Moss View

Updated 18 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector and one medicines inspector.

Service and service type

Moss View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We contacted the local authority safeguarding team for feedback. We used all of this information to formulate our ‘planning tool’ and plan our inspection.

During the inspection

We spoke with two people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the manager, deputy manager senior care workers, domestic staff and registered nurses.

We reviewed a range of records. This included nine people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at risk assessments and quality assurance records. We left our contact details for staff to call us after the inspection if they wished to provide more feedback.

Updated 18 September 2021

About the service

Moss View is a care home providing personal and nursing care to 50 people aged 65 and over at the time of the inspection. The service can support up to 75 people.

People’s experience of using this service and what we found

Records in relation to people’s care and treatment were not always completed or well organised which put people at risk of unsafe care. People requiring specific diets, such as diabetic or high protein did not always have food and fluid charts in place. There were mixed responses with regards to staffing. All of the staff we spoke with told us they felt there was not enough of them to support people safely. Our assessment of rotas and dependency tools showed staffing levels appeared to be consistent across the units, however following our inspection and feedback with the provider, this was being re-assessed. Medication was mostly managed safely. We did feedback some issues which were rectified at the time of our inspection. People had risk assessments in place which covered most aspects of their care and support. The service had enough PPE to keep people safe. Incidents and accidents were well recorded and analysed. Relatives we spoke with said they mostly felt their family member were safe and well cared for. One person said, “They take great care of [person].”

There was no registered manager in post at the time of our inspection. Audits and checks on the provision of care were in place, however they required improving as they did not always highlight areas for improvement within care plans. Staff told us they felt unappreciated by the senior managers of the home. They also said they felt unsupported. One staff member said, “We are never listened to”. The provider has since taken action to improve this. People were routinely asked for feedback about the home.

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 requires improvement. (Published July 2019) The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

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 prompted in part due to concerns received about staffing and medications. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The provider has since taken action to mitigate these risks and has contacted us separately to confirm this. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for moss view on our website at www.cqc.org.uk.

Enforcement - For enforcement decisions taken during the period that the ‘COVID-19 – Enforcement principles and decision-making framework’ applies, add the following paragraph: We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to governance. This was because records were not clear or organised and could put people at risk of harm.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.