Moorland View Care Home

Moorland View Care Home is a residential care home which provides personal care for up to 32 older people. Accommodation is provided over 2 floors, with a passenger lift available. At the time of the inspection 31 people were living at the home.

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

People received safe care. People told us there were enough staff to provide them with support when they needed it. Staff were recruited safely. They had completed safeguarding training and knew the action to take if people were at risk of abuse or avoidable harm. The home was clean and staff followed safe infection control practices, including wearing appropriate personal protective equipment (PPE). Staff managed people’s medicines safely; some minor improvements were needed to ensure medicines processes reflected national guidance. The safety of the home environment was checked regularly.

People received support which reflected their needs, risks and preferences. Staff received an appropriate induction and completed the training necessary to meet people’s needs and support them well. 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 received support with their dietary and healthcare needs and were referred for specialist support when they needed it. Feedback received from community professionals about the quality of care provided at the home, was very complimentary. The home environment was suitable to meet people’s needs and support their independence. Some repairs and redecoration were needed, and the provider had an ongoing plan of improvements.

The management team and staff were clear about their roles and responsibilities. They prioritised providing high-quality, individualised care which gave people a good quality of life. The service worked in partnership with a variety of community health and social care professionals to ensure people received any specialist support they needed. Community professionals gave us positive feedback about the management team. Management sought the views of people and relatives and listened to them. People and relatives told us they were very happy with the management of the service and staff found management approachable and supportive. Regular checks and audits completed by management were effective in ensuring appropriate standards of quality and safety were maintained at the home.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 October 2019) and there were breaches of regulation. The provider completed an action plan after that 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 regulations.

At our last inspection we recommended the provider review their processes for managing accidents and incidents, ensured the home environment was dementia friendly and reviewed their quality assurance processes. At this inspection we found the provider had acted on the recommendations and made the necessary improvements.

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.

Follow up

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

We found the following examples of good practice.

Staff had received training on infection control and the safe use of personal protective equipment (PPE). During the inspection we observed staff wearing PPE in accordance with government guidance. The home was clean and information was placed in communal areas to remind staff and visitors about how to manage the risks of COVID-19. The provider had policies and procedures in place to support staff in safe working practices. The provider had made improvements to bathroom areas and replaced some flooring to support enhanced cleaning in the home. The provider was supporting people to maintain contact with their relatives in line with guidance in place at the time of the inspection. They had been creative in making use of the space in the home to create a ‘pod’ to enable visitors to meet people safely. They had developed a system of newsletters which they posted on their website to keep relatives informed about the situation in the home. The service was meeting the requirement to ensure visiting professionals were vaccinated against COVID-19. The service participated in the regular COVID-19 testing programme for both staff and people living in the home.

Moorland View is a residential care home providing accommodation and personal care to 31 people aged 65 and over at the time of the inspection. The service can support up to 32 people. Accommodation is provided in 32 single bedrooms over two floors. 16 of the bedrooms have en-suite facilities. The home is located in a residential area in Darwen.

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

People told us they were well cared for and felt safe in the home. However, we found staff had not always been safely recruited. In addition, they had not always completed the provider’s mandatory training or annual updates to ensure their knowledge and skills were up to date.

The provider had a system to ensure staff documented any accidents or incidents which had taken place. However, it was not always clear what action the registered manager had taken to help prevent such incidents from occurring. In addition, the registered manager had not informed CQC of some important incidents as required under current regulations. We have made a recommendation regarding the management of incidents and learning lessons when things go wrong. We have also made a recommendation regarding making the environment more dementia friendly.

The registered manager had systems to assess and monitor the quality of the service. However, these had not been effective in identifying the issues found during this inspection. We have made a recommendation that the provider reviews the quality assurance processes they use.

Staff had completed safeguarding training and knew the correct action to take to protect people from the risk of abuse. People received their medicines as prescribed. The interior of the home was clean and free from malodour. The provider took action to improve the laundry after we identified concerns regarding the lack of cleanliness on the first day of the inspection.

Staff told us they felt well supported and received regular supervision during which they were able to discuss their professional development. 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. The provider had systems to assess and monitor people’s health and nutritional needs.

People told us staff treated them with dignity and were respectful. Our observations supported these views. Staff encouraged people to be as independent as possible. People felt listened to and confident to raise any issues. We saw that where concerns had been raised, the registered manager had acted to resolve the matters.

Care plans contained information on people’s health and communication needs as well as their family background, religious needs and social interests. Activities were available for people to participate in if they wished.

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 3 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

We have identified breaches in relation to the recruitment of staff and staff training.

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 for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Boldlawn Ltd is registered to provide accommodation for persons who require personal care at Moorland View Care Home. Accommodation is provided in 32 single bedrooms over two floors. 16 of the bedrooms have en-suite facilities. The home is located in a residential area in Darwen. At the time of this inspection there were 30 people using the service.

The service had a registered manager in place as required under the conditions of the provider’s registration with CQC. 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 registered manager was also the owner of the service.

People told us they felt safe in Moorland View and had no concerns about the care and support they received. Staff had received training in safeguarding adults from abuse. They were able to demonstrate their understanding of the correct action to take if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff told us they would be confident to use the whistleblowing policy that was in place should they witness poor practice in the service.

Staff had been safely recruited and there were sufficient numbers of staff available to meet people’s needs in a timely manner. Records showed staff had received the necessary induction, training and supervision to help them to deliver effective care.

People who used the service told us they felt the staff had the skills and experience to meet their needs. People were happy with the care and support they received and spoke positively of the kindness and caring attitude of the staff.

Systems in relation to the administration of creams needed to be improved. However a visiting district nurse told us they had no concerns regarding the skin integrity of anyone who used the service.

People were cared for in a safe and clean environment. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity or gas supply. Personal emergency evacuation plans were in place to help ensure people who used the service received the support they required in the event of an emergency at the home.

People’s care records contained enough information to guide staff on the care and support required. The care records showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. Care records had been regularly reviewed to ensure they were an accurate reflection of people’s needs.

Records we reviewed showed staff worked in cooperation with health professionals to help ensure that people received appropriate care and treatment. The visiting district nurse we spoke with told us the quality of care provided in the service was very good.

Wherever possible people who used the service were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Systems were in place to help ensure people’s health and nutritional needs were met. People told us the quality of food provided in the service was generally good.

People were provided with the opportunity to engage in a range of activities to promote their well-being.

People had opportunities to comment on the care they received in Moorland View. People we spoke with told us they would feel confident to raise any concerns they might have with the registered manager and were certain appropriate action would be taken to resolve any complaints.

Staff told us they enjoyed working in Moorland View. They told us the registered manager and senior staff were approachable and supportive. Regular staff meetings meant that staff were able to make suggestions about how the service could be improved. Staff told us their views were always listened to.

The registered manager had improved the quality assurance systems in place in the service. They demonstrated a commitment to continuing to drive forward improvements in the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with nine people people who used the service and two relatives. We also spoke with two professional visitors, four staff members and looked at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Comments made to us included, 'I feel safe because there is no one to bother you' and 'I feel safe here because the staff are always about'. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to record and review complaints, accidents and incidents. This should help reduce the risk to people and help the service to continually improve.

The home had policies in place in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards, although no applications had needed to be submitted. Staff understood the need to seek consent from people before they provided any care. This should help ensure people's rights were safeguarded.

Recruitment procedures were safe and thorough. Staff were supported to gain appropriate skills and knowledge for their role. This should help ensure people received safe and appropriate care.

Is the service effective?

Most of the people we spoke with told us they were happy with the care they received and their needs had been met. It was clear from our observations and discussions with staff that they knew people well and had a good understanding of their care and support needs. One person who used the service told us, 'They (staff) come quickly when I ring the bell, I get on with all of them they are all nice girls. The staff talk to me whilst they are bathing me'. Staff had received training to meet the needs of people who used the service.

Specialist dietary, mobility and equipment needs had been identified in care plans where required. Risk assessments were regularly reviewed and care plans amended to reflect people's changing needs.

Is the service caring?

People were supported by kind and attentive staff. We observed staff took care to support and protect people while assisting them to mobilise around the home.

We spoke with two professional visitors. They told us they considered the quality of care provided by staff was good. Comments they made to us included, 'The service is wonderful. They are genuine and caring staff'.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records we looked at showed us people had the opportunity to meet with their key worker to review their care.

Systems were in place to ensure staff had access to up to date information regarding people's needs. This should help ensure they were supported to respond appropriately to any changes to a person's condition.

Is the service well led?

The service worked well with other agencies to make sure people received care in a joined up way. We saw positive feedback had been received by the home from the local hospital. This related to the quality of information provided when a person from Moorland View had been admitted to hospital. This information helped to ensure the person was provided with the care they required when they were away from the home.

Quality assurance processes were in place in the home. Records we looked at showed us people had recently completed a satisfaction survey. We were told the provider was in the process of analysing the results and an action plan would be developed to address the issues raised.

People who used the service were regularly asked their opinion about the service. Regular meetings were held with staff. These provided the opportunity for staff to discuss any concerns or practice issues in the home.

We reviewed the care files of six people who lived at Moorland View. We found evidence that there were some systems in place to record the decisions people were able to make for themselves. Staff told us they understood the need to seek consent from people before providing any care or treatment.

We saw care plans identified the needs of the person and included some information on how they wished their care to be delivered.

People we spoke with told us they received appropriate support with their medication. We found evidence that there were effective systems in place for the safe administration of medicines.

We found there were sufficient numbers of staff on duty to meet the needs of people in Moorland View.

We found that suitable arrangements were in place to manage an effective process for identifying, receiving and handling complaints for people in Moorland View.

People's care was planned and delivered in accordance to their needs. People had individual care plans which were supported by a series of risk assessments. Although the people we spoke with were not always familiar with their care plan, they told us that they usually received the care and support they required and that staff were aware of their wishes and preferences as to how this care should be provided. However people told us they sometimes had to wait for staff to respond to their requests for support.

We found that staff had received training on safeguarding vulnerable adults and had access to appropriate policies and procedures. All people spoken with said they felt safe in the home.

We saw evidence that there were systems in place to ensure staff received appropriate training, supervision and appraisal. This meant that staff were supported to deliver care that was safe and appropriate to people's needs.

We found that there were systems in place to safeguard the records of both people using the service and staff.