This comprehensive inspection of Moorgate Residential Home took place on 22 and 24 January 2019. The inspection was unannounced. This meant that the provider and staff did not know we were coming. The second day of the inspection was announced.
Moorgate Residential Home is registered to provide nursing and personal care for up to 37 people. Since our last inspection the provider had increased the service from providing care from 21 to 37 people. There were 32 people living at the home on the first day of our inspection.
Moorgate Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.
The home is a large detached house on the edge of the village of Yelverton on the Dartmoor park. The home is set over two floors with two passenger lifts providing level access to each floor. There were several communal lounges and two dining rooms where people could spend their time as they chose. People had access to a safe and secure garden area where they could sit if they chose.
At our last inspection in June 2016 we rated the service Good overall with the responsive domain awarded outstanding. At this inspection we found the service remained Good overall and Outstanding in the responsive domain. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good.
There was an excellent understanding of the importance of seeing each person as an individual, with their own social and cultural diversity, values and beliefs. They continued to recognise the importance of social activities and understood meaningful activities formed an important part of people’s lives. Staff were extremely passionate about the activities at the home being meaningful and appropriate. They had established people’s hobbies and interests and supported them to revisit them. There were numerous examples of people doing meaningful activities.
People’s care was centred around them as individuals and was responsive to their needs because staff had a good knowledge of them. Staff were able to tell us detailed information about people’s backgrounds and life history from information gathered.
People received very good care and support from staff who valued them as individuals. Staff were highly motivated to ensure people received care which was compassionate, friendly and kind. They treated people with respect and dignity. There was a friendly atmosphere at the home and a strong ethos from all staff regarding it being a family and people’s home. The registered managers and staff daily went above and beyond what was required to support people. We were told numerous incidences where this had been the case. Everyone we spoke with described a marvellous, caring, kind, friendly and respectful staff team. One person said, “It’s a brilliant, wonderful, lovely place.”
There were good staffing levels to meet people’s needs. Staff knew people very well and understood their needs and cared for them as individuals. People were relaxed and comfortable with staff that supported them. Staff were discreet when supporting people with personal care, respected people’s choices and acted in accordance with the person’s wishes. People where possible and appropriate family members were involved in developing and reviewing their care plans every month.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The service was well led by the registered manager. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. There were effective systems in place to monitor the quality of care provided. The registered manager made continuous changes and improvements in response to their findings.
The registered manager and staff were committed to ensuring people experienced end of life care in an individualised and dignified way.
People remained safe at the service. People said they felt safe and cared for in the home. People were protected because staff knew how to recognise signs of potential abuse and how to report suspected abuse. People’s care needs were assessed before admission to the home and these were reviewed on a regular basis. Risk assessments were undertaken for all people to ensure their individual health needs were identified and met. Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed.
Staff received a comprehensive induction and were knowledgeable. They had received training and developed skills and knowledge to meet people’s needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005.
People were supported to eat and drink enough and maintain a balanced diet. People were positive about the food at the service. People were supported to lead a healthy lifestyle and have access to healthcare services. Staff recognised any deterioration in people's health, sought professional advice appropriately and followed it.
People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the management team. There had been no complaints received at the service since our last inspection. Where there were niggles, or concerns the registered manager took action promptly to resolve them.
The provider had a range of quality monitoring systems in place which were used to continually review and improve the service. People were protected from unsafe and unsuitable premises. Risks for people were reduced by an effective system to assess and monitor the health and safety risks at the home. The home had a pleasant homely atmosphere with no unpleasant odours and was very clean throughout. The furnishings were of a good quality and in good condition.
Further information is in the detailed findings below.