Moorville House

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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.

The provider had suitable systems in place to learn from any accidents or incidents. All accidents and incidents were recorded by staff and analysed by the provider, to try to identify any themes or trends. This information was used to help reduce the risk of repeat events and to make continuous improvements to the safety of the service.

The provider fostered an open and reflective culture where safety concerns were valued as opportunities for learning and improvement. This positive learning environment empowered staff built a confident and knowledgeable workforce and led to improved outcomes in people’s lives. Relatives reported they knew how to make a complaint if needed. A clear complaints policy encouraged people and their representatives to raise complaints and concerns through reviews, quality assurance processes, and questionnaires. The provider and registered manager embraced their responsibilities and fulfilled the requirements of the duty of candour by being open, honest, and transparent when things went wrong. The service worked with families to address concerns and resolve issues.

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.

People's transition into the service was carefully planned. When people were first referred and couldn’t communicate well, their family and close contacts were involved throughout the initial assessment because they knew what was important to their relatives. People were allocated a keyworker to build a relationship with and ensure consistency. Risk assessments and care plans were developed as people got to know staff and vice versa.

People's relatives were happy with the support their family members received to access other services. Staff worked with other organisations to deliver effective care and support to people. Staff regularly sought advice from community health professionals such as the GP and district nurses. This supported staff to achieve good health outcomes for people.

The management showed how when a person's needs had changed, they had promptly engaged with several health and social care professionals to ensure people’s needs were met and fully understood. Records detailed how staff worked effectively with GP’s, district nurses and other external healthcare professionals.

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.

The provider used appropriate systems to safeguard people from abuse. Staff received training about how to safeguard adults from abuse, and they were all confident the registered manager would act quickly on any concerns they raised. The registered manager had made appropriate referrals to the local safeguarding authority, when required.

People told us they liked living at Moorville House and they felt safe. One person told us, “Yes, I feel safe, the staff can tell when I am agitated.” Relatives and friends of people supported said people's safety was promoted. One relative said, “[Name] is safe, and they look after their health. The staff team know who and what they like.” All staff said without hesitation they would be 100% happy for a relative or friend to live at the home and felt they would be safe.

People can only be deprived of their liberty to consent to 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.

Staff we spoke with understood the principles of the MCA and DoLS. Staff also confirmed they had been provided with training in MCA and DoLS. This meant staff had relevant knowledge of procedures to follow in line with legislation. There were clear records kept of DoLS authorisations, and the care plans seen showed evidence of capacity assessments and decisions being made in the person's best interests.

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.

Systems were in place to reduce the risk of people experiencing avoidable harm. People's care records contained assessments of the risks posed to them, and guidance for staff about how to manage those risks. Risk assessments were reviewed regularly or if people's needs changed.

People were enabled to take positive risks to maximise their control over their care and treatment. The service helped people to have a full and meaningful life, while supporting people to stay safe. Risks to people were assessed and managed in the least restrictive way possible. For example, encouraging people to remain as independent as possible within the community.

Staff knew people well and were aware of how to reduce risk to keep people safe. Some people using the service required increased support when distressed and staff received training and clear guidance on how to do this safely. Staff we spoke with were aware of people's individual risks and shared with us how they used techniques to reduce the likelihood of people being harmed.

Risk assessments were completed, looking at the health and safety of the environment and equipment. Staff had received training in fire safety and there were regular fire drills. An emergency evacuation plan was in place for each person, to describe the support they would need in the event of a fire or other emergency evacuation of the building.

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

Environmental risk assessments considered all aspects of the home, both internally and externally to ensure people lived freely within a safe environment. The provider undertook regular health and safety checks of the premises.

The layout of the buildings promoted person centred care. Each person was able to spend time in areas that interested them, engaging in their preferred activities and choosing who they interacted with. The home was surrounded by a secure accessible garden with ramps and flat areas. There was a garden with raised planting beds for people to enjoy, and a well-used BBQ and garden furniture. A relative told us how they and their family member was involved in designing and adapting their living areas to meet their specific needs. They told us how their family members living space had been extended to further improve their environment and promote their independence. The relative said,” [Name] is very proud of their accommodation and likes to show it off. It [the environment] is bespoke to them.” In a recent survey a staff commented, “I think the new and improved kitchen/garden in the house has made a positive impact on our residents and staff. the house feels more clean, modern and easier to manage on shifts now each staff member has their own key lanyard.”

People's living spaces were tailored, to ensure people were kept safe and promote their independence. For example, where required people had lockable cabinets for items which could pose a risk to them. These were risk assessed for each person, to ensure people lived in the least restrictive environment, whilst keeping them safe. People felt safer and more confident in their own homes with reduced anxiety and fewer incidents of distress.

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.

The provider operated safe recruitment processes. Robust recruitment procedures were in place and appropriate checks were carried out to protect people. Checks had been made on relevant previous employment, as well as identity checks. Disclosure and barring service (DBS) checks had also been carried out. DBS checks are a way a provider can make safer recruitment decisions and prevent unsuitable staff from working with people.

There were enough staff on duty to provide people with the care and support they needed. We observed staff were patient and person centred in their interactions with people. They took the time to sit with people and have conversations about things of interest to them. People who use the service told us they felt there was sufficient staff to meet their needs.

People were supported by staff who had received relevant and good quality training. This included communication tools, positive behaviour support, human rights and restrictive interventions. The training was certified as being compliant with the Restraint Reduction Network Standards which applies to all training that have a restrictive intervention component. It provides a benchmark for training in supporting people who are distressed in education, health and social care settings.

The provider placed significant emphasis on skill development and ensured all their staff have received mandatory training in how to support people with a learning disability and autistic people. Staff received high level autism specific and BILD (British Institute of Learning Disabilities) training and supervision. This included training sessions that looked at the unique range of conditions people might be living with and how these conditions may affect their daily lives. Other training included communication tools, positive behaviour support, human rights and restrictive interventions.

Staff reported they had been provided with excellent training and ongoing support to support people to stay safe and empower them to take appropriate risks. One staff member said, “The Training we get is well-led and supports me to do my job effectively “. Staff had also attended regular supervision meetings and an annual appraisal of their work performance, these included discussions about their personal and professional development. The staff we talked with felt very well supported in their roles and said they were able to approach any member of the management team when they needed support or guidance.

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.

People were protected from the risk of infection as staff were following safe infection prevention and control practices. During our assessment we conducted a tour of the premises and found it was exceptionally clean, tidy and odour free.

Staff were trained in infection prevention and control, including hand hygiene. They used protective equipment, such as disposable gloves and aprons and confirmed these were always readily available. Hygienic hand rub was also available around the building.

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.

People were supported to receive their medicines in a way that was safe. The provider ensured all medicines were prescribed in line with the provider's STOMP (STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic

medicines) medicine's policy and ensured people's medicines were reviewed by prescribers in line with these principles.

People received support from staff to make their own decisions about medicines wherever possible. Staff were focused on working closely with people and other health professionals so they could successfully tailor people’s medicines management approach. This enabled the service to fulfil people's aspirations and desire for independence, whilst balancing these wishes and ensuring people had the medicines they needed to remain well. For example, one person was actively involved in their medication review and decisions around their medication. This had resulted in a reduction in anxiety levels and a huge increase in engagement in activities in the community and meant the person was able to move into a self-contained room within the service.

Systems were put in place to keep track of how often certain types of medicines and physical interventions were used. This helped make sure these actions were appropriate, followed agreed guidelines, and matched the person’s support plan.