Moorland House

Updated 6 June 2018

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.

This inspection visit took place on 5 April 2018 at the care home. The inspection was unannounced,

The inspection team consisted of two inspectors and one expert-by-experience. The expert-by-experience had personal experience of caring for an older person who used health and residential services.

Before the inspection visit we reviewed any information we held about the service, including any information the provider had sent us. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed any notifications the provider had sent us. Notifications are reports the provider must send to us to tell us of any significant incidents or events that have occurred.

In order to gather information to make an assessment of the quality of the service, we looked at a variety of records and spoke with people. We spoke to 14 people who used the service or their relatives; as well as the registered manager and 9 staff. In order to capture the views of relatives, (as there were very few available during our inspection) we have referred to comments and feedback, that relatives have left in ‘Thank You’ cards and feedback online at ‘www.carehome.uk.’ We talked to staff with different roles within the service including the registered manager, senior care workers, care assistants, activity workers, administration manager, chaplain, the cook, domestic and maintenance staff. We reviewed 4 care records which included needs assessments, risk assessments and daily care logs; and management records which included three staff records, policies, audits and evidence of training. We asked the registered manager to email us copies of their policies after the inspection and verify their process regarding renewal of Disclosure and Barring Service checks. This information was provided promptly within the time period requested.

Updated 6 June 2018

This inspection visit took place on 5 April 2018 and was unannounced.

Moorland House is a care home. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Moorland House is registered to provide care and accommodation for 48 older people. On the day of our inspection there were 44 people living there. Moorland House, changed from a nursing home to a care home in November 2017, and no longer provides care and accommodation to people who require nursing care.

The registered manager had been in post since November 2017. 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.

The service was safe. Appropriate checks and assessments of staff were completed to ensure they were safe to care for people. Staff understood their duty to protect people from abuse and the policies in place supported this. Risk assessments were in place and identified people who required additional support for some or all of their daily living activities. Medicines were mostly managed safely; and there were processes in place that prevented the spread of infection.

The service was effective. People’s needs were assessed and used to develop personalised care plans. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff had relevant training, skills and knowledge to care for people’s individual needs; and teams worked together across the service to ensure people received safe and effective care. People were supported to live healthy lifestyles and had sufficient to eat and drink. The building was designed to provide a safe living environment with a variety of private and communal spaces, both indoors and outside; where people were able to spend time alone, with friends or with family.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The service was caring. Staff were kind, compassionate and caring and they developed positive and professional relationships with people. They cared for people with respect and promoted their dignity and independence. Family and visitors were made to feel welcome and were encouraged to spend time with their loved ones. People were encouraged to express their views about their daily care and preferences for daily living.

The service was responsive. Staff took time to get to know people, their histories and their aspirations and used this to promote their wellbeing and emotional health. Staff understood people’s individual care needs, preferences and responded positively, when people needed assistance. People felt able to make comments, complaints and suggestions and we found these were acted upon by the staff and registered manager. People received dignified care and support at the end of their life, where families were encouraged to visit and spend time with loved ones.

We found aspects of the service that were not always well led.

The provider, Methodist Homes had not always consulted with staff or people when it made changes to how the service was delivered. Recent changes to the rota had taken place without prior consultation with staff or discussion about impact on people. The service had also recently stopped providing nursing care and had only consulted the four people who were receiving nursing care at that time. It had not consulted all the people in the home, whose needs may change in the future. This had left people and families unsure about their ability to remain in the home if their needs changed.

We recommended the provider considers how to create a more open and inclusive culture, where people and staff are involved in planning future change and developments.

We also found the Statement of Purpose to be a generic statement about the types of care available across all services managed by Methodist Homes. It did not accurately reflect the service user types and care specifically provided at Moorland House; nor had it been updated following the changes to the service and to the registered manager. This had led to people being confused about the admissions process and the suitability of the service to care for them or their loved one.

We recommended the provider review their Statement of Purpose to more accurately reflect the care provided at Moorland House.

We found the local management arrangements to be responsive to the needs of people using the service. The registered manager was caring, responsive and effective in managing the staff team; monitoring performance and assessing the quality of the service. They used the systems and processes in place to ensure people received good quality care and outcomes. There were effective links with other agencies where they all worked together to achieve good outcomes for people.