Moorview House

Updated 1 August 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.

Inspection site visits took place on 29 March, 12 and 25 April 2018. The first day of inspection was unannounced which mean the provider did not know we would be visiting. The other two days were announced. The first day of inspection was conducted by one adult social care inspector and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. The experts by experience who supported this inspection had extensive knowledge of caring for people with a learning disability. The other site visit dates were conducted by an adult social care inspector.

As part of planning our inspection, we contacted Healthwatch and local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England. We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.

The provider sent us their 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 used this information to help plan for the inspection.

During the inspection, we visited the registered location and four supported living services. We reviewed a range of records. These included four people's care records containing care planning documentation, daily records and medicine records. We looked at four staff files relating to their recruitment, supervision, appraisal and training. We reviewed records relating to the management of the service and a wide variety of policies and procedures.

During the inspection we spoke with nine people who used the service and three relatives to gain their views on the service provided. We were unable to speak with some people who used the service due to their communication needs. However, we used the Short Observational Framework for Inspection (SOFI) to observe staffs’ interactions with people. We also spoke with ten members of staff including the registered manager, commercial director and training manager. We also spoke with two healthcare professionals.

Updated 1 August 2018

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

This service also provides care and support to people living in ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Moorview House is situated in Robin Hoods Bay near Whitby. The home accommodates and provides care and support for up to 16 people whose main needs are associated with a learning disability. Supported living services are based in the Whitby and Scarborough area.

Although the care service provides accommodation for 16 people, which does not meet the principles of registering the right support, it was clear it had been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Inspection site visits took place on 29 March, 12 and 25 April 2018. At the time of this inspection, the service was providing support to eight people in the care home and 36 people in supported living accommodation.

At the last comprehensive inspection in August 2015 we found the service was meeting requirements and awarded a rating of good. At this inspection we found the registered manager and staff team had developed the service further to achieve an outstanding rating.

There was a manager in post who had registered with the Care Quality Commission. They assisted throughout the inspection process. 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.

There was an extremely person-centred culture where staff displayed empathy and worked with people and their relatives to understand how to best support them. Life history documents had been developed and staff were encouraged to read these and update them when new information was discovered.

Staff anticipated people’s needs and recognised distress and discomfort at the earliest stage. Staff were particularly sensitive to times when people needed caring and compassionate support.

Staff and management were enthusiastic and committed in helping people to become as independent as possible. They had fantastic relationships with a local charity who had funded many initiatives the service had to improve and promote people’s independence.

The registered manager was proactive in ensuring people were able to access learning resources as soon as possible to encourage and promote independence. People has been able to achieve life time goals due to this approach and the resources made available.

Staff were highly motivated and offered care and support that was exceptionally compassionate and kind. Respect for privacy and dignity was at the heart of the service’s culture and values.

The registered manager demonstrated clear visions and values and was passionate and committed to providing an excellent person-centred service for people and their relatives. These values were owned by staff who were equally committed and enthusiastic about fulfilling their roles and responsibilities in a way that delivered the best possible outcomes for people.

Admissions to the service were carefully considered and subject to a transition period that was suitable to the individual. The service ensured people were given the opportunity to choose where they wanted to live and who they wanted to live with.

Care plans were extremely person-centred and focused on individual needs and how this could be met. There was dynamic approach to care planning and involving people as much as possible.

Staff were continually looking at new ways in which they could improve people’s lives. The use of technology had been embraced to enable people to fully participate in activities or hobbies they enjoyed. People were able to participate in a range of activities and outings that suited their individual preferences.

We observed staff consulting with one another in a respectful and highly collaborative way where individual experience and knowledge was clearly valued.

There were continuous high levels of constructive engagement with people and staff. People, relatives, professionals and staff were encouraged to provide feedback on the service at every opportunity with more formal satisfaction questionnaires being distributed annually.

The registered manager kept a reflective log on research, taught sessions and training they had attended so they could take control of their own learning and understand areas for improvement. This was then cascaded to other staff.

The registered manager had worked considerably hard to develop, discuss, promote and implement innovative ways of involving people in developing the service. Extensive quality assurance processes were in place to consistently and continuously monitor all aspects of the service.

Staff and management had high regard for the safety of people they supported. People were involved in developing a comprehensive and innovated approach to safeguarding.

The service was particularly creative in the way it involved and worked with people to understand their diverse circumstances and individual needs. Extensive discussions and relationship building sessions took place regularly between people, management and staff to ensure they fully understood a person’s needs, wishes and goals.

Robust recruitment processes were in place. People who used the service were given the opportunity to participate in the selection and recruitment of staff.

Staffing rotas showed that consideration had been taken with regards to skill mix of staff, activities that were taking place and preferences of people. There was a flexible approach to staffing numbers to accommodate people’s wishes and interests.

There was a strong emphasis on the importance of eating and drinking well. Staff focused on ensuring people understood the importance of following a healthy balanced diet.

Staff had received extensive training in areas the provider considered mandatory. Training was provided through a range of provision to encourage learning and development. People who used the service were actively involved in the planning, attendance and delivery of training.

Staff and management looked for different ways of ensuring people had a clear understanding of how equality and diversity affected their lives. Training was delivered which was specifically designed for people with a learning disability.

Staff received regular and constructive supervision, observations of practice and appraisal. Focus had been emphasised on staffs' abilities and they were given opportunities to progress within their role.

Staff had excellent relationships with other professionals involved in people’s care and support. People were at the centre of the service and fully, actively involved where ever possible.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Discussions with staff demonstrated they were extremely passionate about the people they supported, building effective communication and improving the quality of life people had.