CQC report explained · a residential care home
What the CQC found at Moorhouse Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2023
Rated Requires Improvement, with well-led rated Inadequate; inspectors found serious problems with staffing, safety, cleanliness and management.
This was an unannounced focused inspection. Inspectors visited on 7 and 8 March 2023 and reviewed information through 16 March. They spoke with people, relatives, staff and visiting professionals, and checked care records, medicines, recruitment, training and management records.
The home was not always safe or effective. People sometimes waited a long time for personal care or help, cleaning was poor, infection control was inconsistent, and medicine and care records were not always properly managed. Staff did not always have the right training, especially for dementia, moving and handling, and agency workers were not always given a proper induction.
Leadership was rated Inadequate. Inspectors found weak oversight, poor communication, a blame-focused culture and audits that had not dealt with repeated problems. The provider had started immediate actions, including extra clinical support and an action plan, but CQC said it would continue monitoring progress.
Kind staff
People were largely positive about care staff and said they were treated with kindness and respect.
“People were largely positive about the staff that supported them and said that care staff treated them with kindness and respect.” from the report
Food and hydration
Inspectors found choice, suitable portion sizes and well-presented modified-texture meals. Kitchen staff understood people's dietary needs and preferences.
“People were supported to maintain adequate levels of nutrition and hydration.” from the report
Some wound care
One person's pressure wound was being managed well, with records showing the treatment and progress.
“At the time of our inspection one person had a pressure wound which was being managed well.” from the report
Delayed personal care
seriousPeople sometimes waited until late morning or afternoon for personal care. Inspectors found that no one was supported to have a bath or shower during the visit.
“People are not getting showers – because not enough staff to support them in the morning.” from the report
Poor cleanliness
seriousInspectors found dirty and cluttered bathrooms, stained carpets and problems with supplies such as soap, towels and protective equipment.
“The standard of cleanliness during our unannounced inspection visit was poor.” from the report
Weak management checks
seriousProblems had been identified repeatedly but were not dealt with effectively. Internal audits did not identify or resolve the concerns found by inspectors.
“The internal audits used by the management team had not been effective in identifying the concerns highlighted throughout this inspection or where the provider's policies were not being followed.” from the report
Dementia and moving support
needs fixingStaff did not consistently have suitable training or support for dementia care and moving and handling. Agency staff were not always given a proper induction.
“Staff did not consistently have the training, experience, and support to deliver their roles effectively.” from the report
Consent and restrictions
seriousThe home did not always record best-interest decisions or consider less restrictive options. Inspectors found bed rails used without a recorded assessment or best-interest discussion.
“We identified two occasions where nursing staff had implemented the use of bed rails without any recorded assessment or best interest discussion.” from the report
- 01What staffing levels are now in place, and how do you make sure people receive personal care, showers and help promptly?
- 02What evidence can you show that the cleaning and infection-control problems found by CQC have been fixed and are being checked?
- 03How are agency nurses and other agency staff now inducted and shown people's individual risks and care needs?
- 04What dementia training and practical moving-and-handling checks have staff completed since the inspection?
- 05How are best-interest decisions, bed-rail use and conditions attached to Deprivation of Liberty Safeguards authorisations now recorded and monitored?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 10 May 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, June 2021
Rated Good overall; inspectors found safe, kind and personalised care, but the home was not always well-led.
This was an unannounced focused inspection on 4 May 2021. Inspectors spoke with six people, seven staff members and five relatives. They reviewed care plans, medicines records, recruitment files, complaints and management records.
The home had improved since the previous inspection. Inspectors found that risks were being managed, medicines were handled safely, staffing was suitable and people received personalised care. People and relatives said staff were kind, approachable and responsive.
The home was rated Good overall. Safe and Responsive were rated Good. Well-led remained Requires Improvement because provider-level leadership, contingency planning and oversight were not yet strong enough. Effective and Caring were not assessed during this inspection, so their previous ratings were used in the overall result.
Safer risk management
Care had been reviewed and clear plans were in place for identified risks. The home was also using incident analysis to reduce repeated risks.
“At this inspection we found that people's care had been reviewed and that where risks were identified, there were now clear plans in place to reduce these.” from the report
Kind and personal care
People were supported according to their choices, routines and preferences. Staff knew people well and gave them time and attention.
“Staff were kind and compassionate and people were able to make decisions about their support and followed daily routines and interests that were meaningful to them.” from the report
Safe medicines
Medicines were given by trained and checked staff. Inspectors found that people received medicines safely and as prescribed.
“There were systems in place to ensure medicines were managed and stored safely.” from the report
More open communication
People and relatives felt more able to raise concerns and felt listened to. Complaints and compliments were recorded and used to improve the service.
“The manager maintained a log of compliments and complaints which fully documented issues raised and how they had been responded to.” from the report
Improved teamwork
Staff morale and teamwork had improved. People, relatives and staff were more involved in the running of the home.
“Staff morale was visibly improved, and we observed good teamwork between staff at every level within the service.” from the report
Provider oversight
needs fixingThe provider's leadership and monitoring were not yet strong enough to make sure improvements would continue. The inspection recommended outside support to develop provider-level leadership.
“Provider governance consisted of a summary of their visit rather than robust monitoring of the service against a strategic development plan that strived for continuous improvement.” from the report
Plan for manager absence
needs fixingThere was no up-to-date plan explaining who would lead the home if the manager was away or had to self-isolate. Staff relied heavily on the manager for leadership.
“There was no up to date and credible contingency plan for the continued safe running of the service in the absence of the manager.” from the report
Care record transfer
minorSome care records were still being transferred to the new electronic system and there were recording gaps. The manager had reduced the risk by ensuring a regular nurse was on each shift.
“The manager recognised that there were still some recording gaps but had mitigated the risk of this by ensuring there was always a least one regular nurse on shift.” from the report
- 01Who would lead the home if the manager was away, ill or had to self-isolate?
- 02What has been done to complete and test the business continuity plan?
- 03How does the provider monitor the home, rather than relying mainly on the manager?
- 04Have all care records now been transferred to the electronic system, and how are recording gaps checked?
- 05How will you make sure the improvements found at this inspection are sustained?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not assessed and their previous ratings were carried forward. This explanation was written from the published report of 18 June 2021 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 Moorhouse Care Home
9 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- June 2021GoodSafe: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- February 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvement
- January 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 3 December 2010.
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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