The service was inspected on 31 July 2018 and was an announced inspection. Moor 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 home provides accommodation for up to thirteen people with a learning or physical disability. On the day of our inspection there were ten people using the service.

Moor View has three locations across the same site. The largest Tyne House service, and two smaller services of Moor View and West Cottage that have all been adapted to meet the needs of the people living there. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had an office at Tyne House but was a regular presence at all three services on site.

Moor View was last inspected by CQC in February 2016 when the service was rated as Good. At this inspection we found the service remained Good and met all the fundamental standards we inspected against.

We saw that medicines were not being stored according to NICE and Royal Pharmaceutical Society guidelines. Guidance stated that medicines stored at room temperature should be at 25 degrees or below to maximise their effectiveness. On the last three weeks of recording prior to our visit, the temperature had exceeded 25 degrees each day and on one day had been 33 degrees. The registered manager had already raised this as an issue with the provider via her quality checks.

We discussed that risk assessments should ensure that any restrictions put in place such as straps for wheelchairs should be fully documented with the risk identified and measures to reduce the impact. Other risk assessments around the environment were in place.

We saw people’s medicines were administered to them in a safe and timely way by competent staff.

Family members told us they felt their relatives were safe and there were sufficient staff to meet people's needs. Following recruitment, there was now a stable staff team and we saw that people were supported consistently.

Checks were made to ensure the environment and equipment was well maintained and safe.

The records we viewed and interviews with staff showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: wheelchair services and other specialist healthcare professionals.

Staff told us they felt well supported in their role; they received an induction and training. Staff members spoke of good team work.

People had choice and control of their lives and staff supported them in the least restrictive way; the policies and systems in the service supported this practice.

Staff were aware of the importance of supporting people with good nutrition and hydration. Relatives we spoke with told us people with specialist diets were well supported. We saw that people were encouraged to shop for and prepare their own meals with staff support where they were able.

People had access to healthcare services, in order to promote their physical and mental health. We saw that people were supported to have annual health checks and to attend health screening appointments.

The premises were homely and suitable for people's nee

We visited Moor View on 23 February and 6 March 2016 and this was an unannounced inspection. This meant the provider and staff did not know we were going to visit.

Moor View had recently extended to add an additional unit and new people had moved into the service. Since, August 2015 Moor View has comprised of three care homes located on the site of the Percy Hedley College and School grounds. The service provides care for up to 13 people with physical disabilities, who may also have learning disabilities. One home is an adapted and extended two storey house; one home is a semi-detached house: and the other is a flat, which is located in the school building.

The registered manager has been in post since January 2013. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

At the time of the inspection 11 people lived in the service and we met nine of the people who used the service. People had limited verbal communication but were able to let us know that they were very happy with the service and found it met their needs.

We found that the registered manager and staff consistently ensured people were supported to lead an independent lifestyle. Staff readily identified triggers that would lead people to become distressed or indicate that their health was deteriorating.

Staff were aware of how to respect people’s privacy and dignity. We saw that staff supported people to make choices and decisions.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans.

There were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.

We saw that people were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as working with people who have learning disabilities.

The staff we spoke with understood the requirements of the Mental Capacity Act 2005 and were ensuring that where appropriate this legislation was used.

Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential.

People and the staff we spoke with told us that there were enough staff on duty. We found there were sufficient staff on duty to meet people’s needs.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

We reviewed the systems for the management of medicines and found that people received their medicines safely.

We saw that the registered manager had an effective system in place for dealing with people’s concerns and complaints. We found that people felt confident that staff would respond and take action to support them.

We found that the building was very clean and well-maintai

Since our last inspection the provider had implemented more robust systems to audit and check the quality of care records, including medication records.

We found that care was planned and delivered in a way that ensured people's safety and welfare. The two people we spoke with said they liked staying at the service. They said the food was good and there were plenty of activities and things to do. We found

people were given appropriate information and were involved in making decisions about their care and treatment.

Comments included:

"I'm happy here."

"Everybody is kind to me."

“The food is good."

"There's plenty to do."

We found staff received professional development and they were well trained to help them understand the care and support needs of the people they worked with. People who used the service told us staff were very kind and caring.

We saw the provider had systems in place to gather feedback from people, who used the service, and to regularly assess and monitor the quality of service people received.

This review was carried out to check improvements made to the service's procedures for record keeping. We did not speak directly with users of the service on this occasion.

A high proportion of people who used the service were unable to express their views verbally on the care they received because of the nature of their condition. However, some people were able to use gestures and signs to indicate they were happy and felt safe at Moor View and Tyne House.

People told us there was a feeling of equality between staff and themselves. They told us that there was an absence of the “them and us” mentality. One person said, “the staff eat with the people who live here. I like that” and “staff have time to sit down with me and socialise. I think that’s part of the job.” We also approached relatives about the care and support their family members received. One relative said, “I would rate the home as excellent” and “they promote a shared home atmosphere that X loves. They foster this very nice approach which makes X content.” Another relative told us, “staff are friendly and caring. They don’t just see themselves as doing a job. They have a rapport with the people living here.”

Staff told us they enjoyed working at Moor View and Tyne House. One member of staff said, “it’s like a big family here.”

We found people were asked to give their consent before receiving care. Family members told us they had been involved in developing their relative’s support plans. Staff gave examples of choices people were supported to make every day.

People had their needs assessed and this information was used to develop personalised care plans. One person we spoke with said, ‘It is good living here.’ One family member commented that the service was, “Very friendly and welcoming.”

The provider had developed procedures to ensure people received their medication in a timely manner. Medication was only administered by staff who had completed relevant training.

The provider had systems in place to ensure staff were suitable to work with vulnerable people.

We found systems in place to audit care records were not effective in identifying issues and ensuring appropriate action was taken to address these issues.

People were given information about how to complain. Staff told us people knew how to complain and would let them know if they were unhappy.