Moormead Care Home

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 inadequate. At this assessment the 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.

In the last assessment we found that accidents and incidents were not thoroughly investigated to learn lessons and embed good practice. Record-keeping did not provide adequate detail about actions taken and outcomes.

In this assessment records showed staff were recording incidents and accidents and these were followed up by the provider. For example, reviewing the risk and notifying others where relevant. This included notifying relatives, safeguarding and CQC. We saw incidents were discussed in team meetings. For example, falls and risk management plans had been discussed for 1 person who had experienced frequent falls.

Relatives told us they were kept informed about incidents. One relative said, “[Relative] has had a couple of falls. The last one was about a month ago and I was informed by a phone call. They keep an eye on [Relative] now. [Relative] has bedrails and an alarm if [Relative] gets up from their chair. There is also a safety mat by [Relative’s] chair.”

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 service worked closely with the local GP practice. Records showed people were reviewed by other external health professionals. For example, we saw people had been reviewed by the speech and language therapy team (SALT), tissue viability nurses (TVN) and hospital specialist nurses. People had access to podiatry services, dentists and opticians.

Relatives confirmed other health professionals were involved in their relative’s care. One relative said, “Once a week the Paramedic from our health centre goes in (to the service] to check [Relative] and [Relative] is being referred to the Mental health team for their memory loss.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

In the last assessment we found accidents and incidents were not investigated thoroughly and safeguarding alerts were not always made.

In this assessment staff confirmed they had received safeguarding training and would speak with the manager if they had any safeguarding concerns. People told us they felt safe in the home.

Safeguarding incidents had been raised appropriately and shared with the local authority safeguarding team. Safeguarding incidents had been investigated, and action had been taken to keep people safe. For example, providing additional support to keep a person safe and seeking advice from other health professionals to help manage the person’s behaviours of distress.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the provider was working in line with these principles. We saw applications for DoLS were made and the provider had oversight of these.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. In the last assessment we found care planning documentation and guidance on how to manage risks relating to skin integrity, falls and malnutrition were not clear.

In this assessment we found, people and their relatives were generally involved in assessing and managing risks. One relative said, “A care needs assessment was done on what [relative] could do, their mobility, and food needs. It was a two-way process with our family and the owner [Nominated Individual].” However, although improvements in some people’s care plans were noted, some plans which contained inconsistent or incomplete information, such as conflicting mobility guidance and missing instructions on how to support a person during a seizure, Wound care monitoring was not always carried out in line with the provider policy, with unclear photographs and inconsistent measurements. This created a risk that changes might be missed. Despite these shortfalls, staff understood people’s needs, and we found no evidence of harm to people. Staff followed other risk-management guidance well, such as monitoring people’s weigh, seeking professional advice when needed, and implementing pressure care support correctly.Further improvement was still needed to ensure all risk information was accurate, complete and consistently applied.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

In the last assessment we found the provider had not completed suitable risk assessments, including leaving actions from the fire risk assessment outstanding.

In this assessment we found the provider had completed actions identified in the most recent fire risk assessment. This meant identified risks had been addressed and the environment was safer.

The provider checked the safety of the environment regularly. Equipment was checked by qualified contractors or professionals to ensure it was safe to use.

Staff confirmed they had taken part in fire drills and knew how to use the fire evacuation equipment.

We saw the provider had risk assessments in place in relation to the environment.During our visit, the service was clean, well maintained and free from obvious hazards. People and relatives told us the environment was kept clear of trip and fall risks, helping them to move around safely.

The provider did not always make sure nursing staff received effective support, supervision and development.

In the last inspection the provider had not provided clinical supervision for nursing staff. Clinical supervision is a formal process of professional support, reflection and learning that fosters individual development and contributes to improved care for people.In this assessment, we found that clinical supervision still had not taken place.

In the last assessment we found supervisions had not taken place in line with the providers policy. In this assessment records showed staff were now having regular supervisions and observations of care and support.

Most relatives said there were enough staff for helping people, however one relative said there was not adequate staffing, they described staff to be, “run off their feet,” and another relative felt the response to call bells was, “very slow.”

In the last assessment staff had training but did not demonstrate adequate understanding in relation to swallowing problems. In this assessment we saw the provider had regularly observed staff practice around mealtimes and had addressed concerns with staff where shortfalls were identified. Staff we spoke with were aware of people who were at risk of choking, and we observed people were supported with their meals appropriately.

The provider used a staffing dependency tool to understand the staffing levels needed to meet people’s needs.

Records showed the provider ensured there were enough staff working throughout the day.

Most staff felt there were enough staff throughout the day. However, some staff said they faced challenges in meeting expectations to provide both care and activities for people.

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 service was clean during the assessment visits. The provider had systems to reduce the risk of infection. For example, colour coded cloths for cleaning. Records showed the service was regularly cleaned. Staff had received infection prevention and control training. Staff told us they thought the service was clean and they had enough Personal Protective Equipment. (PPE) PPE is special clothing or equipment people wear to keep themselves safe at work. For example, gloves.

One relative said, “It’s (the Home) very clean. The cleaner is always around. I’ve never seen any dirt there. It’s very hygienic as well. Yeah, I’ve seen them (staff) wear masks when there’s a virus around. They have gloves on and aprons. So don’t spread germs.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were now stored securely in a designated place with secure methods of controlling access. Medicines were in most cases available for administration and there was evidence that people were receiving their medicines as prescribed. In cases where medicines were not available there was evidence that the appropriate protocols had been followed. PRN ‘as required’ protocols were available to support the administration of ‘as required’ medicines. Medicines were administered by nurses who displayed knowledge of the medicines they were administering, and people were treated with kindness and respect. There was evidence of temperature record keeping (both fridge and ambient temperature) and regular audits taking place. There was a comprehensive medicines management policy to support staff in managing medicines. Relatives did not express any concerns in relation to medicines management. One relative said, “A lovely nurse there gives [relative] the medicines. I’m informed about medication changes.” .