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Moorhouse Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 January 2019

We undertook an unannounced focused inspection of Moorhouse Nursing Home on 15 November 2018. This inspection was done as we had received concerns about staffing levels, how risks to people were managed and the lack of management oversight at the service. The team inspected the service against two of the five questions we ask about services: is the service safe and is the service well led?

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Moorhouse Nursing Home 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. Moorhouse Nursing Home accommodates up to 38 older people, some of whom may be living with a physical disability, in one adapted building. At the time of our inspection there were 26 people using the service.

At the time of the inspection there was not a registered manager in post. The manager who was present was leaving and a new manager, who was also present, had been appointed three days previously. The new manager told us they would be applying to register with CQC as manager in line with the requirements of their registration. 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 were not enough staff to meet people’s needs which left them waiting for care to be delivered. Risks to people were not always managed effectively which placed people at risk of harm. Where incidents and accidents occurred, these were not analysed to reduce the risk of them re-occurring. There had been a high turnover of managers in the last six months which had affected the care being delivered to people. There was a lack of management oversight and audits on the quality of care were not being completed. Staff did not feel listened to when they raised concerns about staffing levels. We asked for information about how the service acted with external agencies but this was not provided.

People received their medicines when they needed them. The management of medicines was safe. People were kept safe from the risk of abuse as staff knew what to do should they have concerns about the standard of care provided. There were safe infection control practices in place which staff followed. The environment was clean and well maintained and safe recruitment procedures were in place.

We identified two breaches of the Health and Social Care Act 2008 (HSCA). You can see what action we asked the provider to take at the back of this report.

Inspection areas

Safe

Requires improvement

Updated 12 January 2019

The service was not always safe.

There were not enough staff to meet people’s needs. People were sometimes having to wait for care to be provided as a result. However staff were recruited safely.

There was an inconsistent approach to risk management which meant people were not always kept safe. Opportunities to learn lessons from accidents and incidents were missed as these were not analysed to prevent a re-occurrence.

Medicines were managed safely.

Staff understood their responsibilities to safeguard people from harm.

People were protected from the spread of infection and the environment was clean.

Effective

Good

Updated 19 May 2018

The service was effective.

Staff received appropriate training and had opportunities to meet with their line manager regularly.

Where people’s liberty was restricted or they were unable to make decisions for themselves, staff had followed legal guidance.

People’s nutritional needs were assessed and individual dietary needs were met. People could choose what they ate.

People had involvement from external healthcare professionals and staff supported them to remain healthy.

The environment was suitable for people living with dementia.

Caring

Good

Updated 19 May 2018

The service was caring.

People’s care and support was delivered in line with their care plans.

People’s privacy and dignity was respected. Staff were knowledgeable about the people they cared for and were aware of people’s individual needs and how to meet them.

People were supported with their religious beliefs and were able to practice their faith.

Visitors were welcomed at the home and people could meet with them in the privacy of their bedrooms.

Responsive

Good

Updated 19 May 2018

The service was responsive.

People had person centred care plans that they and their relatives had helped to write. Where people’s needs changed staff ensured they received the correct level of support.

A variety of activities that interested people were available for them to take part in.

Information about how to make a complaint was available for people and their relatives.

People would receive end of life care that was in line with their needs and preferences.

Well-led

Requires improvement

Updated 12 January 2019

The service was not always well-led.

There had been a number of changes in management which had led to lack of direction and leadership for the service.

There had been no effective monitoring of the service by the manager or provider which impacted on the care being given.

There was no evidence of how the service engaged with people or those important to them to help improve the quality of care provided.