Moorleigh Nursing Home

Moorleigh Nursing Home is a nursing home which provides personal and nursing care for up to 36 people. At the time of the inspection the service was providing care to 34 people. The home is located in Kippax near Leeds. Accommodation is provided over two floors with a passenger lift providing access to the first floor.

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

There were safe systems of recruitment in place. There were safe staffing levels and improved consistency of staffing. Significant improvements had been made in the management of people’s medicines. Staff received safeguarding training and were aware of their responsibilities. Risks to people and within the environment were identified and well managed. Risks associated with COVID-19 were well managed.

People’s needs were assessed, and clear support plans and risk assessments were in place to guide staff. Staff received the induction, training and support they needed to carry out their roles. People’s nutritional needs were met. The home was clean and there was a programme of redecoration and building improvements in place.

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 staff were caring and spoke positively about living at the home.

There was a range of activities on offer for people both within the home and in the wider community, which people told us they enjoyed. There was an appropriate system in place to manage complaints.

The provider had ensured the service continued to improve since the last inspection. We found systems to assess, monitor and improve the service were established and effective. The provider and registered manager had good oversight of the service and all members of the management team demonstrated passion and commitment to the continued development 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 requires improvement (published 18 March 2020) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

At our last inspection we made a recommendation regarding the improvement of guidance regarding diabetes care. At this inspection we found the provider had acted on the recommendation and made improvements.

Why we inspected

The 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Moorleigh Nursing Home is a nursing home which provides personal and nursing care for up to 36 people. At the time of the inspection the service was providing care to 29 people. The home is located in Kippax near Leeds and provides purpose-built accommodation over two floors.

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

People said they felt safe and secure living in the home. People were treated well by staff and risks to their health and safety were assessed. Medicines were generally managed in a safe way although some improvements were needed to documentation. Since the last inspection, staffing levels had been increased, however better consistency of staffing levels was needed from day to day. The service investigated incidents and learnt from them.

People said staff provided effective care. 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. Staff received a range of training, however not all staff had received supervision and appraisal. People received a variety of food and drink that met their needs.

Staff were kind and compassionate and had developed good, caring relationships with people. People were listened to and their privacy and dignity respected.

People’s care needs were assessed and a range of care plans put in place. We made a recommendation around the need to develop a diabetes policy and more robust care planning in this area. People received some activities although staff told us they did not always have time to provide these on a daily basis. Complaints were appropriately managed.

The service had significantly improved since the last inspection. We found systems to assess, monitor and improve the service were more robust. Further improvements were needed to ensure the service delivered a consistent high-quality service, for example around topical medicines and providing staff with supervision and appraisal. People and staff said the manager was approachable.

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 inadequate (published 7 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and a number of regulatory breaches had been addressed. The provider was still in breach of one regulation.

This service has been in Special Measures since 7 September 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We found a breach relating to governance and record keeping. We issued a requirement action and will request an action plan from the provider setting out how it will improve.

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

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.

Moorleigh Nursing Home is a nursing home providing personal and nursing care to 33 people aged 65 and over at the time of the inspection. The service can support up to 36 people.

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

During the inspection, we identified many concerns relating to people's safety. This included the service not having appropriate fire evacuation plans in place. Also, a lack of training and guidance for staff on how to support people in the event of a fire. There were insufficient staffing levels during the day and at night which all put people at significant risk of harm.

We found areas of the premises were not safe. This included windows on the first floor with no restrictors.

There were not enough staff on duty to meet people’s needs which meant people did not have their needs met in a timely manner. They did not receive care that was person-centred or individualised.

Medicines were not managed safely. Staff did not always have guidance to ensure they administered 'as required' medicines to people. Topical cream administration records were not always completed by staff.

Risks to people were not always properly assessed. This included moving and handling, nutritional needs, use of equipment and falls risks. The provider had failed to address this which meant people were at risk of harm.

Assessments of people's needs were not up to date which resulted in people's needs not being met.

Staff demonstrated a limited understanding of safeguarding and records showed they had not received appropriate training in this area. During our inspection, we reported our concerns to the local safeguarding team. This means external professionals will look into our concerns.

The provider did not always maintain appropriate records relating to the requirements of the Mental Capacity Act 2005 (MCA). There was a failure to properly oversee and make applications for authorisations under the Deprivation of Liberty Safeguards (DoLS). People had not been included in decisions about their care.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People's nutritional needs were not always met.

Staff did not always complete mandatory training to ensure they had the skills they required for their roles. Staff did not always receive supervision and appraisal of their performance.

The governance of the service was poor. The provider did not have an awareness of the issues we identified and therefore had not mitigated the risks we identified within the service.

After the first day of the inspection, we requested an urgent action plan from the provider to tell us how they would address the concerns we found. They responded with a plan which gave timescales for the completion of works. We visited the service again to follow this up and found that not all of the actions had been completed. We found there were plans in place as to how these would be met. We continued to monitor the service regarding the improvements they were making.

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 December 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

This service was registered with us under the new provider on 15/01/2019 and this was the first inspection since the new registration.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, medicines management and management of the service. A decision was made for us to inspect and examine those risks.

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

Since our inspection, the provider has worked with other agencies including the fire service to make the necessary improvements.

Enforcement

We have identified breaches in relation to staffing, people’s safety, protecting people from harm, protecting people’s rights and overall management of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.