Archived: Moorlands Care Home

Updated 21 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on the 24 and 25 February 2015 and was unannounced. 

The inspection was carried out by two inspectors from the Care Quality Commission 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. Our expert had experience of caring for older people with dementia care needs.

Prior to our inspection we looked at information we hold about the service. This included notifications and the Provider Information Return (PIR).   This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with five people living at the home, five relatives and/or friends and we interviewed five staff. We also spent time with the new manager, the deputy manager and five members of the senior management team who were providing support and oversight at the service.

We looked at three staff recruitment records, three training and supervision records, four people’s care records, medication records, policies and procedures, activity records and a number of quality monitoring documents.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We also spoke with the local authority safeguarding team and with commissioners of the service.

Updated 21 April 2015

The inspection took place on the 24 and 25 February 2015. The inspection was unannounced. During our last visit we found two breaches of legal requirements in relation to the way people were cared for and the food and nutrition they received. This was a follow up visit to see if the improvements recorded in the provider’s action plan had been made.

Moorlands Nursing Home offers nursing care for up to 68 people who may have dementia care needs, a disability or may require end of life care. The home is owned by Mimosa Healthcare (No 4) Limited who are currently in administration.

The home is divided into two separate units. The home is situated in a residential area of the village of Strensall which has local shops and pubs nearby. All accommodation is on the ground floor and both units have access to a small courtyard. The home has a large car parking area.   

The home does not have a registered manager. 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.  

During this inspection we identified five breaches in regulations. These included Premises and equipment, Safe care and treatment (in relation to infection control), Staffing, Need for consent and Good governance.

People told us they felt safe living at Moorlands care Home. However some of the records used to monitor risks could be improved upon.  

We identified that a number of improvements were required to the premises to ensure they were fit for purpose and suitable for the people accommodated. A programme of redecoration and refurbishment is required throughout the building and senior management have a programme to address this.  

Most people we spoke with told us that there were enough staff. Some people said that weekends could be problematic. The senior management team who met with us during our visit confirmed that they were reviewing staffing levels at the home.  

Where new staff were employed appropriate recruitment checks were completed.  

Medication systems were appropriately managed and people told us they received their medication on time.  

Standards of infection control needed to improve. Some areas of the home were dirty and there were ineffective systems in place to monitor the control of infection.   

Although staff had not received regular supervision and support at the home, there was a clear plan in place to address this.  

Staff were not receiving training which enabled them to provide effective care to people. Training was out of date and there was no clear plan to address this.  

Although we found some evidence that mental capacity was considered, it was not clear whether best interest meetings were held or formal applications under Deprivation of Liberty Safeguards (DoLS) were made. Staff had not received training in this area and we were concerned that decisions may be being made on people’s behalf without consideration of the Mental Capacity Act 2005 legislation.  

People told us that the food had improved since our last visit. A new chef had been employed. Some people felt that further improvements could be made.  

People told us their health needs were monitored and that they could see a doctor or other health professional when they needed to.  

People told us that they were cared for and we observed people being spoken to with warmth throughout our visit.  

People said that they were treated with dignity although two people commented that nurses did not always knock before entering their rooms and we observed this during our visit.  

People had their needs assessed and following an assessment a plan of care was developed. Care records were in the process of being reviewed and updated.  Some of the monitoring records within care plans were not completed appropriately which meant the information may not be accurate.  

People spoke highly of the activities co-ordinator and said that activities were provided throughout the home.   

People told us they felt able to raise concerns and complaints and felt confident that these would be acted upon.  

The home did not have a registered manager although a new manager had been recently appointed.  

Quality monitoring systems required further development so that people were given the opportunity to share their views regarding how the service was managed and so people were supported to make suggestions for improvement.  

Some of the records at the service needed to be reviewed and consideration given to best practice guidance and current legislation.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, now replaced by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.