This inspection took place on 20 and 25 June 2018 and was unannounced.

At the last inspection in October 2017 the provider was found to be in breach of three regulations (10, 12 and 17) in relation to dignity and respect, safe care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of: Is the service safe? Is the service caring? And is the service well led? to at least good. This inspection was carried out to check that improvements to meet legal requirements had been made. We found that sufficient improvement had been made at this inspection to say that the breaches of regulation had been met.

Following the last inspection the provider had enlisted various internal resources to support the service to improve systems and process. This had included appointing a new manager and two deputy managers. The area manager was now acting as Clinical Lead for the service. At this inspection the provider was still working to embed improvements in some areas. The manager was recruiting to and supporting the current staff team whilst encouraging positive change and ensuring staff understood their responsibilities. The provider was committed to making further improvements and we were confident this would happen.

The Moors Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The Moors Care Centre provides nursing and personal care for up to 70 people. The service supports older people and people over the age of 18, who may be living with dementia, mental health problems, physical disabilities or sensory impairment. At the time of our inspection there were 63 people who used the service.

The accommodation for people was located over three floors and in four named areas. Bilsdale was located on the ground floor, Eskdale was on the middle floor and Bishopdale and Nettledale were on the top floor.

The provider did not have a registered manager in post. 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. The manager submitted their application to register with CQC following our inspection. They made themselves available during the inspection and assisted us with finding documentation and other information we required.

People told us they received their medicines on time and as prescribed. However, we found that the arrangements for storage and administration of medicines could be improved. Excessive heat in the service meant medicines were not always stored at the optimum temperature and some mistakes were being made with the new medicine system. Medicine management practices were being reviewed by the manager. We have made a recommendation about this in our report.

The quality of care being delivered had improved, but there was further work needed to ensure changes in care and support were documented and reviewed in a timely manner. We have made a recommendation about this in the report.

There was an audit process in place, which the manager and staff were completing. However, this was not always effective as the latest medicine and care plan audits had not picked up the concerns above. The manager supported the staff team and ensured that people who used the service were able to make suggestions and raise concerns. We saw that the manager was making progress in improving the quality of the service and this was recognised by staff, people and relatives who spoke with us.

Improvements had been ma

This inspection took place on 5 October 2017 and was unannounced.

The Moors Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection

The Moors Care Centre accommodates 70 people, including older people and people over the age of 18, who may be living with dementia, mental health problems, physical disabilities or sensory impairment. At the time of our inspection there were 58 people who used the service. The building has a basement floor containing utility facilities and a cinema. There are a further three floors offering single room accommodation to people who used the service. The top three floors all have various communal spaces including lounges and dining rooms. The ground floor level also has a café facility and a hairdressing salon.

We carried out an unannounced comprehensive inspection of this service on 2 May 2017. After that inspection we received concerns in relation to the care of a person who used the service. The concerns raised included allegations of abuse, poor care and poor management of the service. As a result we undertook a focused inspection to look into these concerns. This report only covers our findings in relation to the key questions of: is the service safe, is the service caring and is the service well-led? You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for (The Moors Care Centre) on our website at www.cqc.org.uk

The provider is required to have a registered manager for the service and at the time of our inspection there was a registered manager in post. 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. The registered manager was not at the service for this inspection. The deputy manager assisted us throughout the inspection.

Safeguarding policy and procedures were in place and staff had received training. We found that although the service usually reported safeguarding alerts appropriately, there were occasions where incidents had not been reported internally and to relevant external authorities / bodies including CQC.

The assessment, monitoring and mitigation of risk towards people who used the service with regard to accidents/incidents, medicine management, food and hydration, falls, oral care and pressure care was not robust. This meant people’s health and safety was at potential risk of harm.

On-going internal and external investigations had shown that people were not always treated with respect and dignity and evidence had been found of poor care practices by certain staff.

The system used to determine the number of staff and range of skills needed to meet the needs of the people who used the service and keep them safe at all times was not effective. Staffing levels and skill mix had not been reviewed consistently. We asked the provider to send us an up to date review, which they did in the agreed timescale. Staff recruitment was carried out safely.

Care files were completed in an inconsistent manner, with some documentation not being completed and care plans not always up to date. This meant staff did not always have appropriate records to show how they were meeting people’s needs. However, people who spoke with us said they felt safe and well cared for. They took part in activities and had access to church services.

The provider’s complaints policy and procedure was not being followed consistently. Some relatives felt their concerns were being ignored or not answered robustly.

The management within the service did not

This inspection took place on 2 May 2017 and was unannounced. The service registered with the Care Quality Commission (CQC) in June 2016 and this was the first inspection.

The Moors Care Centre is a care home with nursing provision for up to 70 people. The service provides accommodation and support to older people and people over the age of 18, who may be living with dementia, mental health problems, physical disabilities or sensory impairment. At the time of our inspection there were 55 people who used the service. The building is new and purpose built with a basement floor containing utility facilities and a cinema and a further three floors offering single room accommodation to people who use the service. The top three floors all have various communal spaces including lounges and dining rooms. The ground floor level also has a café facility and a hairdressing salon. At the front of the service is a car park for visitors and staff and there is disabled access into the building.

The registered provider is required to have a registered manager in post and there was a registered manager at this service. 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.

People told us they felt safe and were well cared for. The registered provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way. Medicine management practices were being reviewed by the registered manager and action was taken to ensure medicines were given safely and as prescribed by people’s GPs.

People that used the service were supported by qualified and competent staff that were regularly supervised and who were to receive their first appraisal in 2017 regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes, but the consistency of how this was recorded was variable. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

Staff were knowledgeable about people’s individual care needs and care plans were person centred and detailed. There was a range of social activities available and people’s spiritual needs were met through in-house services and one-to-one pastoral care when requested.

People told us that the service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people and this was checked during the registered provider visits. People and staff were asked for their views and their suggestions were used to continuously improve the service.