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. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Moor View is a nursing home which accommodates 17 people, living with complex poor mental health in one main two-story adapted building with two adjacent bungalows. The home has garden areas.

There was a registered manager at the home, although they were not present during the inspection because they were on leave. 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 last inspection in October 2015, we rated the home as 'good'. At the time of this inspection, the home was in the process of changing from a residential care home, to a service which provided rehabilitation and re-ablement. There had also been a period of unsettled management and we found there were weaknesses in how the home was being run. We identified three breaches in the regulations, relating to regulation 12 safe care and treatment, regulation 13 safeguarding people from abuse and improper treatment, and regulation 17 good governance.

Recruitment of staff was in progress and there were satisfactory procedures in place to make sure staff were suitably checked before working with vulnerable people.

Risk assessments were not always clear or well organised in people's support plans and some risks were not adequately assessed. Records to show premises and equipment had been checked for safety were not robustly in place. Accidents and incidents were not thoroughly recorded or concerns appropriately reported.

Support for staff to carry out their roles was in place, but not always consistent or sufficient for all staff. Staffing levels were satisfactory to meet people's physical needs, but not to support them with skills in independence or activities they wished to do outside the home.

People were mostly supported to have maximum control and choice over their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice, and although staff understood legislation around people's mental capacity, documentation for consent and decision making was not robust.

Staff had a kind and caring approach and showed respect when interacting with people and good regard for people's privacy and dignity. Staff had discussions with people about their daily routine, although there was limited evidence of people being involved in their own care planning or discussing future goals.

Systems and processes for assessing and monitoring the quality of the provision, including identifying risk, were weak. Audits were not robust and there was little evidence of management oversight of the service.

The overall rating for this service is ‘Inadequate’ and the service therefore is in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. Th

The inspection took place on 8th October 2015 and was unannounced. The service was last inspected in November 2013 and met with legal requirements.

Moor View is a nursing home in Halifax which specialises in supporting people with complex mental health problems. Many of the people who live at Moor View have previously been residents within long stay hospitals.

Moor View comprises of two main rehabilitation units; an 11 bedded unit for people who are more dependent on staff, on the day of inspection it had occupancy of nine. There is a second four bedded unit for people with more independent living skills with an occupancy of three. There are also two bungalows for people who are able to live independently with a view to moving into the community and supported living. There were two people in the bungalow on the day of inspection. Moor view has a total of 17 beds and on the day of inspection there were 14 people living there.

There was a registered manager in place. 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.

There was a strong and clear person centred culture in the service. People who lived there were treated as unique individuals. The vision at Moor View was that ‘recovery is possible for every individual and that everyone has a right to participate fully in society’. This was shared by all the management team and staff. This enabled Moor View to provide a therapeutic programme of rehabilitation based on the principles of recovery and increased individuality and autonomy. This holistic approach enabled Moor View to help individuals develop skills and promote social functioning and self-ability within daily living skills. Management and staff worked together to maximise peoples experiences by promoting evidence based person centred care. For example the use of the ‘Recovery Star’ model (a recognised mental health tool) was used by the service to complete the assessments and plan support.

People living at the home felt there was enough staff to support them and they felt safe. We also found there were sufficient staff on duty at all times to safely support people with their needs.

People said their views were listened to and they were able to make changes and suggestions about the way the home was run. For example people told us they were involved in choosing what to grow in their own allotment and what activities to do on an evening.

People were well supported to develop independence in their daily lives. Staff worked hard supporting them with daily living skills. People were involved in planning the care and support they needed. The care plan records were informative and clearly explained what support people needed. People were cared for by staff with awareness and understanding of their mental health needs. Staff received training in a range of mental health topics to support them in their work.

People were involved in monitoring the quality of the care they received. This was evidenced in a number of ways for example care plans clearly showed people were involved in planning what support they felt they needed.

People spoke highly about the qualities of the registered manager and their supportive approach with everyone. Staff also said they felt supported in their roles and they could always make their views known to the registered manager.

The home was run in an open and inclusive way. People who lived at the home were central to how it was run. For example, their views were included in how the home was decorated and maintained.

People were also able to go to the office at any time, make themselves a drink there, and talk with the staff.

Systems were in place which continuously assessed and monitored the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well and that management took steps to learn from such events and put measures in place which meant they were less likely to happen again.

At the time of our inspection, there were eleven people living at Moor View. We saw that before people received any care or treatment they were asked for their consent and care staff acted in accordance with their wishes. This meant peoples rights were protected because staff understood the need for people give consent to care and treatment.

We found that the staff team at Moor View provided effective support to people who used the service. They demonstrated good knowledge of people's complex needs and spoke about them in a caring and non-judgemental way.

People were protected against the risks associated with medicines because the provider

had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

We spoke with one person who told us they were happy living at Moor View. We observed positive interaction between staff and people using the service. Staff were polite and responded promptly to people's requests for support. The home was clean and people had their own belongings in their bedroom. People had personalised their bedroom to their individual liking.

We looked at a sample of care records and saw that people were involved in making decisions about their care. We also saw evidence of regular care reviews and action taken by staff when a person's needs had changed.