Moorgate Hollow

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 outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.
 

This service scored 92 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s needs were assessed accurately and care was delivered in line with people’s care plans and risk assessments. The provider used music therapy, structured nutritional support and emotional encouragement to support people and meet their needs. This reflected a holistic and strengths-based approach to assessing needs and providing care and support. The provider was able to demonstrate where care and support had maximised people’s potential, improved their quality of life and supported their autonomy. Family members told us about how members of staff talked to people and assessed their needs, “ “On days I visit [relative], occasionally they might be anxious. [Staff] know how to bring [relative] round, [staff] get to [relative’s] level, talk about family, things that are important to [relative] to alleviate their anxiety. That shows they know [relative] well. Last week I took photos in, [staff] put them on the wall and they talk to [relative] about them, it’s just lovely.” Other family members told us, “When you first go in you have an in-depth discussion about [family member’s] needs.” and “When [relative] first went in, it was all new to us, you learn from them. We learn from [staff] how to deal with [family member], it’s excellent.”

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards. For example, the provider had worked with a person and developed a personalised rehabilitation plan to support them to regain movement, rebuild strength, improve appetite, reconnect with the person’s love of music and increase their personal motivation. Positive outcomes for the person included a positive gain in weight, increased strength, independent mobility, increased social engagement and participation in social activities. The provider had maximised the person’s potential, improved their quality of life and supported their autonomy and independence.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff were deployed effectively to meet people’s needs. Information in people’s care plans was clear and ensured care and support was effective and met people’s needs.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. For example, the provider supported a person who was initially non-compliant with care, medication, and social engagement. This made integration into the home environment difficult. A tailored behavioural support plan was developed in collaboration with health professionals and the staff team implemented a consistent, structured routine which ensured the person felt safe and in control. A gradual approach to medication compliance was introduced which enabled the person to take ownership of their care decisions. Close collaboration with external mental health teams ensured the person’s progress was monitored and adapted in real time. Outcomes for the person were improved and the person became fully compliant with medication and care routines. The person actively participated in social activities and formed positive relationships with staff and fellow residents. External professionals praised the leadership and governance of the service in how this complex package of care and support had been managed.

The provider monitored all people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. The provider implemented personalised and specific packages of support which improved people’s outcomes. There was evidence people had gained weight positively, re-engaged in social activities and developed skills and confidence to be actively involved in their own care decisions. People’s care plans and risk assessments were reviewed regularly and appropriate changes made in response to changes and improvements to people’s outcomes. People’s families were kept informed and updated about their outcomes. One relative told us, “I go at least three times a week and I’m always updated then. If there are any concerns they contact me straight away. [Staff] thought [person’s] cough wasn’t good last week and they called the doctor. They keep me fully informed.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People capacity was assessed and the principles of the Mental Capacity Act 2005 were followed. People and their family members were involved best interest decisions which evidenced that the least restrictive option was agreed. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.