Le Moors

Updated 23 April 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Although not part of this inspection, CQC is continuing to investigate the circumstance relating to the death of a person who lived at the service. The information shared with CQC about the incident indicated potential concerns about the management of people's risk of choking.

Inspection Team

The inspection was completed by two inspectors.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We reviewed the action plans the service had completed since the last inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with three people living in the home. We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two staff who were in the home and a further three staff on the telephone. We spoke with the relatives of four people. We reviewed a range of records including; care records, medicines records; staff recruitment, training and supervision records. We toured the building and looked at equipment and maintenance records, fire safety checks, cleaning routines and infection control policies and practice.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with local authority adult social care staff and learning disability nursing staff.

Updated 23 April 2022

Le Moors provides personal care and accommodation for up to eight people who have learning disabilities and/or autism. At the time of inspection there were seven people living in the home. Accommodation is provided in single bedrooms over two floors. There is a lift for access. There is one main communal area and a further room which was being used for visitors during the pandemic.

People's experience of using the service and what we found

People were not always safe because sufficient staffing levels had not been maintained at weekends. People had been supported by more staff during the week and this had helped to maintain their safety and wellbeing.

People had been supported to manage the risks they may experience by staff who had received training to keep people safe from avoidable harm and abuse. People received their medicines as prescribed from staff who had received training in the safe management of medicines.

People's needs had been assessed and staff supporting them had received training to help ensure they could support people effectively. Support for people who experienced anxiety and distress which may present a risk to themselves or others, would benefit from staff having more specialised training in this area. People who were unable to consent to live in the home had the rights upheld, the provider had applied for the appropriate legal authorisations.

People were supported by kind and caring staff. The effort staff made to understand and communicate with people had improved since the last inspection. Some relatives felt there had been big improvements in people's quality of life.

People were being supported to engage in an increased number of activities both inside and outside of the home. Staff continued to explore what people preferred to do.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

The residential model of care meant people did not always have choice and control in their daily lives. There was a lack of choice in relation to the home and who they shared it with. People did not have information in place which detailed their rights and obligations. Lack of space for staff meant staff frequently had to take breaks in people's lounge/dining room. Staff would complete office tasks at the dining tables directly facing people sat in the lounge.

People's dignity was not always upheld due to the lack of access to basic facilities. We raised this with the provider but were not assured by their response that they had fully considered this impact.

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

Rating at the last inspection and update

The last rating for this service was inadequate published 10 August 2021 and there were multiple breaches 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 though improvements had been made, not enough improvement had been made and the provider was still in breach of regulations. We have identified breaches in relation to; staffing, premises and made recommendations in relation to training, visiting and activities.

This service has been in Special Measures since 10 August 2021. 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.

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.

We noted there had been improvements made but these still need to be fully embedded. We have found evidence that the provider needs to make improvements. Please see the safe, effective, and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.