Archived: Moorland Gardens Care Home

Updated 10 July 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 checked 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 was prompted in part by concerns relating to poor care and delays in reporting incidents that put people at risk of harm. There were also concerns about how people’s medicines were managed, particularly in the Rehabilitation unit. This inspection examined those risks.

This comprehensive inspection took place on 16 and 22 May 2018. It was unannounced.

The inspection was carried out by an inspector and two experts by experience on the first day, and one inspector visited the service on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was in the care of older people.

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 reviewed other information we held about the service including notifications they had sent us. A notification is information about important events which the provider is required to send to us.

Prior to the inspection, we contacted the local authority that commissioned the service, the local Healthwatch and the local Clinical Commissioning Group. The local authority told us that when they inspected the service in April 2018, they found areas of improvement in relation to safeguarding people, consistency of good quality care, and management of the service. We looked into these issues when we inspected the service.

During the inspection, we spoke with 15 people using the service, nine relatives, two nurses, seven care staff, an activities coordinator, two professionals working for the service that provided rehabilitation support and treatment to people in the Rehabilitation unit, the deputy manager who was the interim manager. We were supported over the two days by the provider’s regional support manager. We also spoke with the provider’s assistant director of quality and compliance who was doing an internal inspection on the first day of our inspection, and we met the provider’s regional operations manager during the second day of the inspection.

We looked at the care records for eight people to review how their care was planned and managed. We reviewed the provider’s staff recruitment, training and supervision processes. We checked how medicines and complaints were being managed. We looked at information on how the quality of the service was assessed and monitored. We observed how staff supported people in communal areas of the service.

Updated 10 July 2018

This unannounced comprehensive inspection was carried out on 16 and 22 May 2018. This was the first inspection since the service was taken over by Ultima Care Centres (No 1) Limited.

Moorland Gardens Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 80 people with a range of care needs including those living with dementia, mental health needs and physical disabilities. The service also operates a short stay rehabilitation unit where people are admitted from hospital for rehabilitation of up to a period of six weeks. At the time of the inspection, 54 people were being supported by the service.

There was no registered manager in post as she deregistered in February 2018. Prior to this, the deputy manager had acted as the interim manager since August 2017. At the time of the inspection, the deputy manager was managing the service. 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.

Changes in managers had an impact on the leadership of the service. This resulted in inconsistencies in the quality of care at the service. This was because systems to keep people safe from abuse or avoidable harm had not always been used effectively. Additionally, people’s medicines were not always managed safely to provide effective treatment. However, we noted that the provider had put systems in place to support the service to improve and some improvements had been made at the time of the inspection. The provider's senior managers regularly supported the manager to assess and monitor the quality of the service.

There were effective recruitment processes in place and there was sufficient numbers of staff to support people safely. However, the manager needed to review how staff were deployed as some people said that there was not always enough staff.

The service was clean and pleasant for people to live in. Staff took appropriate precautions to ensure people were protected from the risk of acquired infections, and there was evidence of learning from incidents.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Staff had regular supervision and they had been trained to meet people’s individual needs effectively. The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people’s consent prior to care and support being provided. People had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services when required.

People were supported by caring, friendly and respectful staff. They were supported to have choice and control of their lives, and the policies and systems in the service supported this practice.

Staff regularly reviewed the care provided to people with their input to ensure that this continued to meet their individual needs in a person-centred way. The provider had an effective system to handle complaints and concerns. Some activities were provided, but some people did not find these enough to occupy their time. The manager also needed to review how they supported people to pursue their hobbies and interests. People were supported in a dignified way at the end of their lives.

Further information is in the detailed findings below.