Moorlands Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Requires Improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although the provider regularly assessed and reviewed people’s health and care, this was not always effective.

The registered and deputy manager ensured assessments of people’s health and needs were completed before they moved into the service. This was to ensure their needs could be met. The registered manager told us, “We use the preadmission assessments from [the previous provider] as they’re really effective. We go out to 98% of our assessments. If it’s very far away, we do a phone assessment.”

People’s needs were regularly reviewed, and people were involved in reviews of their care where possible. Relatives were also invited to share their input. However, due to the inconsistencies identified in people’s care plans, we could not be assured that reviews of people’s needs were recorded accurately in people’s care plans.

The provider used legislation and current evidence-based good practice and standards but did not always plan and deliver this effectively.

Staff used evidence-based care and treatment to assess people’s level of need in areas such as nutrition and hydration, skin integrity and choking. Nationally recognised tools such as the Malnutrition Universal Screening Tool (MUST) and Waterlow score were used. The Waterlow scoring tool predicts the risk of developing pressure ulcer or sores based on people’s characteristics, medication or known high level risks.

However, this was not always effective as we identified risks to people were not always effectively assessed and monitored. For example, one person’s care plan stated due to a recent fracture, they should only sit in a recliner chair for 30 minutes to 1 hour. We observed they were sat in the recliner chair in the lounge for over 2 hours during the morning of our assessment.

The provider did not always work well across teams and services to support people. They did not always escalate declines in people’s health to different services when necessary.

Daily clinical meetings took place so management and clinical staff could discuss any changes in people’s needs or wellbeing. However, as identified elsewhere in this report, staff had not escalated concerns about a person’s deterioration in health, nor effectively communicated or escalated concerns from monitoring a person’s bowel movements. Therefore, communication between staff teams was at time ineffective.

Staff informed us of a difficult dynamic within the staffing team at times, due to negative biases against members of staff from specific ethnic backgrounds. The registered manager also informed us of tensions between older and newly recruited staff. The told us they were monitoring the situation.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People with conditions like diabetes were supported to have a diet their met their health needs whilst ensuring they were able to enjoy their nutrition. The registered manager told us, “We have lots of residents who are diabetic. We’ve provided them with a diabetic diet such as diabetic biscuits, so they don’t need to miss out.” A relative added, “The food is good, they control her diabetes, she picks what she wants.” Other dietary needs were also catered for, with one person telling us, “They are wonderful with my food; I am gluten free and they always make me lovely things I can eat. I really enjoy them.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

One person’s care plan stated they were at high risk of constipation, but they were able to use the toilet independently. Their bowel chart for April 2026 demonstrated they had either gone 21 consecutive days without a bowel movement, or staff had not witnessed this due to them going to the toilet independently. Therefore, the provider had not considered how they would effectively monitor the person’s bowel movements to prevent constipation.

However, monitoring tools were being used effectively elsewhere. Food and fluid charts were being completed by staff to monitor those with additional nutrition or hydration needs. This was done alongside regular weight checks to determine if people required fortified meals to improve their calorie intake. Skin integrity was also monitored to prevent deterioration. This included completing body maps and photographing pressure sores when they occurred, and regular turning and correct air mattress settings to promote healing.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Some people living at the service received their medicines covertly. However, we identified covert medicine protocols did not always follow best practice or national guidance. We fed this back to the registered manager and deputy manager who informed us they would review the protocol.

Staff were aware of the principles of the MCA. One staff member told us, “They should decide for themselves. Those who can’t decide, we have to do things in their best interest.”

We observed family members and professionals involved in a person’s care had been involved in best interest decisions where these were appropriate.