CQC report explained · a residential care home
What the CQC found at Moorland House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable staff checks, safeguarding arrangements, risk assessments and infection control. They raised a concern that medicines were sometimes left with people to take without direct observation, meaning others might have accessed them.
- Effective?
- Good
- People's needs and choices were assessed and care was personalised. Staff had relevant training, people had access to healthcare, and inspectors found improvements in the dining experience since the previous inspection.
- Caring?
- Good
- Staff were kind and compassionate and treated people with dignity and respect. People and families were involved in care decisions, and visitors were made welcome.
- Responsive?
- Good
- Staff understood people's preferences and supported activities, personal routines and end-of-life care. Comments, suggestions and complaints were recorded and acted on.
- Well-led?
- Requires improvement
- The registered manager was visible and effective in monitoring care, but the provider did not always create an open and inclusive culture. Changes to care provision and staff rotas were not fully discussed with people and staff, and service information was inaccurate.
What inspectors found, June 2018
Rated Good overall, but well-led Requires Improvement because some major changes were made without enough consultation and information was unclear.
Inspectors made an unannounced visit on 5 April 2018. They spoke with people, relatives and staff, and reviewed care records, staff records, policies, audits and training evidence. There were 44 people living in the home at the time, out of 48 places.
The home was rated Good for being safe, effective, caring and responsive. Inspectors found kind staff, personalised care, suitable food and healthcare, good activities, and support that respected people's dignity, choices and independence.
The well-led rating was Requires Improvement. The provider had changed the service from nursing care to care care only, and had changed staff rotas, without fully consulting everyone affected. The home's written information was also out of date and caused confusion about the care available.
The report did not identify a breach of regulations. It made two recommendations: involve people and staff more in future changes, and update the home's statement of purpose and online information.
Personalised care
Care plans recorded people's wishes and preferences, including personal routines and how they liked to dress. Staff adapted support to individual needs.
“When we reviewed people's care plans we noted people were consulted about their care and we saw their wishes were clearly recorded.” from the report
Improved mealtimes
Inspectors found that the dining experience had improved since the previous inspection. People had drinks, support and time to enjoy their meals in a calm setting.
“The atmosphere was calm and sociable and we saw people enjoying their food and conversing with staff and each other.” from the report
Good activities and community links
People were offered varied activities and trips, with changes made to reflect their wishes. The home also had links with local groups and services.
“People told us they enjoyed going out on trips around the Peak District in the provider's mini-bus.” from the report
Strong local management
The registered manager was approachable and used audits and other information to identify risks and improve care. Staff also had opportunities to develop specialist knowledge.
“The registered manager had the knowledge and skills to develop the staff and improve the quality of the service.” from the report
Medicines not always directly supervised
needs fixingSome medicines were left with people to take later, although the home checked that they had taken them. Inspectors could not be sure that this prevented another person from accessing the medicines.
“However it did not take into account that other people might have access to these medicines too.” from the report
Limited consultation about changes
needs fixingThe provider changed the care offered and introduced a new rota without fully considering the views or impact on all affected people and staff. This left some people and families worried about the future.
“This meant the impact on other people, or their views, were not considered when making the changes.” from the report
Information was out of date
needs fixingThe statement of purpose and online brochure did not clearly describe the care available at this home. This caused confusion about whether the home could meet future or more complex needs.
“This had led to people being confused about the admissions process and the suitability of the service to care for them or their loved one.” from the report
Regular activities became harder to plan
minorThe new rota made it difficult to hold some activities on the same day each week. Inspectors noted that this could affect people who planned around regular activities.
“The fortnightly rota made it difficult to plan some activities on the same day each week” from the report
- 01What care can you provide if my relative's needs increase or they develop dementia?
- 02How will you keep us informed about any future changes to the care offered or staffing arrangements?
- 03Have the statement of purpose and online information now been updated to describe this home accurately?
- 04How are medicines given and supervised, particularly when someone does not want staff watching them take them?
- 05How will you make sure regular activities remain predictable and accessible after changes to staff rotas?
This was an unannounced inspection of the overall service, covering all five CQC questions; the previous inspection was in September 2016. This explanation was written from the published report of 6 June 2018 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 2017
Moorland House was rated Requires Improvement; inspectors found safe and caring support, but staffing, mealtimes and responsiveness needed improvement.
Inspectors visited without notice on 30 November 2016. They reviewed care and staff records, observed care and mealtime arrangements, and spoke with people, relatives, staff and healthcare professionals. There were 45 people living in the home, which was registered for 48.
People were safe and treated kindly. Staff had training, risks were assessed, medicines were generally managed well, and people received help from health professionals. People’s choices, privacy and dignity were respected.
Some care was not reliable when staffing levels were low. The lunchtime service was disorganised and people waited a long time for food. Relatives also reported that staff did not always respond to personal requests or concerns. Staff said repeated concerns about staffing had not been properly resolved.
The overall rating was Requires Improvement. Safe and Caring were rated Good. Effective, Responsive and Well-led were rated Requires Improvement. The report did not say that the home was in special measures.
People felt safe
Staff understood how to protect people from harm. Risks were assessed and managed while still supporting independence.
“Staff have the skills and knowledge to keep people safe.” from the report
Kind and respectful care
Inspectors saw warm relationships between people and staff. People’s routines, choices, privacy and personal appearance were respected.
“This demonstrated that staff had positive and caring relationships with people and people felt they mattered.” from the report
Personalised activities
The home offered group and one-to-one activities based on people’s interests and abilities, including trips in the local area.
“The service had a very good activities programme that was personalised, creative and responsive to individual wishes and preferences.” from the report
Support with healthcare
People were referred to appropriate healthcare professionals, including dieticians, physiotherapists, speech and language therapists, dentists and GPs.
“People were supported to access healthcare services and received on-going healthcare support.” from the report
Long and disorganised mealtimes
needs fixingThe lunchtime service lacked clear leadership. People waited for food, some had no drinks or cutlery, and there was not enough soup or choice for everyone.
“However, we found the lunchtime service was poorly managed and people waited a long time for their meal.” from the report
Staffing shortages affected care
needs fixingVacancies and absences affected response times, mealtimes, record updates and household tasks. Staff said they were under pressure when covering extra duties.
“It had not satisfactorily resolved the issue of insufficient staff available to cover periods of absences or increasing need.” from the report
Personal requests were not always followed
needs fixingRelatives reported that drinks, glasses and remote controls were sometimes left out of reach, clothing instructions were not followed, and a person was not repositioned when needed.
“This indicated that care was not always person centred and staff did not always respond to personal need, personal preferences or advice from relatives.” from the report
Medicine records were incomplete
needs fixingPatch charts were not signed every day. This meant staff could not always confirm that patches were in place or that the prescribed dose had been given.
“However, we found that the records were not signed consistently every day, which meant staff could not always be sure that the patches were still in place and people were receiving the prescribed dosage of medicine” from the report
Concerns about openness
needs fixingStaff were coached on how to respond to CQC questions and were discouraged from discussing poor staffing. Inspectors said this showed the provider was not always open or transparent.
“This had resulted in staff being nervous throughout the inspection and concerned about 'saying the wrong thing'.” from the report
- 01How many care, nursing and kitchen vacancies are there now, and how are absences covered?
- 02What changes have been made to stop people waiting a long time for meals?
- 03How do you check that drinks, glasses, remote controls and other personal items are left within reach?
- 04How are medicine patch records checked each day?
- 05How can families raise concerns, and how will you show that these concerns have been acted on?
This was an unannounced inspection covering all five CQC questions and the overall rating; the previous inspection in April 2014 was compliant in the areas it inspected. This explanation was written from the published report of 10 May 2017 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 Moorland House
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- June 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 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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