Archived: Moorleigh Nursing Home

Updated 20 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 7 and 8 November 2017. The inspection was unannounced on the first day and we told the registered provider we would be visiting on the second day.

The inspection was carried out by one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience in providing care for their relatives.

We contacted the local authority prior to visiting the home. We also reviewed the information we held about the service which included notifications of significant events that affect the health and safety of people that use the service. A notification is information about important events which the service is required to send us by law.

During the inspection we spoke with four people living at the home and eight visiting relatives. We spoke with five members of staff, the clinical lead, the registered manager and the registered provider. We looked at the records of four people which included plans of care, risk assessments and medicine plans. We also looked at recruitment files of six members of staff, a range of policies and procedures, maintenance records of equipment and the building, quality assurance audits, feedback forms and minutes of meetings.

Updated 20 December 2017

The inspection was carried out on 7 and 8 November 2017. The inspection was unannounced on the first day and we told the registered provider we would be visiting on the second day.

We last inspected Moorleigh Nursing Home in July 2016 when the home was rated 'Requires Improvement' overall. We identified four breaches of regulations. We found medication systems were not robust to ensure safety, known risks identified in the property were not mitigated to prevent harm to people and risk assessments did not cover all known risks and where they were completed guidance from assessment was not always followed. As a result we served a warning notice for Regulation 12 (Safe care and treatment). We also found assessments of people's capacity and records of decisions made in people's best interests were not completed where required. This was a breach of Regulation 11 (Need for consent). Quality assurance systems were not robust enough to ensure quality and safety. This was a breach of Regulation 17 (Good governance). We also saw that staff training was not up to date. Clinical training and competencies for nursing staff were not in place for all areas of clinical practice. This was a breach of Regulation 18 (Staffing).

Following our July 2016 inspection, the registered provider sent us an action plan detailing the changes and improvements they intended to make to improve the quality of service provided to people living at the home. We took this into account when planning this inspection to make sure we checked these actions had been completed. At this inspection, we found the provider had made all the required improvements and addressed all the concerns that had been highlighted last time we visited the home.

Moorleigh Nursing Home is a large property which consists of a Victorian main building with modern extensions. People have access to extensive gardens which are accessible to people with mobility difficulties. The service provides accommodation care and support for up to 36 older people who require personal care and nursing. The service is close to all local amenities.

There was a registered manager in place. 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.

People received care and support from staff who were appropriately trained and confident to meet their individual needs. They were able to access health, social and medical care, as required. There were opportunities for additional training specific to the needs of the service, such as diabetes management and the care of people with dementia. Staff received one-to-one supervision meetings with their line manager.

People's needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were personalised and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people's changing support needs.

There were policies and procedures in place to assist staff on how to keep people safe. There were sufficient numbers of staff on duty to meet people's needs. Staff told us they had completed training in safe working practices. We saw people were supported with patience, consideration and kindness and their privacy and dignity was respected.

Thorough recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People were supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were provided with suitable amounts of food and drink and were happy with the meals they received. People's nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

The provider had systems in place to assess the quality of care provided and make improvements when needed. People knew how to make complaints, and the provider had a process to ensure action was taken where this was needed. People were encouraged and supported to express their views about their care and staff were responsive to any comments made.