Residents at a care home in Hampshire are now receiving better care after the home made significant changes following a series of CQC inspections earlier this year.
Moorwood Cottage provides accommodation and nursing care for up to 35 older people. The home is situated in Chandlers Ford in Hampshire.
What happened...
At the start of 2013, Moorwood Cottage Care Home was struggling to provide good care to their residents, many of whom had very high nursing and dependency needs. Following our unannounced inspection in March 2013, involving our inspector and a clinical expert in the field of nursing care, a number of serious concerns were identified.
Enforcement notices were issues for:
- care and welfare
- nutritional needs
- staffing levels.
We then followed up with an inspection in May 2013.
What changed...
The management at Moorwood Cottage Care Home made some positive changes to the leadership team. Julia Adey, one of our inspectors for Hampshire, said: “Moorwood Cottage took our concerns very seriously and very quickly started to implement some new ways of working. The culture of a place doesn't change overnight but some of the initiatives put in place in those first few weeks set the tone for the significant improvement that we have seen over the last months.”
Some work on improvement were already underway, and a new registered manager was appointed who followed through with some innovative ideas about how they might tackle some of the organisational issues that staff were facing which resulted in people not getting the high quality care they needed.
Gary Briggs, the new registered manager at Moorwood Cottage said: “We haven’t stopped working to improve things for the benefit of our residents and next on my list is to further improve the clinical training for all of our staff at Moorwood, which I’m hoping to start to do in the next few months. I am delighted with the progress that we’ve made, and look forward to keep driving up the quality care that we offer at Moorwood Cottage Care Home.”
Within a month all the care plans for residents at the home had been reviewed and rewritten, ensuring the individual needs of the residents had been identified.
Fluid champions and intentional rounding – new ideas...
A system of ‘intentional rounding’ was introduced, which is a structured process where staff carry out checks with individual people at set intervals. A ‘fluids champion’ was appointed to ensure that people were supported to drink and changes were made to the way in which care was delivered by staff.
These changes meant that staff were able to work more efficiently as part of a team. To put the effect of this new approach into content, on the first inspection, the inspector was only talk to one resident due to the state of their health, but in the follow up inspection two months later, she spoke to ten.
Gary explained that “intentional rounding is a simple and effective way of monitoring people at regular intervals throughout a 24-hour period. At Moorwood Cottage we use it to record the checking and changing of incontinence pads, and the position and turning of those who are unable to reposition themselves. This means that not only are we systematically recording key information about our residents, but it is consistent, clear and easy to read so all staff can manage the care needed.”
Julia, our inspector, also highlighted the fluids champion as an excellent initiative, saying, “When we visited in March we observed that people who were unable access fluids independently were often not supported to drink, but the appointment of a fluids champion meant that a system was in place to support people to drink more regularly. Fluid charts were maintained for all people who were unable to drink unsupported. This meant that fluid intake was monitored daily and staff could ensure that people’s fluid intake was sufficient for their needs.”
Nurses taking charge...
The staff rota for both nurses and care workers had been reorganised so that they worked more effectively. Julia said: “We can now see that nurses take charge of the care and that care workers now work in teams with an extra care worker available to assist with personal care and nutrition. Without recruiting additional staff the new way of planning the work and organising the teams meant that people’s needs could be met.”
Moorwood Cottage, who voluntarily agreed not take in any new residents whilst they were making the changes and improvements, have now started to open their doors again.
A huge improvement, but some way still to go...
Julia explained: “The regional manager and the registered manager worked hard to move from a position where we were really concerned about the care being offered, to a place where we can see a big improvement in the environment, culture and most importantly the health of the residents, who tell us they feel happy and safe.”
Gary Judd, Director of Care for Adiemus Care Ltd, the provider organisation for Moorwood Cottage, said: “We had to hear some tough messages from CQC at the start of this year, but I am really pleased with the progress that has been made by the manager and staff at Moorwood Cottage. The well being of our residents is our number one priority and with the support of CQC we are making sure that we continue to improve the standards at Moorwood Cottage so that we can rightly be seen to be delivering high quality care.”
Whilst there are still elements at Moorwood Cottage that need to be worked on, there was a positive reaction from the staff and management. They have embraced the new practices that have been introduced.
Moorwood Cottage took our concerns very seriously and very quickly started to implement some new ways of working.
Julia Adey, CQC Inspector