Moorview Care (East Yorkshire and Hull)

About the service

Moorview Care (East Yorkshire and Hull) is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older and younger people, people who may be living with dementia, people with a learning disability and/or autism spectrum disorder, or people with mental health support needs. At the time of our inspection there were 11 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, further improvement was required when recording best interest decisions, and we have made a recommendation about this.

The service had effective safeguarding systems and processes in place and people were supported to stay safe. People were involved in their care and support plans and risk assessments were person-centred with the least restrictive option always considered. Outcomes were identified for people and appropriate referrals to external services were made to ensure people’s needs were met. People had access to enough food and drink and mealtimes were set to suit people’s individual needs.

Right Care:

There were enough competent staff on duty to ensure people received safe care. Staff completed a comprehensive induction and supervision, and appraisals were used to develop and motivate staff. Staff treated people with kindness, dignity, and respect. People and their families were consistently positive about the caring attitude of staff. Care planning was focused on the person’s whole life, including their goals, skills, abilities and how they preferred to manage their health.

Right Culture:

Staff understood their responsibility to raise concerns and report incidents and near misses, and were fully supported to do so. The service had a positive culture that was person-centred, open, inclusive, and empowering. Leaders and managers were available and led by example. Staff understood the service’s vision and values and felt respected, valued, and supported. People, their families and staff were involved in the development of the service and managers ensured feedback was acted on to shape services and culture. There was a strong focus on improvement and learning at all levels.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 December 2022). The provider completed an action plan from the previous inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to the safe care and treatment of people using the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Due to improvements found on this inspection we decided to undertake a comprehensive inspection to review all the key questions.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection. We found no evidence that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Moorview Care on our website at www.cqc.org.uk.

Recommendations

We recommend the provider reviews its practice in the recording and retaining of best interest decisions.

Follow up

We will continue to monitor the information we receive about the service, which will help inform when we next inspect.

Moorview Care (East Yorkshire and Hull) domiciliary care agency providing personal care to people within their own homes, in a supported living setting. The service provides support to older and younger people, people who may be living with dementia, people with a learning disability and/or autistic spectrum disorder or people with mental health support needs. At the time of our inspection there were 11 people using the service.

People’s experience of using this service and what we found

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. There was a lack of knowledge and understanding about the Mental Capacity Act 2005 and how this legislation was applied in practice.

There was not always enough staff to meet people’s needs. Staff shortages meant that people were not receiving the level of support they needed and were funded for. Relatives and staff told us this affected people’s opportunities to engage in the local community. Some staff felt that a shortage of staff had affected staff morale.

Care plans and risk assessments did not always provide sufficient guidance for staff or were not understood/ followed.

Processes where in place to ensure the safe administration of medicines.

We found systems and processes used to ensure the service was running safely were not effective. We identified a lack of oversight and knowledge of what was happening within the service.

The provider’s quality assurance systems had failed to identify gaps in records, knowledge and practices to ensure people were safe and receiving effective care.

Recruitment practices were safe and robust. Staff demonstrated an understanding about safeguarding procedures. Staff had good knowledge about people and their daily routines. Some staff demonstrated a passion and commitment to providing quality care to people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 17 February 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staffing levels, understanding and application of the Mental Capacity Act, person-centred care and a lack of oversight regarding these matters.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.