Moorhouse Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

People, relatives and staff felt the manager had made positive changes since starting her role at the service. We were able to observe the improvements made since our last inspection, but more time was needed to ensure they were fully embedded. The atmosphere and ethos within the service was positive and compassionate, with staff clear on their roles and responsibilities. Staff felt able to raise concerns in the knowledge they would be looked in to, but also knew how to whistle blow if needed. The governance systems within the service drove improvement of quality in the care delivered to people. There was a strong emphasis on working closely with the local community and other stakeholders to ensure people had enriched lives.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

On the whole, staff felt positive about the service and shared the same ethos in providing compassionate and quality care. One staff member told us, “I have worked here a while and this home has a homely feel. People are cared for with compassion and comfort always in mind.” Another staff member said, “We are clear in the direction we are going.” A further staff member told us, “'Everyone has a positive attitude. I am enjoying the work.”

The service had made improvements since our last inspection. However, further time was required to ensure the new processes and procedures had fully embedded, as well as the successful transition from nursing to solely residential care. There were regular staff meetings in which staff were encouraged to give suggestions and raise concerns in order to encourage improvement in the service.

The manager ensured she was accessible to people, relatives and staff. They told us, “I’ve held lots of meetings. I gave relatives my mobile number and email and made myself available.” Staff supported this view. When we asked one staff member what was working well at the service, the replied, “Teamwork. We all work together. Even the manager; she listens to the care staff. She will support them when needed.' Another staff member told us the manager was visible 'on the floor' and they saw the manager regularly. They went on to say the manager kept staff up-to-date and encouraged staff to contribute their views to meetings.

The manager operated an open-door policy in which staff felt able to approach her with issues. A recent staff survey demonstrated this, with the score for the statement ‘The Home Manager operates an open door policy’ being high.

There was a transparent culture within the service in which staff felt comfortable in being able to speak up if necessary. One staff member told us, “I wouldn’t worry about whistleblowing. I feel confident if I had a worry, [the manager] would deal with it. Or I know I can go to [the operations manager]. Everyone is given the opportunity to speak up.” Another staff member told us they would contact the local authority safeguarding team or CQC if they needed to whistle blow. The clinical lead told us, “The staff now feel if they have a concern, they can voice it and be heard.'

A whistleblowing policy was in place for staff. This gave them information of who they could contact if they felt their concerns were not being taken seriously or resolved by the management team.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider had recently made the decision to no longer provide nursing care within the service and to become exclusively residential. The manager had informed staff and relatives of the change and were working with the local authority and health services commissioners to support those requiring nursing care to identify alternative services. The operations manager told us, “We can’t retain or recruit nurses, so we needed to change. Relatives received the news about removing nursing element positively. It was well received. There may be three people who need to leave.”

There were robust governance arrangements in place which checked all aspects of the service. Audits were completed by maintenance staff, the manager and the provider. Actions identified were addressed and improvements made as a result. Lessons were learnt from accidents and incidents as well as complaints. The provider had addressed all of the shortfalls. The provider, senior management and the manager had developed a project plan for the service. This was an overarching plan for the immediate, medium, and long-term actions and improvements. This included sourcing additional training in and services for dementia which we observed had been booked.

The service worked closely with the local community and other stakeholders to enhance people’s lives. One person said, “The activities are great – we have a singer this afternoon so I’ll go down for that. She is so nice. She comes and chats with me. It’s lovely. It makes you feel part of it.” Another person told us, “There’s always something going on.” A relative told us, “Every day they are doing something with them. Someone is coming in to sing today and on Friday there is someone coming in to play the flute.” Another relative said, “Recently a new activities manager has been appointed and this has bought a fresh approach with lots of more new events been introduced which has certainly enhanced my mother’s quality of life.”

Staff were able to demonstrate the close links they had made with the local community and stakeholders. The manager told us, “We have made a great effort to connect with our local community who have been very supportive of Moorhouse. We have every intention of embedding ourselves deeply in the community and working with everyone we can to increase the choices and wellbeing of our residents. We really have so much going on and it will grow so that our residents can live their best lives.” The activities coordinator at the service told us, “'We have a lot of musical events; we have got a singer coming this afternoon and we have got animals coming tomorrow. We have talks from museums and things like that. Everybody is different. They all have different capabilities and interests so we are not going to lump everyone together. I try and persuade people to come out but some people prefer to stay in their rooms. I try and spend as much time with them as I can.' There were also close links with medical professionals involved in the service. For example, the clinical lead said, “We have a great relationship now with our GP.”

The manager was approached by a lecturer at a local college who teaches level 3 in Health and Social care . As a result of a discussion, the manager plans to offer work placements, as her “pupils are the care staff of the future.” However, we had received feedback from the local authority that at times there was a slow response from the manager to safeguarding concerns, as well as a reluctance to work with commissioners to review people’s needs. Much of this related to the process around removing the nursing care from the service and as such would not have a long term impact on the service.

The provider and manager had good links with local communities. School children visited people and the local scout group had held a carol service in the home at Christmas. Some people had been set up with pen pals with children with a learning disability. They plan to start holding coffee mornings at the service and invite people from the surrounding area. Input from health and social care professionals involved the speech and language therapy team, tissue viability nurses and GP. The service used a Medicare system which resulted in a quicker response to incidents or medication requests. They had developed a partnership with a dementia team to look at internal furnishings and how they could involve people living at the service.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.