CQC report explained · a nursing home
What the CQC found at Moss View
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2021
Moss View was rated Requires Improvement because care records and management systems were not reliable enough to assure safe care.
This was an unannounced inspection on 29 July 2021 and 04 August 2021. Inspectors looked at infection prevention, staffing and medicines after concerns had been raised. They spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
Inspectors found that some care records were incomplete or difficult to follow. Food and fluid records were missing for people with specific dietary needs. Important information about risks and procedures was also not always recorded clearly. This meant people could have been put at risk of unsafe care.
Medicines were mostly managed safely, and problems found during the visit were corrected straight away. Staff recruitment, safeguarding arrangements, infection control and incident records were also positive. However, staff raised concerns about staffing levels and feeling unsupported.
The overall rating remained Requires Improvement, as it had at the previous inspection in July 2019. Safe remained Requires Improvement. Well-led fell from Good to Requires Improvement. The other key questions were not inspected at this visit, so their previous ratings were carried forward.
Mostly safe medicines management
Medicines were generally stored, administered and managed safely. Two issues found during the inspection were corrected before inspectors left.
“Medication was mostly managed, stored and administered safely.” from the report
Infection control
The home had enough personal protective equipment and was using it safely. It also arranged testing and used hygiene measures to reduce infection risks.
“The provider was using PPE effectively and safely.” from the report
Safe recruitment
Staff recruitment included checks to assess whether people were suitable for their roles.
“Staff were recruited and selected safely following a robust selection process.” from the report
Safeguarding arrangements
There were safeguarding policies and procedures, and staff knew how to report concerns and escalate them.
“Safeguarding concerns had been reported to the Local Authorities and staff knew how to report safeguarding concerns” from the report
Working with other services
The home worked with health and care professionals to support people.
“The manager and clinical lead worked closely with GPs, OTs, and the local authority.” from the report
Incomplete care records
seriousRecords did not always show what people had eaten or give enough information about risks and procedures. Inspectors said this could lead to unsafe care and identified a breach of governance requirements.
“Records in relation to people's care and treatment were not always completed or well organised which put people at risk of unsafe care.” from the report
Staffing concerns
needs fixingMost staff inspectors spoke with felt there were not enough staff and said they were struggling or exhausted. Rotas and dependency records appeared to show staffing at expected levels, but the provider agreed to reassess this.
“All of the staff we spoke with, with the exception of the home manager and deputy manager, told us they felt the home was understaffed, and they were struggling.” from the report
Weak management oversight
needs fixingThere was no registered manager at the inspection. Audits did not always identify gaps in care plans, and staff reported feeling unsupported and unable to raise concerns.
“There was no registered manager in post at the time of our inspection.” from the report
Conflicting care guidance
seriousSome important information was difficult to find or conflicted with other records. In one case, inspectors could not tell which speech and language guidance staff should follow.
“We could not be sure from looking at the persons records which guidance the staff ought to be following.” from the report
- 01How have you checked that food and fluid records are now complete for people who need diabetic, high-protein or other special diets?
- 02How do you make sure risk assessments and instructions, including suctioning and speech and language guidance, are clear and consistent?
- 03What has changed in staffing levels since this inspection, and how do you assess whether staffing is enough at busy times such as mornings?
- 04Who is currently responsible for managing the home, and what is the plan for having a registered manager?
- 05What action has been completed in response to the Regulation 17 breach, and can you show us the new auditing process?
This was a focused inspection of Safe and Well-led, including infection prevention, staffing and medicines; the other key question ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 18 September 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, August 2019
Rated Requires Improvement; inspectors found kind care and better management, but medicines, staffing deployment and activities still needed attention.
Inspectors visited without notice on 23 and 26 July 2019. They spoke with people living at the home, relatives and staff. They observed care and reviewed care plans, medicines records, staff files and management records.
The overall rating was Requires Improvement. Safe and Responsive were also Requires Improvement. Inspectors found problems with medicines records, the storage temperature for medicines, staff deployment and the range of activities. The temperature problem was corrected during the inspection, and one medicines error was corrected straight away.
Effective, Caring and Well-led were rated Good. Staff were trained, people were supported with healthcare and food, and inspectors saw kind and respectful care. The home had improved since the previous inspection and was no longer in breach of the regulations previously broken, but this was the second consecutive Requires Improvement rating.
Kind and respectful care
Inspectors observed caring interactions. People and relatives said staff were kind, friendly and caring.
“People we spoke with said the staff were kind and caring.” from the report
Staff training
Mandatory training was up to date, including training about supporting people living with dementia. Agency staff received a thorough induction.
“Staff were appropriately trained, inducted and supervised in line with the registered providers policies and procedures.” from the report
Healthcare support
People were referred to health professionals when needed, and staff followed the advice given.
“Care plans evidenced that people had been referred to other health care professionals such as Speech and Language (SALT) and Dieticians when needed.” from the report
Medicines records
needs fixingOne person's medicine instructions were recorded incorrectly, and one medicine did not have a required PRN plan. The errors were corrected, but inspectors recommended further checks.
“One person's directions for taking a medication was documented incorrectly on the Medication Administration Record (MAR) chart.” from the report
Staff deployment
seriousAlthough staffing numbers were considered sufficient, staff were busy and were not always placed where people's needs required. One lounge was left unsupervised for over 15 minutes while a person at risk of falls was there.
“We observed on day one of our inspection one of the communal lounges was left unsupervised for over 15 minutes.” from the report
Activities and time with staff
needs fixingSome people and relatives said there was not much going on. People also wanted staff to have more time to spend with them.
“Some people and their relatives told us the activities were 'fine' however there was not much going on.” from the report
Personal information in care plans
minorPeople's backgrounds and hobbies were not always recorded. This could make it harder for staff to plan activities and support based on individual interests.
“People's backgrounds and hobbies were not always recorded in their care plans which meant staff were not always able staff to get to know more about them.” from the report
Accessible information
needs fixingThere was limited information in formats such as easy read and large print. Menus were only available in print.
“There was limited information available for people to access in formats such as easy read and large print.” from the report
- 01How are medicines records checked now, including medicine directions and PRN plans?
- 02How have staff deployment arrangements changed so that lounges are supervised and people receive enough time with staff?
- 03What activities are now available, and how are they matched to each person's interests and background?
- 04How do you provide menus and other information in easy read, large print or other suitable formats?
- 05Has the manager completed CQC registration, and what checks show that the improvements are being sustained?
This was an unannounced inspection covering all five CQC questions, and both the premises and care provided were looked at. This explanation was written from the published report of 29 August 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 Moss View
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- September 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Good
- August 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 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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