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The Moorings Retirement Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 January 2019

The Moorings Retirement 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. This inspection took place on 15 and 16 November 2018 and was unannounced.

The home is registered to accommodate up to 39 people, including people living with dementia care needs. There were 38 people living at the home when we visited. The home is a large building, based on multiple levels. There is a range of communal areas where people can spend their time and all bedrooms had en-suite bathrooms.

The home had a registered manager. 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.

Although people told us they felt safe at The Moorings, we found not all staff were clear about the correct action to take in the event of a fire. Most other risks to people were managed effectively. The risks associated with some blood thinning medicines had not been assessed but this was addressed during the inspection.

There were clear recruitment procedures in place to help ensure only suitable staff were employed; however, these were not always followed.

Staff acted in people’s best interests, but did not fully follow legislation designed to protect people’s rights. Some staff did not demonstrate an understanding of related legislation designed to protect people’s freedom.

Staff were suitably trained and said they felt supported in their work. However, there was not a process in place to demonstrate that new staff had the necessary practical skills before they were permitted to support people on their own. Records of one-to-one meetings between managers and staff were not adequate to show staff had been offered appropriate support and personal development.

Although new quality assurance procedures had recently been put in place, these had not identified the concerns we found during the inspection. Therefore, the procedures had not been fully effective.

Staff felt motivated and were engaged in the running of the service; however, records of staff meetings did not demonstrate how issues raised by staff were progressed or resolved.

There were enough staff deployed to meet people’s needs. Staff knew how to protect people from the risk of abuse.

All areas of the home were clean and there were procedures were in place to protect people from the risk of infection.

People’s nutrition and hydration needs were met and people were satisfied with the quality of the meals.

Staff monitored people’s health and supported them to access healthcare services when needed. They also made appropriate use of technology to support people.

People consistently told us they were treated in a kind and compassionate way and we observed positive interactions between staff and people. Staff respected people’s privacy and protected their dignity.

Staff encouraged people to be as independent as possible and involved them in discussions about their care.

Staff knew people well and took a person-centred approach to the delivery of care and support. They responded promptly when people’s needs changed and were committed to supporting people at the end of their lives to have a comfortable, dignified and pain-free death.

People had access to a range of activities based on their individual interests and used creative approaches to engage people.

There was a complaints procedure in place and people told us they felt able to raise concerns. There was an open and transparent culture where visitors were welcomed. Positive links had been developed which benefited people.

Inspection areas

Safe

Requires improvement

Updated 9 January 2019

The service was not always safe.

Not all staff knew the correct action to take in the event of a fire. The risks associated with blood thinning medicines had not always been assessed. However, this was addressed during the inspection and other aspects of medicines management were safe.

Appropriate recruitment procedures were in place, but these were not always followed to ensure staff were suitable for their role.

There were enough staff to meet people’s needs. Appropriate procedures were in place to protect people from the risk of abuse.

Effective

Requires improvement

Updated 9 January 2019

The service was not always effective.

Staff acted in people’s best interests, but did not always record the views of relevant people when making decisions. Staff did not understand legislation designed to safeguard people who were subject to restrictions of their freedom.

Staff were suitably trained and supported in their work. However, assessments of the practical skills of new staff were not recorded before they were permitted to support people on their own. One to one meetings with staff were not completed effectively to ensure any development needs were identified and followed up.

People's nutrition and hydration needs were met and people were satisfied with the quality of their meals.

Staff supported people to access healthcare services and made appropriate use of technology to support people.

Adaptations had been made to the home to help make it supportive of the people who lived there.

Caring

Good

Updated 9 January 2019

The service was caring.

People were treated in a kind, considerate and compassionate way by staff.

Staff knew people well and used this knowledge to initiate conversations and interact positively with people.

Staff respected people’s privacy and encouraged people to be as independent as possible.

Staff involved people and their families, where appropriate, in planning the care and support they received.

Responsive

Good

Updated 9 January 2019

The service was responsive.

Staff demonstrated an extensive knowledge of people’s needs. They met people’s needs in a personalised way.

Care plans were developed in conjunction with the person and relevant family members.

Staff responded promptly when people’s needs changed.

Staff supported people at the end of their lives to have a comfortable, dignified and pain-free death.

People were empowered to make as many choices as possible.

People had access to a range of activities suited to their individual interests.

People knew how to raise concerns and there was an appropriate complaints procedure in place.

Well-led

Requires improvement

Updated 9 January 2019

The service was not always well-led.

The quality assurance tools used to assess the service had recently been amended and were not fully effective.

There was an open and transparent culture where visitors were welcomed. However, the duty of candour requirements had not been followed fully.

People, family members and healthcare professionals praised the management. Feedback was used to enhance the service.

There was a clear management structure in place. Staff were happy and motivated. They had developed positive links with the community that benefited people.