Moorfield House

Updated 8 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors, a medicines inspector and 3 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Moorfield House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Moorfield House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service including information submitted to CQC by the provider about specific incidents. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We sought feedback from the local authority contracts monitoring team, North East and North Cumbria Integrated Care Board (ICB) and safeguarding adults' teams and reviewed the information they provided. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 5 people's care records, the medicine records for 20 people and the recruitment records for 3 members of staff. We also reviewed the induction information for 9 agency staff members who had recently worked at the home. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

We carried out observations in the communal areas of the home. We spoke to 5 people who used the service, 22 relatives, and 13 members of staff. This included the registered manager, regional manager, care staff, registered nurse, the chef and senior carer.

Updated 8 March 2023

About the service

Moorfield House is a residential care home providing personal and nursing care to up to 35 people. The service provides support to people aged 18 and over, some of whom were living with a dementia. At the time of our inspection there were 26 people using the service.

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

Since our last inspection the service had improved in some areas. However, action was still required in relation to care records and the quality assurance system. Care records did not always demonstrate that people were given a safe and suitable diet or fluids which met people’s assessed needs and that steps were in place to safely monitor people with an identified risk of choking.

An effective quality monitoring system was still not fully in place. Improvements had been made to the overall checks and audits, but these were not always completed effectively and did not monitor risks associated with choking.

People’s care and support plans had improved since our last inspection. Care records required a review to ensure all information was accurate and up to date. We have made a recommendation about this.

People were happy with the care provided and enjoyed living at the service. People were complementary about the staff team and the changes that had happened since our last inspection. One person commented, “I think the staff do their very best, they are effective, and improving the service.”

There was improvement with the leadership at the, which had increased staff morale and the culture. Relatives were positive about the improvements that were being made to the service by the management team. A relative said, “The biggest improvement is the stable management regime that [registered manager] has provided. They [the staff] all work together for the benefit of the residents.”

People were safe living at the service and were protected from potential abuse. The home environment had improved and there was a calm, relaxed and pleasant atmosphere.

Medicines were managed safely and there was appropriate clinical oversight in place. Risks which were not related to choking, were well managed and there were detailed assessments for staff to follow to keep people safe.

Staffing levels had been reviewed regularly to make sure people’s needs were met. The management team had reduced the amount of agency staff used and were in the process of recruiting more permanent staff. Agency inductions had improved and the provider’s agency induction processes were being followed. Staff were recruited safely and provided with on-going training and 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.

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 inadequate (published 12 July 2022) and there were breaches of regulation. We imposed conditions on the provider's registration to ensure that staff were qualified and competent to support people who were at risk of choking, required continence monitoring and oxygen therapy. We requested that people with an identified risk of choking, receiving continence monitoring and oxygen therapy had their care needs assessed and reviewed. We also restricted any new admissions to the home. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made in some areas and we have removed the imposed conditions from the provider’s registration. We have found the provider continued to remain in breach of regulations.

This service has been in Special Measures since 12 July 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to risk management and the quality and assurance systems in place at this inspection.

We have issued the provider with a warning notice because the quality and assurance systems in place did not allow for effective oversight of people at risk of choking.

We have made a recommendation under the effective key question that the provider reviews the care records in place to make sure they reflect the current care and support needs of people.

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.