We carried out a review of the data available to us about The Moorings on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Moorings, you can give feedback on this service.
About the service
The Moorings is a residential care home providing personal care for up to three people with learning disabilities. At the time of the inspection one person was living there. The service is an extended and adapted bungalow in a residential area. People lived on the ground floor which provided level access to all communal areas including an outdoor garden.
People’s experience of using this service and what we found
Right Support
People were supported to have choice and to be as independent as possible. Staff knew people well and focussed on helping people achieve the daily activities that they enjoyed. This included regular trips out and taking part in activities. People could choose where to spend their time, either in their bedrooms, the communal area of the service or an outdoor garden area. We saw people’s bedrooms which had personal items including photographs, pictures, music and televisions all of which meant people felt comfortable and able to do what they wanted in their rooms. People were supported to make daily choices about what jewellery to wear, what clothes they wanted to wear and what food and drink to have. Risk assessments were in place to safeguard people as they did the activities that they enjoyed.
Right Care
People’s equality and diversity were celebrated at the service by staff. Staff understood people’s cultural needs and supported people for example, arranging contact with local faith and support groups in the local community. Staff knew the best way to communicate with people. Usually communication was either verbal or through observing people’s reactions to suggestions or actions. People and staff used Makaton, a form of sign language, to communicate some things for example, emotions, whether people were happy or sad. Staff then responded appropriately. We spent time observing interactions between people and staff and these were caring and supportive, providing people with enough time to make their feelings or thoughts known.
Right culture
The provider sought advice from professionals and specialists to help support people and to meet their health and social care needs. Staff had been trained in safeguarding, diabetes, epilepsy and autism. Staff responded to people’s daily needs and to their wishes to be involved in activities away from the service. People were supported to spend time with their families and loved ones either on trips out for the day and sometimes for weekend visits.
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.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. This was a focussed inspection, we looked at our safe, effective and well-led domains. This was in response to information received about the management of risks at the service, the levels of training provided to staff and the management of the service.
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.
The inspection was unannounced.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Moorings is a residential care home providing personal care for up to three people with learning disabilities. At the time of inspection, one person was living there.
The Moorings is situated in Pevensey in East Sussex. People’s bedrooms were located on the ground floor, while the provider lived upstairs. The person had a large bedroom and other communal areas such as an open plan lounge, dining room and kitchen to relax in. There was also a wheelchair accessible garden.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff knew the person and risks to their health and wellbeing well. The person had detailed assessments to identify areas of risk and we observed staff working in ways that met this guidance. Staff were recruited safely and there was always enough to meet the person’s needs and allow flexibility to meet their preferences and choices. Staff had all received safeguarding training and understood signs a person could be at risk of harm and what actions to take. The person had complex health needs and received their medicines safely from well trained and competent staff.
Staff told us training was regular and gave them the skills and knowledge they needed to meet the person’s needs. One staff member said, “The provider is a real training advocate. They ask us what we want to do and send us on it.” The person’s personal and support needs were holistically viewed. Their health, nutrition and hydration needs continued to be met through input from a variety of health and social care professionals.
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.
We observed that the person was happy and familiar with staff that supported them and everyone we spoke to felt staff were kind and caring. A relative said, "It's a very good service, I would definitely recommend it and wouldn't change it for anything." Staff demonstrated passion for what they did and had built strong relationships with the person. One staff member said, “I love it here and love working with (person’s name).” We saw that the person’s privacy, dignity and independence was always promoted and respected.
The person was supported by staff that knew them very well. A relative said, "Staff really know my relatives needs and what they like and dislike." The person was supported to do activities of their choice every day and had complete flexibility due to good staffing levels and accessible transport. They were continually supported to maintain relationships with those they cared about. Staff knew the person’s communication needs and understood how to meet their preferences. Although there had been no complaints since the previous inspection, the process to raise concerns was regularly reviewed.
Everyone we spoke to was complimentary about the provider and the way the service was run. It was clear that the provider knew the person and their needs well and the person enjoyed being with them. There was a good quality assurance system that ensured oversight of the person and the service. The provider was part of several initiatives that promoted person centred practice, which they continually discussed with the staff team. Staff told us they felt part of a strong, inclusive team that centred around the person.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 7 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Moorings is a service registered to accommodate a maximum of three people who require support with their personal care. The service specialises in supporting adults with learning disabilities and complex needs including epilepsy and challenging behaviour. On the day of the inspection there was one person using the service. The accommodation was provided on the ground floor of a fully adapted detached bungalow. There was level access to the side of the property garden and decking which is located to the rear of the property.
At the last inspection on 14 July 2014 the service was rated Good. At this inspection we found the service remained Good.
A relative a social care professional involved in the person’s care and staff spoke highly of the service and felt that it was well-led. Without exception everyone told us the care provided had a positive impact on people. One staff member told us “You can’t get care like this anywhere else it is totally unique”. Another staff member told us “I love it here. It’s nice to be able to say to people I love my job. (Providers name) is very efficient, they are always one step ahead and has everything covered. The care is absolutely 100% good; I’m not just saying that I really mean it”. Written feedback from a social care professional included ‘I have been impressed by the manager’s in-depth knowledge of the person and holistic support – managing complex health care and community links, activities etc. There’s good communication with family members and they are responsive’. A relative commented “I wouldn’t want to move them or for them to be moved. They are really happy there and I am really pleased. I don’t have to worry anymore.
The person remained to be supported by kind and caring staff who knew them well. The person was observed to be relaxed with staff. They were seen to be happy and comfortable with the support provided and staff were kind and caring in their approach. A relative told us “All the staff are great. They know what they (the person) wants and what they need”.
The person’s individual needs continued to be assessed and planned for. They were still supported to participate in wide range of activities in line with their personal preferences and to maintain their independence. A relative told us “They are happy there. They go out every day”.
The person continued to be supported to maintain good health, access health care services and supported to maintain a varied and nutritious diet.
The person continued to receive safe support in a secure environment. A relative told us “My relative is very safe. The staff are good they make sure they don't fall out of bed or walk out on their own”. The person remained protected from the risk of abuse because staff understood how to identify and report it. The person was still supported to get their medicines safely and when they needed them.
Staff received the training and support they needed to undertake their roles and meet people’s specialist needs. A relative told us “The staff know what support they need and how to help them. (Provider’s name) and the staff are very good with them“.
Staffing levels had been maintained. There were sufficient number of skilled staff on duty to meet the person’s needs and provide effective care. The person received one to one or two to one staff support at all times.
The provider was aware of their legal responsibilities and kept up to date with good practice. Accident and incidents continued to be recorded and monitored to identify trends and themes. Records had been audited and were gaps had been identified action had been taken to rectify this.
Further information is in the detailed findings below.
This inspection took place on 24 February 2015 and was unannounced.
The Moorings is registered to provide accommodation and nursing care for a maximum of three adults with profound and multiple learning disabilities, including autism, cerebral palsy, Down Syndrome and epilepsy and is managed by the provider, who is a Learning Disability Nurse.
People’s care needs were complex with limited or no verbal communication. They also required support with mobility. Two young adults, one male, one female, lived in the home full time and one person used the home for respite care on alternate weekends. All three people had their own personalised rooms, with ensuite facilities, and there were two bathrooms.
The home is not required to have a registered manager but the registered provider is a ‘registered person’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the home is run.
The provider had taken steps to make sure that people were safeguarded from abuse and protected from risk of harm. Relatives told us they felt their loved ones were safe. One person told us, “He’s very happy there. He’s very important to them.” People were protected from harm as risks to their safety were assessed and managed appropriately. People, their families or representatives were involved as far as possible in their assessments and action to minimise risk was agreed with them. One relative said, “We are involved in all discussions about important issues, such as the cameras.”
The provider operated safe recruitment procedures which included carrying out legally required checks on every applicant to make sure they were suitable to work with the people who lived at this home. Staff told us there was a good atmosphere and staff worked as a team. One staff told us, “It’s very demanding but very rewarding.” We saw there were enough staff to care for people and keep them safe.
Regular health and safety checks of the home’s environment were made and any works required noted for attention by the maintenance man. Fire equipment and emergency lights were regularly serviced and tested.
Medicines were stored, administered and recorded by suitably trained staff. Records were comprehensive and up to date and there was a robust policy for “as required” (PRN) medicines.
Hygiene and infection control were maintained by cleaning schedules and hand-washing practices.
Staff were provided with suitable training to enable them to carry out their roles. Staff told us, “We have all of the essential training and specific training for the complex needs of the people here.”
Staff understood their roles and responsibilities. They told us they felt, “Listened to.” Staff received regular supervision and appraisal to make sure they were competent to deliver appropriate care and treatment.
Where people lacked the mental capacity to make decisions the manager was guided by the principles of the Mental Capacity Act (MCA) 2005 to ensure any decisions were made in the person’s best interests. Whilst no-one living at the home was currently subject to a Deprivation of Liberty Safeguard DoLS, we found that the manager understood when an application should be made and how to submit one and was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The manager had submitted applications to the Local Authority in relation to DoLS and these were being processed.
Staff received MCA and DoLS training to make sure they knew how to protect people’s rights. Staff understood the importance of obtaining consent from people and carrying out best interest meetings before care or treatment was provided.
People were provided with a varied and nutritious diet which was included food which the people enjoyed. Staff were both patient and used specially adapted cutlery and crockery to support people to eat as independently as possible.
People’s health care needs were managed by staff together with involvement from a variety of external healthcare professionals.
People were treated with respect, kindness and compassion. Each person had an individual care plan. These were continually reviewed and updated to make sure all their needs were understood by staff. Relative’s told us they had been consulted about how they wanted their loved one’s care to be delivered.
People were treated with dignity and respect. Their privacy was protected wherever possible and staff spoke to people, not over them. Staff knew people well. They were calm and patient with people; they communicated effectively and responded quickly.
Care plans were regularly reviewed with the person’s relatives, health professionals and, if relevant, social homes to make sure they were up to date and reflected their individual preferences, health needs, interests and aspirations. There were a wide variety of outside activities arranged to involve people in the wider community.
There was a policy and procedure in place for dealing with complaints. Relatives we spoke with told us they hadn’t needed to complain but knew what to do if they did. They also said, “The manager is very approachable” and they would be “Confident that any concerns raised would be dealt with.”
There were effective systems in place to review the quality of all aspects of the home regularly. Relatives’ surveys and regular ‘resident and relatives’ meetings gave people the opportunity to comment on the quality of the home. People were listened to and their views were taken into account in the way the home was run. The manager and staff worked hard to enable people to live happy, interesting and fulfilling lives despite their complex and extensive needs.
We saw good leadership by example during our inspection and a culture of doing everything possible to enhance the quality of life for people.
Staff said they asked people for their consent before they provided support. We found evidence that people were encouraged to make choices and observed staff treat people with respect and dignity.
We examined two care plans and found that they were based on people's individual support needs. The care workers we spoke with demonstrated a good understanding of people's needs and how these were met.
The systems for the management of medicines were appropriate.
We found the premises were secure, and appropriate health and safety procedures were in place.
We reviewed the staff rotas and staffing levels. We found that the shift patterns and number of care workers and nurses on each shift were appropriate.
Complaints policies and procedures were in place, and staff said people were encouraged to discuss the support they received.
Staff told us that The Moorings was a good place to work. One commented, "It's a lovely place to work". Another said, "It's a very nice job, I am learning here". We saw that staff interacted positively with the person living there.
We found The Moorings to be clean, comfortable and maintained to a high standard. As a bungalow, it had level access throughout and the open plan lounge, kitchen and dining area was well arranged. The outdoor space included a large deck. It was evident that the environment met the needs of people who use the service.