Moorgate Croft

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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 a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The management team told us they placed a lot of emphasis on creating culture of honesty, openness, and learning, rather than blame. Staff confirmed this. They told us they were encouraged to raise concerns and were confident they would be listened to and supported. Staff were aware of changes made to the service as a result of lessons learned from incidents, accidents and concerns.

The registered manager was fully aware of their duty of candour and was open and honest with people when things went wrong.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services. For example, the electronic care planning system was used to generate key information to accompany people to hospital and care planning documentation was kept under review to make sure up to date information was passed on to partner professionals.

We saw evidence of the team providing stability and personalised support in complex and sensitive circumstances. For instance, the team implemented a structured transition plan for a person, who required a tailored approach to help them to settle into the home and feel safe. The plan included making sure the person was provided with consistent keyworkers to help them build trust, and carefully adapted communication so they felt heard and in control. A personalised activities plan was created, based on the person’s interests and the team had worked well with psychiatric services. This approach had helped the person to settle well.

People and their relatives confirmed they had positive experiences when moving into the home. For instance, a relative said, “[Staff] understand [person’s] needs. [Person] is anxious, and they [staff] weighed [person] up straight away.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe. Typical of people’s responses, one person said. “I do feel safe because [staff] look after you,” and a relative said, “[My family member] is safe and we know this because of the interaction of staff, and what [my family member] says.”

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.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

The service supported people to effectively manage known risks. Areas of risks identified for people were assessed and planned for. People’s care plans included best practice guidance for staff to follow. We saw evidence of the team using an effective risk reduction model that had resulted in exceptionally good, measurable, and sustained improvements in people’s safety. There were instances where significant reductions in the number of falls people experienced had led to real and meaningful improvements in their confidence, quality of life and relationships.

People and those close to them felt risks were well managed without overly restricting people’s freedom. For instance, 1 person said, “I feel safe. I have been here for quite a while and I have had no falls or accidents” When telling us about how staff supported them with risk, another person said, “Yes, [staff] discuss things with me.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Where equipment was used, this was regularly serviced, and checks were carried out to ensure safety. Regular checks and maintenance were carried out to make sure the environment was safe, and meetings held included discussion of potential risks and how they could be managed. Maintenance records were up to date and any actions addressed in a timely way.

Care plans were in place to help make sure safe care was provided and people had personal emergency evacuation plans [PEEPS] which were kept under review. A PEEP is a plan for a person who may need assistance, for instance, a person with impaired mobility, to evacuate a building or reach a place of safety in the event of an emergency.

Everyone said the environment was well maintained. For instance, 1 person said, “My bedroom is lovely.” One relative said, “Everything is well maintained. It has been decorated. All the equipment [my family member] works well. [The staff] are very aware of [my family member’s] needs.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

New staff received an induction and shadowed existing staff. The provider used a dependency tool to identify the numbers of staff required throughout the day and

night. Staff received training and support to carry out their roles effectively. Staff told us they felt supported and said they worked well together as a team.

Staff were recruited safely. The provider completed pre-employment checks such as references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

Overall, we received positive feedback about the staffing of the service. One person said, “When I call for [staff] they come quickly.” Another person said, “I do think there are enough staff. They are very kind.” Relatives’ comments included, “The staff have time to spend with the residents,” [My family member] is safe because the staff check on them. I have no worries about any of the staff,” and “When [my family member] rings their buzzer [staff] come quickly.” Another relative said, “Oh yes, [person] is definitely well cared for. The staff are well trained.” They went on to say that in the daytime staff responded quickly but it took longer at night. Another relative felt people would benefit from having more staff to support them at teatime. We shared this feedback with the registered manager who undertook to include this feedback as part of their regular review of mealtime support.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. We carried out a tour of the home and found it to be clean and well maintained. The management team undertook regular infection prevention and control (IPC) audits to make sure staff were working within IPC good practice guidance. Personal protective equipment, such as gloves and aprons (PPE) was available throughout the home and kept well stocked. We saw staff used PPE appropriately.

People told us there was a good standard of cleanliness in the home. People’s comments included, “Cleanliness is excellent. They are on top of everything” and “My room is cleaned every day.” Relatives also provided positive feedback. Their comments included, “[Person’s] room is always clean” and “The house keeper is brilliant. [House keeper] is hands on and will contact us if there is anything. [My family member’s] room is always good and fresh”.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Processes were in place to make sure people received their medicines as prescribed. Medicines were administered and stored safely. Some people were prescribed medicines on an ‘as and when’ required basis, often referred to as PRN. Protocols were in place to help make sure people received their PRN medicines appropriately.

People told us they received their medicines on time and we saw staff made sure people were provided with drinks with their medicines. One person said, “I get my medication regular and [staff] stay with me while I take it.” Another person said, “[Staff] check on me in the night and bring me a pain killer when I need one.” One person’s relative also said, “[My family member] gets their medicine and [staff] discuss [my family member’s] medication and things with us.”