CQC report explained · a nursing home
What the CQC found at Moorfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found kind, responsive care and progress since an Inadequate rating, but choking risks and oversight were still not reliably managed.
This was an unannounced follow-up inspection after the home was previously rated Inadequate and placed in Special Measures. Inspectors reviewed care, medicines, staffing and management records, observed the home, and spoke with people, relatives and staff.
The home had improved in several areas. People were treated kindly, their dignity was respected, and activities and family involvement had increased. Medicines, staffing, recruitment, safeguarding and most risks were managed safely.
However, staff did not always follow specialist diets and fluid instructions for people at risk of choking. Care records were not always accurate or up to date, and the home's checks did not reliably identify these problems.
The overall rating is Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. The home is no longer in Special Measures, but it remains in breach of regulations.
Kind and respectful care
People and relatives described staff positively. Inspectors saw that people were treated with dignity and supported to make choices and stay as independent as possible.
“Staff treated people kindly and had respect for equality and diversity.” from the report
Safer medicines and staffing
Medicines were managed safely, with regular oversight. Staffing levels had been reviewed, recruitment checks were completed and agency staff received an induction before providing care.
“Medicines were safely managed and there was a consistent nurse in post who had daily oversight of all medicine administrations” from the report
Improved personalised care
Care plans had been rewritten to include people's choices and personal details. Relatives were involved in care planning and healthcare professionals contributed to people's care.
“Care plans had been reviewed and re-written to contain person-centred detail.” from the report
More activities and family involvement
People had access to more activities, including gardening, quizzes and games. Relatives were welcomed and could attend regular meetings with management.
“People and their relatives told us there was access to more activities since our last inspection, this included a gardening club, quizzes and games.” from the report
Choking risks were not consistently managed
seriousStaff did not always follow specialist diet and fluid instructions. One person was given regular fluids on 11 occasions despite needing thickened fluids, and another received a normal diet despite needing soft food.
“People remained at risk of choking because guidance in relation to specialist diets was not always followed.” from the report
Checks did not find important problems
seriousAudits and quality checks did not identify that people's assessed needs were not being met or that choking risks were present. The provider was issued a warning notice.
“Audits and checks in place did not identify that people were not having their assessed needs met and were potentially at risk of choking.” from the report
Care records were not always up to date
needs fixingSome care plans and related records contained conflicting or incorrect information. The report recommended a review so records reflect the latest professional guidance.
“Care records required a review to ensure all information was accurate and up to date.” from the report
- 01How will you make sure every person's specialist food and drink instructions are followed at every meal and drink?
- 02How will you monitor people who are at risk of choking, and what will you do if staff do not follow their care plan?
- 03How often are care records checked against the latest advice from speech and language or other healthcare professionals?
- 04What action has been taken in response to the warning notice, and how will you show that it has worked?
- 05How are relatives involved in reviewing care plans and raising concerns about food, fluids or other care needs?
This was an unannounced follow-up inspection covering all five key questions, including infection prevention and control under Safe, after the previous Inadequate inspection. This explanation was written from the published report of 8 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2022
Moorfield House was rated Inadequate and placed in special measures; inspectors found serious risks involving care, medicines, staffing and management.
This was an unannounced inspection. Inspectors visited on 12 April and 27 April 2022, and reviewed care records, medicines records, staffing records and management systems. They also spoke with people, relatives and staff.
Inspectors found people were at serious risk of harm. Risks such as choking, continence needs and oxygen therapy were not properly assessed or monitored. Medicines were not always given as prescribed, staffing levels were not always enough, and agency staff did not always have safe recruitment checks, induction or competency assessments.
Care was not always based on people's choices and needs. Records were missing or inaccurate, people sometimes waited a long time for help, and staff did not always follow dietary or healthcare guidance. Staff were described as kind, and infection control was effective, but staffing pressures meant people's needs were not always met.
The overall rating was Inadequate. Safe, Effective and Well-led were rated Inadequate. Caring and Responsive were rated Requires Improvement. The home was placed in special measures, which means the CQC would keep it under review and normally reinspect within six months.
Kind staff
Inspectors saw staff being kind and caring. Relatives also gave positive feedback about the permanent staff.
“Staff were very caring towards people whilst delivering support but due to staffing issues the support was not always provided when it was needed.” from the report
Infection control
Inspectors were assured that infection prevention measures, testing, PPE and visiting arrangements were being followed.
“We were assured that the provider was using PPE effectively and safely.” from the report
Choice at mealtimes
People were offered choices about meals, and feedback about the food was positive, although assessed special diets were not always followed.
“People were provided with choices for their meals and were complementary about the food provided.” from the report
Privacy and dignity
Staff generally understood how to protect people's privacy and dignity, although staffing shortages limited independence at times.
“Staff promoted people's privacy and dignity.” from the report
Serious risks not controlled
seriousPeople at risk of choking were not always given their required special diets. There were also serious gaps in continence monitoring and oxygen therapy support.
“People were at serious risk of harm, as risks associated with choking, continence management and oxygen therapy had not been fully assessed, mitigated or monitored.” from the report
Medicines
seriousMedicines were not always given at the prescribed time, records were incomplete and some instructions for as-required medicines were missing.
“Systems for managing medicines were not safe or in line with national guidelines.” from the report
Staffing and agency workers
seriousThere were not always enough suitably skilled staff. Agency staff records, inductions and competency checks were incomplete, and inspectors found people sometimes waited a long time for support.
“The provider did not ensure there were adequate levels of staff available to safely support people.” from the report
Poor records and oversight
seriousCare records, medicine audits and other records were missing, inaccurate or incomplete. The provider's checks did not identify or correct the problems found.
“The provider did not have effective systems in place to monitor and improve the quality and safety of the service.” from the report
Care not personalised
needs fixingCare plans did not always include people's choices, communication needs or professional guidance. Staff did not always follow the plans that were in place.
“People did not have appropriate care plans in place which were person-centred.” from the report
Delayed support and appointments
needs fixingPeople sometimes waited for help with personal care, food or drinks. Some healthcare appointments were delayed, missed or lacked staff support.
“People did not always have access to other healthcare services in a timely way.” from the report
- 01What evidence can you show that the urgent conditions about choking, continence monitoring and oxygen therapy have been met?
- 02How do you check that medicines are given at the right time and that staff are competent to administer them?
- 03How many suitably qualified staff are planned for each shift, and what happens when staff are absent?
- 04How are agency workers checked, inducted and assessed before supporting people?
- 05How are care plans kept accurate and made sure to reflect people's diets, communication needs, preferences and healthcare guidance?
This was an unannounced inspection covering all five key questions, including infection prevention and control; inspectors visited on two dates and reviewed records, observations and feedback from people, relatives and staff. This explanation was written from the published report of 13 August 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Moorfield House
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2022InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2020Inspected but not ratedSafe: Inspected but not rated
- November 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- August 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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