Moorland Gardens Care 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. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to safeguarding. The provider had not always supported people in line with the Mental Capacity Act (MCA).
 

This service scored 58 (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 not always effectively assessed people's needs. People's care plans had not effectively assessed or provided enough guidance for known risks or support needs such as when people were known to experience emotional distress. Although there were systems in place to review people's care plans, this had not always resulted in accurate and consistent information within them. For example, one person’s care plan had not clearly stated if they needed emergency rescue medicines for a known health condition.

The provider was responsive to our feedback, and we observed they had planned and taken action to review people's care plans.

The provider used tools, such as the Waterlow assessment, to assess the risk of skin tissue breakdown and Malnutrition Universal Screening Tools (MUST) were completed to identify and act in response to people’s health risks.

The provider worked across teams and services to support people. Records showed people had seen health professionals such as tissue viability nurses for skin health. For example, staff sought advice from NHS 111 or diabetes specialists, and adjusted monitoring as advised in relation to people’s glucose readings. Relatives told us, “The nurse was extremely supportive at a CHC meeting the home set up.” And “If there are any changes in my loved one’s health a nurse will always ring and let me know.”

Overall, people were supported to live healthier lives through regular monitoring of their health needs and timely involvement of external professionals. Staff carried out routine checks, and escalated concerns appropriately, helping to maintain people’s wellbeing. A relative said, “The staff assist [relative] with eating and inform me they eat well. I trust the home to look after my loved one.”

We could not be assured the service always effectively monitored people's care and treatment to continuously improve it. We identified incidents that were not always documented appropriately, and safeguarding concerns were not always escalated and reported appropriately. The provider's systems to monitor the environment had not always been effective in managing safety risks. This increased the risks to people's safety and wellbeing and the provider's ability to promote consistently positive outcomes.

 

People had not always been supported in line with the Mental Capacity Act (MCA) 2005. Where there were known risks relating to people’s ability to consent to care, the provider had not acted in accordance with the MCA to complete mental capacity assessments or to ensure that any decisions made on behalf of people were the least restrictive and in their best interests. Records showed people had experienced restraint during the delivery of personal care, or, for example, had been supported back into bed when they did not want to be, without this being assessed, planned for, or justified in line with MCA requirements. This increased the risk that people’s rights were not consistently upheld.
However, other mental capacity assessments, such as those relating to people’s ability to consent to take medicines had been completed appropriately and in line with the MCA.
Following concerns identified during the inspection, the provider completed additional assessments, best interest decisions and staff training to support the application of MCA requirements.