Moriah House Limited

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. For example, incidents and complaints were recorded and investigated to find the root cause. Lessons learnt were identified after each incident and complaint, to reduce or mitigate the risks of reoccurrence. Staff were aware of how to raise concerns and risks; they were confident the management team would take all necessary action. This meant raising concerns helped manage risks before safety events happen to protect people from harm.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The staff had completed pre-admission assessments with people, the people who knew them well and other professionals where required. This meant care was planned and organised with people and other partners to ensure continuity of care before they moved in. People had summary profile records in place, these records included key information regarding people’s safety risks. These were in place to be shared with any other professionals in an emergency to ensure smooth transition into other services such as hospital. This meant systems were in place for people to receive continuity of care when moving between different services.

People were not always protected from the risk of harm or abuse. We observed a person with multiple visible unexplained bruising and staff had not completed any record of this and management were not aware. The manager had reported this incident to the local safeguarding authority once we had raised it. For concerns that were identified by staff and management, these were investigated promptly and referred to the local safeguarding team as required. Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLs), this is where the person cannot make decisions about their care and treatment. So restrictive care arrangements are legally authorised in the person’s best interest. This meant people had decisions made lawfully in their best interest. Staff could explain how to protect people from harm and abuse. All staff had completed safeguarding training. The provider had a detailed safeguarding policy in place, explaining what needed to be done if abuse was suspected. People told us they felt safe, one person told us, “I feel very safe.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were in place for people who had known, risks to provide staff with guidance on how to manage those risks. The registered manager knew people’s needs well and spoke to us about care planning and details of how people and their relatives were involved with managing risks. The registered manager told us, “Where people can be involved, they are involved with their care planning and risk assessing, people who can’t, due to their capacity, we work with their family and other professionals to ensure we manage people’s risks. We have care reviews for people each month and people are involved with them.” This meant people were involved in managing their risks. We observed people being supported safely and specialised equipment was in place to minimise risk of accidents and incidents, for example, sensor equipment was in people’s bedrooms to reduce the risk of falls. This meant measures were in place to protect people from the risk of harm. People and relatives told us equipment was used safely. One relative told us. “He has no mobility now and has to be hoisted. They seem to do that safely enough.”

The provider had not always detected and controlled potential risks in the care environment. For example, not all doors were locked that stored high risk cleaning items. This could have placed people living with dementia at risk of harm if they had access to these products and ingested them. The registered manager took immediate action during our onsite visit and replaced the lock. The provider made sure equipment, facilities and technology supported the delivery of safe care. Health and safety checks such as gas, fire alarm and Portable Appliance Testing (PAT) had been completed. This meant the environment was checked to ensure it was safe.

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. Processes were in place to ensure safe staffing levels. The registered manager monitored staffing levels regularly and used a specific tool to assess the number of staff needed on each shift in line with people’s dependencies. People told us there was enough staff, one person told us, “I’d say there’s mostly enough as I see them in the lounge.” Staff told us they felt there was sufficient staffing levels. One staff member told us. “Generally, yes [enough staff]. Staffing levels are reviewed regularly to ensure safe care delivery.”

Staff were recruited safely. The process ensured that necessary checks were completed which included reference checks, proof of identity as well as Disclosure and Barring Service (DBS) checks. A DBS check isa way for employers to check an employee’s criminal record, to help decide whether they are a suitable person to work for them. Staff had completed an induction when they first started. One staff member told us, “Yes, the induction was comprehensive. It included mandatory training such as moving and handling, safeguarding, fire safety, and shadowing experienced staff to understand each residents’ needs and routines.” Staff had one to one supervision regularly to discuss their development and training opportunities.

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. The provider had a clear policy and procedure in place to manage infection outbreaks. Staff had completed infection prevention and control training. This meant staff had the knowledge on how to deal with outbreaks safely. We observed and people told us the home was clean. One person said, “Everywhere is kept very nice for us.” Staff had access to Personal Protective Equipment (PPE) such as gloves and aprons. People told us their personal hygiene was maintained. One person said, “I use the shower in the corridor when I want one as I can manage myself. The [staff] clean my room every day and it’s good enough for me. My clothes come back fresh from the laundry.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines systems were well-organised and safely managed. Medicines were stored securely in a locked room. Some people at the home were prescribed controlled drugs. These are subject to enhanced restrictions due to the addictive nature of these medicines. We saw staff had followed national legal requirements by storing these medicines in an extra secure place. We observed Staff had carried out administration tasks safely and in a timely manner. Staff kept clear records of when they had given prescribed medicines. Staff did regular checks of the amount of medicine in stock. This ensured that suitable stock levels were always in place, and more medicine could be ordered from the pharmacist as needed. Some people required ‘as needed’ medicine and staff had clear written guidance on how this should be administered. Staff had received training on how to administer medicines safely. The management team had regularly assessed the staff’s competency, to ensure they were following best practice.