Archived: Moorhouse Farm

Updated 29 September 2015

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 improvements had been made to the service provided and if the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. In addition, this inspection was carried out to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 and 22 July 2015 and was unannounced.

The inspection was carried out by an inspector, a specialist advisor and an expert-by-experience. Specialist advisors are clinicians and professionals who assist us with inspections. The specialist advisor on this inspection was a registered nurse who specialised in nutrition. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience who was part of this inspection team had expertise in older people and those who had a dementia related condition.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We reviewed the PIR and other information we held about the service prior to our inspection. This included reviewing statutory notifications the provider had sent us. Notifications are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of.

We reviewed information we had received from third parties. We contacted the local authority commissioning and safeguarding teams. We also contacted the local Healthwatch team. We spoke with a care manager and a member of staff from the local health trust’s challenging behaviour team. We used the information that they provided us with to inform the planning of this inspection.

During the inspection we spoke with four people who used the service. We also spoke with the registered manager, the regional manager, two care workers, a kitchen assistant and a domestic assistant. We reviewed two people’s care records including their medicines administration records. We looked at three staff personnel files in addition to a range of records in relation to the management of the service. Throughout the inspection we spent time in the communal areas of the home observing how staff interacted with people and supported them.

Updated 29 September 2015

Moorhouse Farm is a residential care home, registered to provide accommodation and personal care for up to 24 people. At the time of the inspection six people were accommodated at the home.

This inspection took place on 21 and 22 July 2015. The inspection was unannounced. The last inspection we carried out at this service was in April 2014 when we found the provider was not

meeting one of the regulations that we inspected. This breach of regulation related to assessing and monitoring the quality of service provision. At this inspection we found improvements had been

made to the systems in place to monitor the quality of the service and this breach in regulation had been met.

The provider had two services on one site. Moorhouse Farm is a residential home and Ashington Grange is a nursing home. We inspected both services at the same time. The same staff were used across both services and the same management structure was in place. Our findings for Ashington Grange are discussed in a separate report.

A registered manager was in place. 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.

People we spoke with told us they felt comfortable and safe at the home. Staff had been trained in recognising and responding to potential abuse. Staff we spoke with were aware of how they should proceed if they had any concerns over people’s safety or wellbeing.

Areas of risk to people had been assessed. Action had been taken to mitigate risks wherever possible. Accidents and incidents records had been completed to a good level of detail They had been reviewed by the manager to ensure appropriate action had been taken and to determine if there were any trends where action could be taken to reduce the likelihood of accidents happening again.

During our inspection we saw there were enough staff to meet people’s needs. Staff were able to respond to any requests from people quickly, so people did not need to wait if they needed support. Staff recruitment procedures were in place to determine if potential employees were of good character before they started working at the home.

Processes were in place to manage medicines appropriately. Medicines were stored securely and any unused medicines were disposed of. Staff had received training in administering medicines and their competency to do so was regularly re-assessed.

Staff had received a range of training to equip them to carry out their roles. Staff training was up to date and monitored to ensure refresher courses were booked whenever training was due to expire. Staff regularly met with senior staff to discuss their role and the people they supported in supervision sessions. All staff had received an appraisal within the previous 12 months.

The manager was aware of the principles of Mental Capacity Act 2005 (MCA). The manager and staff told us that all of the people who used the service were able to make all of their own decisions about their care. Staff told us, and we observed, that they asked for people’s consent before delivering any care. The provider acted in accordance with the Deprivation of Liberty Safeguards (DoLS) and at the time of our inspection none of the people who used the service were subjected to any restrictions on their movement.

People told us they enjoyed the food and that the choice available to them was good. We saw food looked appetising and that mealtimes were relaxed with staff eating their lunch at the table with people after they had served people’s meals.

People told us staff respected their dignity and were caring towards them. We observed good staff practice staff knew people’s interests and we saw them engage them in conversations about their hobbies and families.

Activities had been planned to meet the individual needs of all of the people who used the service. People took part in a range of activities both inside and outside the home. A beach hut and caravan had been hired over the summer so people could visit it and enjoy their local area.

People had been involved in planning their own care. We saw care plans contained detailed information about people’s life histories. Care had been planned to meet people’s individual needs. When one person missed their morning medicines as they enjoyed a lie in on a morning, staff spoke with the person and their GP and were able to change the times of the medicine round for that person so that they could sleep in uninterrupted.

People had been asked to discuss their wishes as they approached the end of their lives. Staff had received training in end of life care and the manager made arrangements so that when needed families could stay at the home to be close to their relatives as they approached the end of their lives.

People told us they felt their needs were met. Care records were individual and personal to the person receiving care. Assessments had been carried out to determine people’s needs. Where people needed support from staff, specific care plans were in place. Staff were knowledgeable about people’s needs and about how they should care for them.

Meetings were planned regularly for people and their relatives. There had been no complaints within the previous 12 months.

Improvements had been made to systems in place to monitor the quality of the service since our last inspection.. People, relatives and staff spoke highly of the new registered manager and told us about the improvements she had made to the home.

Audits and checks of the service were carried out regularly. Both the manager and the care staff were involved in monitoring the quality of the service.