Moorland Garden Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Risks to people were monitored and managed in a safe way, particularly risks associated with pressure care and falls. People received their medicines as prescribed. People's records contained accurate, complete and contemporaneous information. There were systems in place to safeguard people from abuse and avoidable harm. There were enough staff who had been trained, and during inspection we observed warm interactions between people and staff. Staff knew people well and could describe them and their care needs to us. People told us they felt safe.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe. Comments included “I absolutely feel safe here”, “They’ve never made me feel unsafe” and “Staff are friendly and kind and will do anything for you”.

People were supported by staff that had received adequate training and knew how to raise and report safeguarding concerns. Staff we spoke with told us I would go to my line manager (with any safeguarding concerns) and follow the safeguarding process and record this as well” and “First I would speak to the management if I witnessed any abuse or had any concerns. All the safeguarding information is on every bathroom door on what to do if we needed to take action ourselves”.

People appeared safe and well kept. People were comfortable in the presence of staff . We observed how one person clearly had a positive bond with staff and the clinical lead. We noted that another person was moving around the home freely and had access to regular visits from family.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People were supported to have maximum choice and control of their lives. Where the service supported some people to make decisions about different aspects of their care there were mental capacity assessments to show these decisions had been made in a person's best interests or with appropriate consent. Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse. The provider had logs and records that showed appropriate action had been taken. Systems were aligned to the providers policies and procedures.

At the time of this inspection people’s risks were well managed. One person told us “They always include me in decisions and keep me safe”. All care plans and subsequently the risk management plans demonstrated people, relatives and representatives were involved in managing people’s individual risks.

The leadership team had good knowledge of people’s individual risks and the action they needed to take to mitigate the risk of harm associated with people’s care. One staff member we spoke with was able to describe the action they would take to monitor and reduce the risks associated with one person’s care. The information shared by the staff member matched the information in the persons care records.

From our observations and speaking with the leadership team and staff we were satisfied that at the time of this inspection appropriate action was being taken to reduce the risks associated with peoples ongoing care needs.

People's care plans contained risk assessments which included risks associated with moving and handling, falls and pressure damage. Where risks were identified plans were in place to identify how risks would be managed. All care plans and subsequently the risk management plans demonstrated people’s involvement in managing their individual risks.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us there were enough staff to meet their needs and that staff were not rushed in their duties. One person told us “Yes there is always staff about if you need them”. People told us staff were well trained caring and compassionate. One person told us “They know what they are doing and they are lovely I couldn’t ask for better”.

The provider told us, and staff confirmed their were enough staff to meet peoples needs. They told us “Staffing wise we have daily currently on days 1 nurse 2 care assistants, 1 kitchen staff. At night we have 2 care assistants and 1 nurse. Sometimes we are overstaffed. We also have an activities coordinator who does 40 hrs a week”. Staffing rotas confirmed this.

From our observations and talking to staff and people we identified there were sufficient numbers of staff to meet people's needs. Staffing rotas confirmed planned staffing levels were being maintained.

The provider had systems in place to ensure the appropriate staffing levels were maintained. The provider had contingency plans in place for when shortfalls in planned staffing levels were identified. Records showed that Staff completed training which included safeguarding, MCA, infection control and moving and handling. Records showed newly appointed care staff went through an induction period. This included training for their role, shadowing an experienced member of staff and having their competencies assessed prior to working independently with people. One staff member told us “I was on shadow shifts and I observed day and night shifts as well and when I needed help they were always there”. People were protected against the employment of unsuitable staff because the provider followed safe recruitment practices.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they received their medicines as prescribed. One person told us “They are really good at making sure I take my tablets”.

The leadership team and staff were able to describe how they recorded and managed medicines safely to ensure people received their medicines as prescribed. Staff told us and records confirmed they received medicines training and had their competencies checked regularly by the provider.

Medicines were ordered, checked and available when people needed them. Medicines were stored, administered, recorded and disposed of safely. Nurses and staff were trained and assessed as competent to administer medicines. They were regularly supervised to make sure they were following best practice. One person was receiving their medicines covertly. This is when a person’s medicine is hidden in food, drink or given through a feeding tube without the knowledge or consent of the person receiving them. The service had ensured that this was carried out in line with CQC guidance and that it was in the person’s best interest.