Archived: Moorfield House Nursing Home

Updated 21 June 2019

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

Inspection team: The inspection was carried out by one inspector.

Service and service type: Moorfield House Nursing Home is a 'care' home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: The inspection was unannounced.

What we did: Before the inspection, we liaised with the local authority safeguarding team and commissioners of the service. We did not ask the service to complete a Provider Information Return before this inspection. 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. We reviewed all the information we held about the service including notifications we had received from the provider. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about.

During the inspection, we spoke with five people who used the service and two relatives. 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 also spoke with nursing and care staff, activity and maintenance staff and the cook. Throughout the inspection we liaised with the registered manager and the deputy manager.

During the inspection we reviewed five staff recruitment files, five people's care records and medication administration records. We also looked at records relating to the management of the service. We spoke with two visiting professionals.

Updated 21 June 2019

About the service: Moorfield House Nursing Home is a nursing home that was providing personal and nursing care to 49 people at the time of the inspection. Care was provided to people who were accommodated in two separate units. One for older people and one for people with physical disabilities.

People’s experience of using this service: We identified a number of concerns relating to fire safety which put people at risk of harm. Following our inspection, we contacted the fire service and they visited the service and issued an enforcement notice.

Systems were in place to monitor the quality of the service. However, these were not robust and had failed to identify the issues we found. Where audits identified areas for improvement we saw action was not always taken.

Issues relating to records were identified. Each person had a range of care plans which were detailed and included how they wished to be cared for. However, these differed between the two units and were not always completed and reviewed in a timely manner.

People told us that they were happy at the service. They gave examples of how staff supported them to remain as independent as they could be.

People and their relatives told us staff treated them well and with kindness and respect. Relatives said they were always made to feel welcome when visiting their family member.

Medicines were managed safely. Guidance was in place to ensure people received their as required medicines when they needed them.

Staff knew how to respond to possible harm and how to reduce risks to people. Lessons were learnt about accidents and incidents and these were shared with staff, to reduce the risk of further occurrences.

Staffing numbers were sufficient to keep people safe. The provider followed safe recruitment procedures to ensure staff employed were suitable for their role.

People's needs were assessed and care provided in line with their preferences. Staff completed an induction when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people. People received enough to eat and drink and were supported to use and access other health and social care professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and staff were encouraged to provide feedback about the service and it was used to drive improvement. Staff felt supported and received supervision and appraisals of their performance. The registered manager was aware of their responsibility to report events that occurred within the service to the Care Quality Commission and external agencies.

Rating at last inspection: At the last inspection the service was rated Requires improvement (report published 24 April 2018). This service has been rated requires improvement at the last three inspections.

Enforcement: We have identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to the safety and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up: We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk