Moorland House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were reported, reviewed and analysed to improve safety. Data was regularly analysed to spot themes and trends, ensuring timely action could be taken to mitigate risks. Learning was shared across the provider’s services, helping to ensure lessons and good practice were not just applied locally. Leaders met monthly to review key safety themes, sometimes informed by incidents and emerging risks, providing opportunities to reflect on what had happened, identify learning and share good practice to support safer care. The registered manager explained, “We share good and bad practice, we discuss what we are going to stop, start and continue doing in our homes. We talk through the focuses and what is happening in the general care sector.” This demonstrated an organisation-wide learning culture and supported consistent improvement across services.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

People were supported to transition into the service smoothly. A comprehensive pre-admission assessment was completed before people moved into the service. People were involved in identifying their health and safety needs, alongside their individual routines and preferences. This helped staff understand how each person wished to be supported, promoting a person-centred transition into the service. This was then reviewed once people had moved in and added to as staff started to learn about the person. The registered manager explained they also considered how well the person would fit within the existing community of the home, and the impact on others living at the service. This demonstrated a thoughtful and holistic approach to admission planning.

Similarly, where people moved out of the service, staff worked collaboratively to make this transition well-planned and safe. For example, following an increase in one person’s needs, staff engaged with an advocate and the dementia team to ensure the person’s changing needs, and best interests were fully understood and to identify a placement able to meet their needs. Staff worked collaboratively with those involved to plan the transition and share relevant information, reducing the risks associated with the move and providing continuity of care.

Feedback confirmed that people were supported to transition into the setting safely, and staff and leaders provided comfort and reassurance during this period of time. One relative praised the maintenance team for preparing for their loved one’s transition by making their bedroom ‘homely’ on arrival. Another shared their loved one who had recently moved into the service was settling in and adjusting well. They told us the registered manager had visited them at their previous care setting, and this had been very helpful to reassure and settle anxieties concerning the transition to Moorland House. The relative explained it was a difficult time for the family, and the registered manager’s visit made a significant difference and helped make the transition a lot smoother. Another relative shared, “Settling in was quite difficult for [person] and the staff were very good. They gave [person] extra attention while they were new.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People, and relatives confirmed they felt safe using the service, and that concerns about safety would be listened to and acted on. A relative told us, “I have peace of mind that [relative] is safe and comfortable.” Another shared, “[Relative] is safe at the home, no doubt about that.”

Staff had completed safeguarding training and demonstrated a good understanding of the action they would take if they were alerted to potential abuse. One member of staff confidently told us how they responded to historic concerns they were alerted to. Where concerns were raised, staff and leaders took prompt action and worked with relevant authorities to investigate and ensure people’s safety. Safeguarding was supported by appropriate policies, procedures and oversight arrangements. Unannounced night-time spot checks were undertaken, and safeguarding champions across the organisation helped promote awareness and good safeguarding practice.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found the principles of the MCA, and DoLS requirements were met and understood.

The provider worked with people to understand and manage risks by thinking holistically. For example, falls risk assessments considered relevant health conditions, such as osteoporosis, ensuring the increased potential for injury following a fall was recognised and appropriately managed. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Relatives told us staff were proactive in responding to changing risks. This included increasing monitoring when a person could no longer use their call bell, introducing equipment to reduce the risk of injury from falls, and seeking speech and language therapist’s advice when swallowing difficulties developed.

We identified some care records which required strengthening to ensure risks were consistently recorded. Leaders explained they had already identified this as an area to work on and assured us they were working to address this.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were cared for in a safe, well-maintained environment. Equipment people needed to keep safe, such as mobility aids, specialist beds or falls equipment, were accessible and in good working order. Routine health and safety checks were completed on the premises, and equipment. A comprehensive environmental risk assessment was in place to ensure risks were identified and managed.

Plans for refurbishment were underway, and people and relatives fed back positively on the impact of this. Another told us, “There are lots of improvements being made with the décor, which needed doing. The home is clean and well kept.” At the time of our site visit, the kitchen was undergoing an extensive refurbishment. People and relatives confirmed this was well managed. A relative said, “[Staff] have been very careful to minimise the disruption caused by all the renovations and building work. They have been courteous and it has been all hands-on deck. They are good at engaging and they are thoughtful. Even the contractors have been considerate and engaged residents during the work.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were enough suitable staff to meet the needs of people using the service. The provider used a tool which considered people’s dependency levels when calculating safe staffing numbers which was kept under continuous review. Staff attended to people’s requests for support promptly and were visible around the service. Staff confirmed they felt staffing levels were adequate. Relatives also shared, “The levels of staffing are impressive.” And “Staffing levels are a lot better since the new manager came, everything has improved tremendously. There are enough staff at the weekends, sometimes you used to be able to tell they were a bit short staffed, but the levels are much better now.”

Staff received appropriate training to carry out their roles. The registered manager explained staff were extremely motivated to learn and develop. One staff member told us, “What I value most here, they give you the right training and the opportunity to learn.” Staff received regular support by way of supervisions, appraisals and team meetings.

The provider followed safe recruitment practices, utilising technology well to ensure staff were safe and suitable to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were cared for in a clean environment. The provider had a proactive approach to IPC. For example, infection, prevention and control ‘champions’ met regularly to discuss best practice, policies and wider health and safety matters. Staff were suitably trained and followed best practice guidance in relation to infection, prevention and control (IPC), such as ensuring personal protective equipment (PPE) was used appropriately, and understanding relevant policies and protocols in the event of infection outbreak.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were administered safely by competent staff. People and relatives confirmed medicines were given as prescribed.

There were clear arrangements for the oversight of medicines, including policies, regular audits and medicine stock checks. Staff worked collaboratively with the GP and pharmacy to ensure people’s medicines remained safe and appropriate. For example, when staff identified that a person was having trouble swallowing tablets, they liaised with relevant healthcare professionals, and the medicine was changed to liquid form.

Some people’s emollient creams were not stored in line with the provider’s policy. We discussed this with leaders who agreed to review.