We carried out a review of the data available to us about Moorlands Rest Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Moorlands Rest Home, you can give feedback on this service.
Moorlands Rest Home is a care home without nursing that provides personal care for up to 12 older people, some of whom may be living with dementia. At the time of our inspection there were 9 people living at the service. The care home, which is set in a residential area, accommodates people in one adapted building, arranged over two floors. There was a communal lounge and a communal dining area on the ground floor. There was a garden at the rear of the building.
People’s experience of using this service and what we found
People experienced safe care from staff who understood how to protect them from abuse and avoidable harm. Risks to people were assessed and managed safely, in a manner which promoted their freedom and independence. Enough suitable staff with the right mix of skills, competence and experience were deployed to meet people’s needs safely. Medicines were only administered by trained staff who had their competence to do so regularly assessed by the registered manager. Staff carried out good infection control and food hygiene practices, which protected people from the risk of infection. Staff raised concerns and reported incidents and near misses, to enable the registered manager to take action to reduce the risk of future occurrence.
People’s needs assessments were detailed, identified expected outcomes and were reviewed and updated regularly to reflect people’s changing needs. Staff were supported to develop and maintain required skills and worked well with partners to ensure they followed best practice. People were encouraged to eat a healthy balanced diet and staff effectively managed their identified risks associated with poor hydration and nutrition. The registered manager made timely referrals to relevant professionals and effectively implemented their guidance to achieve good outcomes for people. The registered manager had established a rolling programme of environmental improvements based on recognised guidance, to improve people’s quality of life and promote their wellbeing.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The registered manager and deputy manager were committed to delivering care and support that treated people with compassion, kindness, dignity and respect. Staff provided sensitive and respectful care and supported people to take the lead in decisions about their care. The registered manager had ensured people who required support to make certain decisions had suitable advocates appropriately appointed.
People were supported to maintain relationships with those people important to them. Staff actively promoted companionship within the home and enabled people to carry out a programme of activities, hobbies and interests. People were supported to make choices and have as much control and independence as possible. Complaints were dealt with in an open and transparent way and used identified learning to improve the quality of the service. People were sensitively supported to make decisions about their preferences for end of life care. Staff had received additional training to support people living with dementia and those who required end of life care.
The registered manager promoted a person-centred culture where people and staff felt valued. Staff were passionate about their work and the people they supported. The service involved people, their family and advocates in a meaningful way. The registered manager and staff understood their responsibilities to be open and transparent when things went wrong and the importance of completing thorough investigations to identify lessons learnt to prevent a recurrence. The registered manager operated robust processes to monitor the quality, safety and the experience of people within the service. Professionals consistently identified partnership working and staff implementation of their guidance to be a strength of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (report published 10 June 2019).
Why we inspected
This was a planned comprehensive inspection based on the date the service was registered.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
The provider followed current Government guidance to protect visitors from catching and spreading infection. For example, visitors were provided with personal protective equipment (PPE) to wear whilst visiting the home. Visitors, including health care professionals were asked to complete a lateral flow test (LFT) and health care professionals were asked to provide evidence of their COVID-19 vaccination status before entering the home. Records demonstrated that all staff who worked at the home had been fully vaccinated against COVID-19, including having the booster dose.
Staff conducted twice daily temperature checks for people and visitors were required to complete a declaration to confirm they did not have symptoms of COVID-19.
People were admitted into the service safely. The provider ensured people had been tested for COVID-19 before admitting them into the home.
People and staff had risk assessments in place to identify their individual risks associated with COVID-19. We saw protective measures were in place to keep people and staff safe.
Staff had received infection prevention and control training. During our visit we observed staff adhere to good practice in relation to PPE. The provider ensured sufficient stock of PPE and COVID-19 tests were available.
The management maintained the testing regime in line with national guidance to ensure people and staff had adequate access to the COVID-19 testing programme. The provider had an infection prevention policy in place and contacted their local health protection team in a timely way in the event of a COVID- 19 outbreak.
Staff had a good understanding of COVID-19 symptoms that present in older people. The registered manager ensured the staff and people who presented with COVID- 19 symptoms were tested immediately.
The provider’s visiting policy ensured that individual risk assessments assessed the rights and needs of people, as well as any specific vulnerabilities outlined in their care plan, and considered the important role that visiting can play in this.
The care home was clean, well maintained and odour-free. Enhanced cleaning schedules included regular cleaning of high touch areas, such as handrails and door handles. Enhanced cleaning reduced the risk of cross infection.
Moorlands Rest Home is a residential care home that was providing personal care to eleven people aged 65 and over at the time of the inspection.
People’s experience of using this service:
People were kept safe from the risk of abuse and learning took place from any incidents to reduce the likelihood of repetition. Staff identified potential risks to people and ensured the safe management of risks. People told us there were sufficient good quality staff to provide their care at all times. Trained staff ensured people’s medicines were managed safely.
People’s care was delivered by well trained and competent staff who based the delivery of their care on current good practice guidance. Staff ensured people were supported to eat and drink enough for their needs. People’s health care needs were monitored and they were referred to relevant health care professionals as required. The environment was clean, regularly maintained and suitable for people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People told us the staff who provided their care were, “Very good.” They enjoyed their relationships with staff who had time for them and saw them as individuals. Staff involved people in decisions about their care. People’s privacy, dignity and independence were respected and promoted.
Staff provided people with personalised care that was responsive to their needs. People were provided with a range of activities and were encouraged to access the local community. People’s complaints were listened to and used to improve the quality of the service provided. Staff ensured people were appropriately supported at the end of their lives.
People’s care was underpinned by an open and positive culture where staff felt valued. The registered manager/provider was clear about their responsibilities. People and staff were engaged and involved in a meaningful way with the service. Processes were in place to enable continual monitoring of the quality of the service and to identify areas for potential improvement for people. Staff worked with key organisations to ensure people received effective care, both at the service and when they transferred to other services for care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At the last inspection the service was rated good (29 November 2016).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Moorlands Rest Home is a care home without nursing that provides care for up to 12 people with needs relating to old age. Twenty four hour support is provided by a small regular team of staff.
A registered manager was in place as required in the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe and well cared for by the staff and that they were consulted and involved in decisions about their care. They confirmed their views about the service had been sought and felt the registered manager was accessible.
Most health and safety issues were effectively monitored and servicing and safety checks had mostly been carried out regularly. The registered manager acted promptly following the inspection to address identified issues. These included consulting the fire authority regarding the existing fire evacuation plans and placing an order for a suitable commode pot sterilizer. Individual guidelines were needed for the administration of PRN (as required) medicines, to ensure consistent and appropriate administration.
Staff understood their role in keeping people safe from harm and knew how to recognise and report any concerns about abuse. They were confident management would respond appropriately and act on anything they reported.
People's rights and freedom were protected by staff who supported people’s rights and dignity in the course of their work. Staff took time with people and didn’t rush them. They engaged people in conversation in the course of supporting them and encouraged group discussions. Staff were familiar with people’s needs as well as their preferences and sought consent from them before providing care.
Some changes had been made to the garden in response to people's needs. These enabled them to enjoy as much freedom as possible and provided opportunities for exercise. The environment was bright and clean and people’s bedrooms were personalised with their own belongings and pictures.
A range of activities and entertainment was provided which people enjoyed. However, there remained some room for further development in this area.
Care plans were supported by relevant risk assessments and other information about people’s history, likes and dislikes. External health professionals were consulted where appropriate. People’s health needs were monitored and met in consultation with external medical services. Nutritional needs were risk assessed and people’s intake was monitored where necessary. For example, the advice of a dietitian had been sought appropriately.
The interactions we saw showed staff and people had positive relationships and people were encouraged to make decisions and choices about their daily lives. We saw instances of humour and smiling between people and staff in the course of discussions activities and interactions.
The staff recruitment process was robust and appropriate checks took place. Recruitment files contained the required evidence of the process. Staff received an induction based on the national Care Certificate competencies. They received ongoing training through the provider’s rolling programme, mainly through external courses. Staff received regular supervision, attended team meetings and annual appraisals. They felt positive and enthusiastic.
The service was subject to a range of audits by the registered manager, to monitor standards. The views of people, families and staff about the service, were sought and acted upon.
Care plans and risk assessments were in place. However, some of the information contained within them was not up to date and identified issues were not always carried through into the care plans. However, people told us they were happy with the care and support they received from staff and the staff were aware of individual's needs. One of the people we spoke with told us "they are wonderful here' and another said 'the staff are friendly and I get on with all of them'.
The home had an appropriate system to manage and record people's medication and staff had been trained on medication management.
The provider had an appropriate system in place for the recruitment and induction of new staff and maintained records of the required checks.
The manager had systems to monitor and review the performance of the home and carried out an annual survey of the views of the people supported, their relatives and visiting professionals. The feedback from the recent survey was very positive.
The staff had received appropriate training and support in relation to their work. The manager had made appropriate notifications to the Care Quality Commission of reportable events in the home.