This inspection took place on 28 and 29 September 2016. The inspection was unannounced. The service was last inspected in October 2013, when it was found non-compliant because care plans and risk assessments were not always up to date or consistent. A desk-top review was subsequently completed in February 2014 when the service attained compliance in these areas.

Moorlands Rest Home is a care home without nursing that provides care for up to 12 people with needs relating to old age. Twenty four hour support is provided by a small regular team of staff.

A registered manager was in place as required in the service. 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.

People felt safe and well cared for by the staff and that they were consulted and involved in decisions about their care. They confirmed their views about the service had been sought and felt the registered manager was accessible.

Most health and safety issues were effectively monitored and servicing and safety checks had mostly been carried out regularly. The registered manager acted promptly following the inspection to address identified issues. These included consulting the fire authority regarding the existing fire evacuation plans and placing an order for a suitable commode pot sterilizer. Individual guidelines were needed for the administration of PRN (as required) medicines, to ensure consistent and appropriate administration.

Staff understood their role in keeping people safe from harm and knew how to recognise and report any concerns about abuse. They were confident management would respond appropriately and act on anything they reported.

People's rights and freedom were protected by staff who supported people’s rights and dignity in the course of their work. Staff took time with people and didn’t rush them. They engaged people in conversation in the course of supporting them and encouraged group discussions. Staff were familiar with people’s needs as well as their preferences and sought consent from them before providing care.

Some changes had been made to the garden in response to people's needs. These enabled them to enjoy as much freedom as possible and provided opportunities for exercise. The environment was bright and clean and people’s bedrooms were personalised with their own belongings and pictures.

A range of activities and entertainment was provided which people enjoyed. However, there remained some room for further development in this area.

Care plans were supported by relevant risk assessments and other information about people’s history, likes and dislikes. External health professionals were consulted where appropriate. People’s health needs were monitored and met in consultation with external medical services. Nutritional needs were risk assessed and people’s intake was monitored where necessary. For example, the advice of a dietitian had been sought appropriately.

The interactions we saw showed staff and people had positive relationships and people were encouraged to make decisions and choices about their daily lives. We saw instances of humour and smiling between people and staff in the course of discussions activities and interactions.

The staff recruitment process was robust and appropriate checks took place. Recruitment files contained the required evidence of the process. Staff received an induction based on the national Care Certificate competencies. They received ongoing training through the provider’s rolling programme, mainly through external courses. Staff received regular supervision, attended team meetings and annual appraisals. They felt positive and enthusiastic.

The service was subject to a range of audits by the registered manager, to

We saw from records that people’s consent had been sought for their care plan and other elements of their support. People also told us their consent was sought in the course of staff providing care.

Care plans and risk assessments were in place. However, some of the information contained within them was not up to date and identified issues were not always carried through into the care plans. However, people told us they were happy with the care and support they received from staff and the staff were aware of individual’s needs. One of the people we spoke with told us "they are wonderful here” and another said “the staff are friendly and I get on with all of them”.

The home had an appropriate system to manage and record people’s medication and staff had been trained on medication management.

The provider had an appropriate system in place for the recruitment and induction of new staff and maintained records of the required checks.

The manager had systems to monitor and review the performance of the home and carried out an annual survey of the views of the people supported, their relatives and visiting professionals. The feedback from the recent survey was very positive.

The people in the home and their representatives were happy with the care provided by the staff. Several positive comments were made about the care provided by the home. People told us that they could make choices in their day-to-day lives and that their views were listened to by staff. We saw evidence of individual wishes and preferences documented within care files. We saw staff enabling people to make choices. Some care records would have benefitted from additional detail. People enjoyed the activities and the food provided for them.

The staff had received appropriate training and support in relation to their work. The manager had made appropriate notifications to the Care Quality Commission of reportable events in the home.

The people living in the home that we spoke with were happy with the care and support they received. They were positive about the quality of the staff working in the home. They were settled and felt safe and said that their care needs were met. They enjoyed the food the home provided and had access to various activities. People had been told about the home’s complaints procedure if they had any concerns.