Moorland House

Updated 13 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Moorland House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Moorland House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post, however, they had resigned from their post. This was due to take affect from the 20 November 2022. The registered manager had not, however, been in the service since February 2022. Since that time the home had been managed by the deputy manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used information gathered as part of a monitoring activity that took place on 10 August 2022 to help plan the inspection and inform our judgements.

We received feedback from 2 health and social care professionals.

We used all this information to plan our inspection.

During the inspection

We spoke with 8 people living in the home and 3 relatives. We also spoke with the deputy manager, 6 care staff and a member of the housekeeping team as well as the operations manager and nominated individual.

Updated 13 January 2023

About the service

Moorland House is a residential care home providing personal care to up to a maximum of 23 people. The home does not provide nursing care. At the time of our inspection there were 15 people using the service, some of whom were living with dementia. The accommodation at Moorland House is arranged over 2 floors accessed by a passenger lift and by stairs. There is a communal lounge 2 dining areas and a secure garden area.

People’s experience of using this service and what we found

Risk to people had not always been assessed and risk management plans were not always in place to guide staff. Improvements were needed to ensure the safe and proper use of medicines, and infection control risks were not consistently being managed safely. Staff recruitment processes did not promote safety. Observations indicated that were sufficient numbers of staff deployed, but we were not assured that staff were always suitably knowledgeable and skilled. Improvements were needed to ensure that robust investigations consistently took place to establish the reason for incidents and accidents so that learning might be shared.

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. However, improvements were needed to ensure that the Mental Capacity Act 2005 was fully understood and implemented in line with legal frameworks. Care plans lacked completeness or contained conflicting information.

Improvements were needed to ensure that each person was provided with the support they needed with their dietary needs. Completion rates for developmental or specialist training which was designed around the needs of people using the service was poor and we were concerned about the competence of some staff, their ability to apply their training in practice or to effectively communicate with people. The provider, who had taken on ownership of the service in July 2022, had an extensive plan in place to undertake improvements to the environment. People felt that staff supported them to stay as well as possible and there was evidence that staff worked with a range of community healthcare professionals.

Governance arrangements were not effective at identifying all of the areas where the safety and quality of the service was compromised. Feedback described cultural issues amongst some of the staff team which had detracted from the ability of the new leadership team to manage the service effectively and drive improvements as quickly as they would have liked. The provider is taking action to put in place additional support, a new manager has been appointed and an external consultant hired. People spoke positively about the new provider and of their commitment to listen to their feedback and use this to improve 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

The last rating for this service was good (published 20 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

The overall rating for the service has changed from good to requires improvement with breaches based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Moorland House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, governance, recruitment, safeguarding people from abuse and the need for consent.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.