We carried out an unannounced inspection of the service on 11 August 2016.

Moorlands Care Home provides accommodation and nursing for up to 40 people who have nursing or dementia care needs. There were 34 people living in the home at the time of our inspection.

On the day of our inspection there was not 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.

People felt safe and trusted the staff who cared for them. Staff knew how to keep people safe from harm. People had access to information on how to keep them safe. Individual risks were identified and managed. Risks to people’s health and welfare were assessed and action was taken to minimise any risk. Sufficient staff were on duty at the time of our visit. Safe recruitment had taken place to ensure staff were suitable to care for people. People received their medicine in a safe and timely manner and as prescribed.

People needs were met by skilled and knowledgeable staff. Staff had opportunities to improve and develop their skills and knowledge. People were involved in decisions about their care and welfare. Staff had received training about the Mental capacity Act (MCA) and the MCA was adhered to. People received sufficient to eat and drink. Where supported appropriately to receive a balanced diet. People were supported and had access to other healthcare professionals to ensure they maintained their health and wellbeing.

People were encouraged to form and develop caring relationships, but people felt staff needed to spend a little more time with them. People were supported to express their views and were actively involved with decisions about their care and support. People were involved with their care planning and had access to advocacy services if needed. People were treated with dignity and respect.

People felt their needs were responded to appropriately and in a timely manner. People were encouraged to make choices and have their preferences adhered to. People were supported to participate in activities that were meaningful and of interest to them. There was a complaint procedure available and accessible for people should they wish to raise a concern. People were aware how to make a complaint in line with the provider’s policy and producers.

The service had been without a registered manager since August 2015. The manager had not submitted an application to CQC at the time of our inspection. People felt there had been some improvement to the home since the new manager was appointed. Effective systems were in place to monitor and assess the quality of the service.

This inspection took place on 8 December 2014 and was unannounced. When we last inspected the service in September 2013. The provider was meeting all expectations.

Moorlands Care Home provides accommodation and nursing for up to 40 people who have nursing or dementia care needs. There were 34 people living in the home at the time of our inspection.

The registered manager was present on the day of our visit. 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.

We found people felt safe with the staff that cared for them. The provider had suitable arrangements to keep people safe. We saw appropriate information was available to ensure people and their relatives were aware of what abuse was and how to stop abuse from happening. All risks to safety were minimised. We observed the staff on duty were task orientated and did not fully interact with people. The provider had systems in place to address any shortfalls in staff numbers, but they were not always effective. People received their medicines as prescribed and they were stored and monitored correctly

People told us that they had plenty to eat and drink and we saw some people were supported at mealtimes, but not always in a dignified manner. We saw that the home involved outside professionals in people’s care as appropriate and, the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of liberty safeguards were adhered to.

Staff received training, supervision and appraisals, which ensured they developed the right skills and knowledge suitable to their role.

Most people and their relatives told us staff were very caring and respectful. They were encouraged to form relationships within the home and with others. People were encouraged to be independent where possible and fully supported by staff when needed.

People were not proactively supported to express their views and be involved with decisions relating to their care. Staff communicated effectively, but did not always spend quality time with people.

People did not always participate in activities that were relevant to their interests and hobbies.

We found risk assessments were in place and care plan reviews had been completed, but the records were not always up to date.

We found quality assurance systems were in place. People, their relatives and staff told us the culture of the home was open and transparent. People told us they felt the person in charge was approachable. Staff generally felt supported. People and their relatives were able to voice their concerns and raise complaints, which we found were dealt with in a timely manner and in line with the provider’s policies and procedures.

During our inspection we spoke with three people using the service, three relatives and three members of staff. We visited the home and observed people using the service. We looked at people’s care files to assess how well care was delivered. One relative we spoke with told us they had moved their relative from another home and was happy with the care provided. Their relative had "a lovely room with views across the grounds to the moorlands". They told us they visited regularly and always found people being well care for by staff.

We found that people’s privacy, dignity and independence were respected and that care and treatment was planned and delivered to ensure people's safety and welfare.

Another relative told us the standards of care had noticeably improved recently. They told us that "the home was not plush but that they were more interested in the quality of care and kindness". Another relative told us the family had looked at a number of homes and had chosen this one because "staff seemed to be kind to everyone". They told us their relative had recently moved to the home and they were happy with the care so far. They told us had minor issues but accepted that living in a care home was different to living in your own home.

We found that people who used the service were protected from the risk of abuse and the risk of inadequate nutrition and dehydration. The provider had a safe system in place for managing the administration of medicines.

We visited the location to carry out a responsive review as we had received some concerning information regarding a number of issues. These issues were staff being bullied by other staff with no response from the manager when this issue was raised. Other issues raised were the security code for the front door being known by relatives of people who use services, insufficient levels of staffing, a member of staff sleeping while on duty and poor care being provided.

We spoke with one person who uses services. They said, “I’ve been looked after all right. I get everything I need.” They also said, “The home is clean and well looked after.” They said, “There are enough staff at the moment." They also said, “I’ve talked about my care plans and I’ve completed surveys. I go straight to the office if I’ve got any problems.” They told us they hadn’t seen any issues of concern and were happy with how other people who use services were cared for by staff.

We found that people who use services experienced care, treatment and support that met their needs. They were protected from the risk of infection and were also protected against the risks of unsafe or unsuitable premises.

We also found that there were enough qualified, skilled and experienced staff to meet people’s needs. People were cared for by staff who were supported to deliver care and treatment safely and the provider had an effective system to regularly monitor the quality of service that people receive.