Archived: Moorlands Care Home

Updated 23 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8, 13 and 14 March 2018. The first and second days of the inspection were unannounced. The provider was aware we were returning on the final day.

Day one of the inspection was carried out by two inspectors, an inspection manager and a specialist professional advisor. The specialist professional advisor was a registered mental health nurse (RMN). On the second day the inspection team consisted of three inspectors. The final day of inspection was completed by two inspectors.

Before this inspection we reviewed the information we held about the home, such as information we had received from the local authority and notifications we had received from the provider. Notifications are documents that the registered provider submits to the Care Quality Commission (CQC) to inform us of important events that happen in the service. We used information the provider sent to us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with three people who lived at the home and seven family members. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with nine members of staff including the home manager, supporting manager, nominated individual and the head of quality and governance.

We looked around communal areas of the home and some bedrooms, with people's permission. We also spent time looking at records, which included the care records for nine people who lived at the home, the recruitment and induction records for five members of staff and other records relating to the management of the home, such as quality assurance, staff training, health and safety and medication.

Following the inspection we spoke with a health care professional who visits the service.

Updated 23 May 2018

This comprehensive inspection took place on 8, 13 and 14 March 2018. The first and second days of the inspection were unannounced. The provider was aware we would be returning to complete the inspection on the third day.

At the inspection in February 2017 we judged the service to be ‘Requires Improvement’ overall, and in the key questions of Responsive and Well-led, and ‘Good’ in all other areas. There was no breach of regulation at this time.

Moorlands Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Moorlands care home accommodates up to 67 people across two separate areas. One unit provides nursing care whilst the other unit specialises in nursing care for people living with dementia. During our inspection there were 37 people living at the home.

The home is required to have a registered manager in post. At the time of our inspection the service did not have a registered manager. The registered manager had left the home at the end of December 2017, having completed a four week handover with a new manager. However, the new manager had left the organisation. The previous registered manager had returned to the role of manager with the intention to re-apply to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found that there were breaches of three of the fundamental standards of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to the safe delivery of care and treatment, person centred care and the governance of the service.

People told us they felt safe. However, we identified some concerns in respect of safe care and treatment. Risks to people had not been adequately assessed or mitigated which meant people were at risk of potential harm. These related to health care needs such as the risk management of epilepsy and diabetes.

Infection control measures were poor. We saw some communal areas, people’s bedrooms and equipment which was not clean.

People were not provided with care which consistently met their needs. Care records contained gaps which meant it was difficult to establish whether people had received the support they needed. Care plans did not always provide staff with the guidance they required to meet people’s needs. The registered provider had identified this as an area which required improvement and had an action plan to address this.

Quality assurance systems had identified some but not all of the issues we saw during the inspection and some of the issues known to the provider had not been rectified in a timely manner.

Staff understood how to safeguard people and overall safeguarding referrals had been appropriately made to the local safeguarding authority.

Medicines were safely managed. Essential safety checks had taken place such as gas and fire safety.

Staff had been safely recruited. There was a high use of agency staff but measures were in place to mitigate risks associated with this and the provider had a plan to try and recruit more permanent staff.

Staff described feeling supported by the manager and they had access to a range of training and supervision. Annual appraisals had not taken place and the manager agreed to rectify this.

We saw a variation in the quality of support provided to people who required assistance to eat. Overall, the lunchtime experience was positive and people had access to a variety of nutritious meals.

Staff understood the principles of the Mental Capacity Act and sought consent before they provided support. However, records associated with this required further improvement.

People had access to a range of health care professionals to support them to maintain their health.

There was a variation in the quality of activities on offer to people living at the home. People living on the general nursing unit had access to more meaningful stimulation and we saw the activities co-ordinator spent the majority of their time on this unit. However, the manager explained they hoped to recruit an additional member of staff who would concentrate on meaningful activities for people living with dementia.

People and their relatives knew how to make complaints. The home had received two complaints in the last year which had been appropriately investigated and responded to.

We were provided with positive feedback from relatives about the manager and they were pleased to see them back in post. People, relatives and staff had the opportunity to give feedback on the service via regular meetings with the manager.