CQC report explained · a residential care home
What the CQC found at Moorgreen
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, medicines, staffing and infection control were managed well, although the home said it would improve the evidence showing which care plans and risk assessments staff had read.
- Effective?
- Good
- People received support from trained staff and achieved positive outcomes, including through dialectical behaviour therapy and support with healthy eating. This rating improved from Requires Improvement at the previous inspection.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions about their care and were encouraged to develop confidence and independence.
- Responsive?
- Good
- Care plans reflected people's needs, preferences, goals and abilities. People were supported to keep in touch with family and friends and to take part in activities based on their wishes.
- Well-led?
- Good
- The home had effective quality checks, positive staff morale and open leadership. Inspectors found that lessons from the previous death had led to changes in policies, staffing and management support.
What inspectors found, April 2022
Rated Good; inspectors found safe, kind and personalised care, and said actions after a previous death had been completed.
This was an unannounced comprehensive inspection on 9 March 2022. One inspector spoke with people, observed staff, reviewed care, staffing and medicines records, and gathered feedback from relatives, staff and professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines arrangements, personalised care plans and kind, respectful support.
The inspection followed the death of a person and concerns raised by the Coroner about management and support. Inspectors found the home had made the changes it had promised and found no evidence that people remained at risk of harm from that concern.
The previous overall rating was Good. The Effective rating had previously been Requires Improvement but improved to Good at this inspection.
Safe staffing
Inspectors found enough appropriately trained staff to meet people's needs. A senior staff member was on duty on every night shift, following changes made since the last inspection.
“People were supported by enough appropriately trained staff to meet their needs, and there was always a more senior staff member on shift to provide necessary leadership if incidents occurred.” from the report
Kind and respectful care
Staff communicated positively with people and supported their dignity, privacy, choices and independence.
“We observed staff communicating with people in a consistently positive and kind manner.” from the report
Personalised support
Care plans covered people's goals, skills, abilities, preferences and support needs. Staff knew people well and delivered the care set out in their plans.
“Care plans were focused on the person's whole life, including their goals, skills, abilities and individual aspirations.” from the report
Learning from serious events
The provider reviewed the Coroner's concerns and introduced changes, including a policy about room searches and removing potentially harmful items.
“The provider had reviewed its policies, procedures, staffing levels, and management support arrangements as a result of the learning from that previous death.” from the report
People's involvement
People helped shape their care, activities and aspects of the home. Feedback led to changes such as regular use of a hot tub in the garden.
“The service had a 'You said-We did' display board which showed the improvements made as a result of people's comments.” from the report
Evidence that staff had read updated plans
minorThe home did not fully evidence which specific care plans and risk assessments each staff member had read, and when. The manager said this would be improved.
“They subsequently told us they would better evidence which specific care plans and risk assessments each staff member had read, and the date they read them.” from the report
- 01How do you record that each staff member has read the latest care plans and risk assessments?
- 02How do you decide when someone needs close observation, and how do you make sure this is reviewed as their risks change?
- 03What changes were made after the Coroner's concerns, including the room search and removal of risk items policy?
- 04How is dialectical behaviour therapy provided, and how do you measure whether it is helping the person?
- 05How do you ensure there is senior leadership on every night shift and enough staff when people's needs change?
This was an unannounced comprehensive inspection covering all five CQC questions and infection prevention and control; the inspection was prompted in part by a notification following a person's death. This explanation was written from the published report of 20 April 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.
What inspectors found, May 2019
Heathcotes (Moorgreen) was rated Good overall, but inspectors found people’s legal rights and some medicines arrangements needed improvement.
Inspectors visited on 23 April 2019. They spoke with people living at the home, care staff, the manager and a psychologist. They observed care and checked care records, staff files, medicines, incidents, staffing and quality checks.
People generally felt safe and received kind, personalised care. Risks were managed, medicines were usually given as prescribed, the home was clean, and staff supported people with healthcare, activities and independence.
The home was rated Good for Safe, Caring, Responsive and Well-led. Effective was rated Requires Improvement because some restrictions had been placed on people without the required consent or capacity assessments. Inspectors also found problems with variable-dose medicines instructions and the medicines fridge temperature.
The previous overall rating was Requires Improvement in December 2018. Inspectors found improvements in safety, staff boundaries and leadership. The home did not have a CQC-registered manager at the inspection, although a new manager was in post and planned to register.
People felt safe
People said they felt safe, and staff understood safeguarding responsibilities. Risks were assessed and managed while supporting people’s independence.
“People told us they felt safe and staff, and the manager, had a good understanding of safeguarding adults.” from the report
Kind and respectful care
Staff were friendly and caring. Inspectors saw people being treated with dignity, privacy and respect.
“People told us staff were kind and caring.” from the report
Personalised support
Care plans described people’s needs and preferences. People chose activities and were supported to build independence.
“People received personalised support that was based upon their needs and preferences.” from the report
Improved leadership
Inspectors found better governance and leadership than at the previous inspection. The new manager was described as having a positive impact.
“Since our last inspection, improvements had been made to the governance and leadership of the home, consequently, we found the home was well led.” from the report
Consent and legal rights
seriousSome people were subject to restrictions without evidence that they had agreed to them or that their capacity to make the decision had been assessed. Inspectors recommended that the provider seek advice about applying the Mental Capacity Act.
“Further work was needed to ensure people's rights under the MCA were respected.” from the report
Medicines storage and instructions
needs fixingStaff did not always have clear directions for medicines with variable doses. The medicines fridge was routinely above the recommended temperature, which could affect medicines.
“Some improvements were required to ensure staff had clear directions about how to administer medicines that were variable dosage.” from the report
Manager registration
minorThere was no manager registered with the CQC when inspectors visited. A new manager was in post and said they planned to register.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01How do you now assess whether a person has capacity to agree to restrictions on leaving the home or other choices?
- 02What legal authority is in place if a person needs to be prevented from leaving the home?
- 03What changes were made to the medicines fridge and how are its temperatures checked now?
- 04How are variable-dose medicines explained to staff and checked for safe administration?
- 05Has the new manager completed CQC registration, and how is the home’s leadership being monitored?
This was a planned inspection of the care home, covering accommodation and care and rating all five key questions. This explanation was written from the published report of 16 May 2019 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 Moorgreen
7 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- April 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementWell-led: Requires improvement
- February 2017InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- August 2016
Registered with the Care Quality Commission on 5 August 2016.
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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