spend talking to people.

During our walk around we noticed people spent time in communal areas with little interaction from staff. We did not always witness choices being offered for example of what people would like to eat or where they would like to sit. However, when we did witness staff interactions with people, this was always in a kind and calm way.

Relatives felt their loved ones would be referred to the appropriate healthcare professionals should they need to. While people we spoke to had no concerns in this area, our assessment found elements of care did not meet the expected standards as we saw a lack of referrals being made to healthcare professionals when needed.

Staff told us how they would monitor concerns and report back to the management team if they thought someone was unwell. One staff member said, “I would tell the senior, they escalate it.”

Partners felt referrals were being made in a timely manner to their services and had no concerns in this area.

We reviewed a number of records relating to people’s weights which evidenced referrals needed to be made to healthcare professionals to ensure they were receiving the appropriate level of care. Despite some people regularly losing weight, no referrals had been made and no extra measures had been put in place to ensure people were receiving a good level of nutrition. This was rectified during the assessment process where referrals were made. We did see evidence of other referrals being made including the speech and language therapy team and the district nursing team as required.

People and their relatives were not always aware of any information provided to them by the service. The majority of people had not seen a care plan or a service user guide and did not know this was available. One relative said, “We haven’t been asked if we wanted to see any records and we weren’t aware we could access them.”

Staff held very little knowledge on the Accessible Information Standards. Staff either did not understand what this meant or advised there was no alternatives for providing information. The manager told us information would be available in large print should there be a need for this.

Processes in this area were not robust. One staff member told us about a person being non-verbal, however, their care plan held no information on this or any advice for staff on how to communicate with this person. Confidential information was not kept secure, and we found several records relating to people’s care in communal areas and in empty bedrooms which were not locked. This meant people’s personal information was not protected.

Relatives told us they were not always aware of when their loved ones became unwell. One relative said, “The doctor visited 2 weeks ago. Staff didn’t ring me. I happened to see somebody I know who works there on the street and they put it down to deterioration.” Most people knew what the complaints procedure was, however, some people did not know the official process for making a complaint. People did advise they had attended a residents meeting where various topics were discussed.

Staff and managers told us the process for listening and responding to concerns. One staff member said, “We help people to be independent and make decisions for themselves.” Whilst another staff member said, “I would escalate concerns to the manager.”

There was no evidence to suggest people and their relatives had been asked to complete a feedback form to give their opinion on the care they received. The feedback forms we saw dated back to 2022. There had been no complaints logged but there was a procedure in place for this and we saw evidence of a recent resident and relative meeting which took place.

Relatives told us they were overall happy with the care their loved ones received. One relative said, “I’ve been impressed with the staff. They understand [person using the service].” Another relative described the care as ‘very good.’ While people we spoke to had no concerns in this area, our assessment found elements of care did not meet the expected standards as there were no arrangements in place to ensure those who were confined to their bedrooms had additional stimulation to promote their wellbeing.

The provider had not considered that the staffing issues and issues with the lift had a disproportionate impact on those people who could not leave their rooms independently. Staff told us they were often short staffed, and people were not always supported in a way they would like. When asked whether they feel the care provision is rushed, one staff member said, “When we are short staffed yes. Like today, I feel I am constantly apologising as it upsets their routine.” Staff also advised that when the lift is broken, there is no stimulation offered to people in their bedrooms. One staff member said, “The people cared for in bed or on bed rest don’t really get involved in activities.”

Partners did not offer any feedback in this area.

Care plans did not hold information on people’s accessibility needs. When the lift was broken, there were no additional measures in place to support people who could not access the communal areas. No extra protection was put in place such as falls sensor mats and no extra checks or stimulation was being done to promote people’s safety and wellbeing. Processes did not take account of the potential for inequalities or unequal impact on people with physical support needs when the lift was broken. On the first day of the inspection there was a shortage of staff and despite a staffing agency being called, this was not rectified until the afternoon. There was an on-call arrangement at night but there was no supporting policy or guidance for this.

People and their relatives told us they were not always involved in the care planning process and evidence in people’s care plans showed a lack of involvement in this area. Although relatives felt people were treated well, they felt there was not always enough staff. One relative said, “Sometimes they don’t have time for a conversation.”

Staff were generally happy with the care provided and knew how to raise concerns. However, they did feel more staff were required. One staff member said, “I just think we need to have more time, which means more staff.” Staff also told us they didn’t have enough time to take people out into the community which affected their experience of care. They said, “If people go out it is with their families, staff don’t have enough time to take people out.” Staff were aware that people without family involvement may be disadvantaged by this approach. Staff knew how to support people who had concerns and supported people to express their views.

There was little evidence to suggest people and their relatives had been involved in the care planning process. Care plans contained blank forms where people or their relative would agree to the care record and although we saw evidence of letters being sent to relatives for care plan reviews, we saw no evidence of this taking place. We saw no evidence of people being able to access the community or how the staff team would support with this. However, there was an accessible garden for people to sit in should the weather allow.

People and their relatives did not offer any feedback in this area and no-one was receiving end of life care at the time of the assessment.

Staff were aware of plans being in place for people’s end of life care wishes and told us they had completed training in this area.

Care plans held very little information on people’s advanced wishes and most forms were either blank or had not been updated to reflect people’s current address. There was a policy for end of life care planning, however, this policy was not being followed as records relating to people’s end of life care and treatment were not fully completed. Staff had completed training in this area.