CQC report explained · a residential care home
What the CQC found at Moorlands Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2021
Moorlands Care Home was rated Requires Improvement; inspectors found staffing and staff deployment remained unsafe enough to breach Regulation 18.
This was a focused inspection on 10 and 15 June 2021. Inspectors observed care, spoke with people, relatives and staff, and reviewed care, medicine, training and management records.
The main problem was staffing. People and staff said there were not enough staff, and inspectors saw delays and a person left in an undignified situation. Staff rotas also showed gaps, including shifts without cover.
The home managed people's individual risks, medicines and infection control safely. Care planning, staff training, food and access to healthcare were effective. The home was rated Good for Effective, but Requires Improvement for Safe and Well-led.
The overall rating stayed at Requires Improvement. The service had the same overall rating at its previous inspection in June 2019, and the provider was still in breach of the staffing regulation.
Risk management
People's individual risks were assessed, monitored and managed. Emergency evacuation plans and falls monitoring were also in place.
“People were assessed for known risks, which were managed and monitored effectively.” from the report
Medicines
Inspectors found that medicines were given as prescribed and staff had their medicine skills checked.
“Medicines were administered to service users as prescribed.” from the report
Care planning
Care plans reflected people's current needs and were reviewed with people's involvement. Changes were updated when needed.
“Care plan reviews had taken place at regular intervals and changes updated as required.” from the report
Food and healthcare
People received support with eating and drinking, including specialist diets. They could access GPs and other healthcare professionals.
“People received the support they needed to have enough to eat and drink and to maintain a balanced and healthy diet.” from the report
Not enough staff
seriousInspectors were not assured that enough staff were available and deployed properly. They saw delays, a person left needing care, and a person waiting to be supported by two staff.
“At this inspection we were not assured the action taken to improve in this area was effective to ensure staff numbers were sufficient and always deployed appropriately, therefore the breach remains in place.” from the report
Staffing gaps
seriousRotas showed shortfalls in staff cover. Agency staff were used heavily, especially at weekends, and some shifts had no cover arranged.
“Cover was mainly provided by agency staff. However, on some of the days there was no cover.” from the report
Incomplete temperature records
needs fixingMedicine room temperature records had gaps, although the room was otherwise described as clutter-free. The manager said this would be addressed.
“The medicine room was clutter free and records for medicine room temperatures were completed, but gaps were identified.” from the report
Improvements not sustained
needs fixingThe provider's monitoring had not picked up the continuing staffing problem, despite this being an issue at the previous inspection.
“Therefore, the service had not learnt or improved their staffing issues since the last inspection.” from the report
- 01How many staff are planned for each shift now, and how are they deployed across the home?
- 02What has changed since the inspection to prevent people waiting for help or being left without support?
- 03How much agency cover is currently used, particularly at weekends, and how are agency staff checked and supported?
- 04How are medicine room temperatures recorded now, and how are any gaps followed up?
- 05What action was sent to CQC about the Regulation 18 staffing breach, and what improvements have been completed?
This was a focused inspection of Safe, Effective and Well-led only; the other question ratings were not assessed and the previous ratings were used in calculating the overall rating. This explanation was written from the published report of 6 August 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.
What inspectors found, June 2019
Moorlands Care Home was rated Requires Improvement; inspectors found kind care and good responses to people's needs, but staffing and staff training were not sufficient.
This was an unannounced visit on 21 May 2019, followed by an announced visit on 22 May. The inspection was comprehensive. Inspectors spoke with people, families, staff and health professionals. They reviewed care records, staff files, medicines and quality checks.
The main concern was staffing. There were not enough skilled and experienced staff at some times to meet people's needs safely. Staff also needed better training to support people living with dementia and people whose behaviour was challenging.
People generally received their medicines safely, had suitable food and drinks, and were supported by health professionals. Staff were often kind, and the home offered personalised care, activities and end of life support. However, some people felt rushed or did not have enough time with staff.
The overall rating was Requires Improvement. Safe, Effective, Caring and Well-led were also Requires Improvement. Responsive was rated Good. The previous overall rating was Good in 2016.
Safe recruitment
The home used checks and records to assess whether staff were suitable before they started work.
“Staff underwent a robust recruitment process. Staff records included all required information, to evidence their suitability to work with people.” from the report
Medicines
Medicines were generally managed safely. Records included people's doses, allergies and instructions, and staff asked people whether they needed pain relief.
“People's medicine was managed safely and records we viewed confirmed this.” from the report
Personalised support
Care plans included people's routines, interests and communication needs. Staff supported people to make choices and remain independent.
“People had a plan 'day in the life of'. The plan detailed people's preferences for the day” from the report
Health and nutrition
People had access to healthcare professionals and received specialist diets where needed, including soft diets and thickened fluids for people at risk of choking.
“People had access to a range of health care services.” from the report
Not enough staff
seriousPeople, families and staff reported that staffing was too low. Some people had to wait, and staff could not always support people who needed more than one staff member.
“The provider failed to ensure there were sufficient numbers of skilled and experienced staff to meet people's needs.” from the report
Dementia training
seriousSome staff did not feel confident or knowledgeable enough to support people living with dementia or people whose behaviour was challenging. Additional training had been requested but was not available at the inspection.
“Staff did not undertake effective training to enable them to support people living with dementia and those whose behaviour was challenging.” from the report
Time and attention
needs fixingStaffing pressures affected people's experience. Some people said staff rushed personal care or did not have time to sit and talk with them.
“People did not consistently feel well treated or supported, their views about their care was linked to the both the approach and availability of staff.” from the report
Activities and going outside
minorActivities were available, including one-to-one support, but not everyone had the chance to take part in activities they chose or go outside.
“Not everyone had the opportunity to engage in activities of their choosing.” from the report
Provider oversight
needs fixingThe provider did not send inspectors requested evidence about management meetings and agreed actions. This meant inspectors could not be confident that governance arrangements were effective.
“We did not receive the information. Therefore, we cannot be confident that governance arrangements are effective to ensure the continued development of the service.” from the report
- 01What staffing levels are now in place at weekends, after 7pm and at other busy times?
- 02What dementia and behaviour support training has each member of staff completed since this inspection?
- 03How do you make sure people who need two staff members for personal care do not have to wait?
- 04How do you make sure every resident can take part in activities they choose and get outside if they want to?
- 05What evidence can you show of actions taken after provider and area manager meetings?
This was a planned comprehensive inspection covering the whole service, including the building and the care provided, with ratings given for all five questions. This explanation was written from the published report of 28 June 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 Moorlands Care Home
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- August 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 21 August 2012.
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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