Morton Close

Updated 2 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Morton Close is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Morton Close is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

Following our last inspection the registered manager left the service. A new manager was recruited and came in to post in February 2023. At the time of this inspection the new manager had left the service and there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 18 July 2023 and finished on 27 July 2023. We visited the home on 18 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We reviewed the provider’s action plan. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time with people in the communal areas observing the care and support provided by staff. We spoke with 6 people who used the service and 2 relatives about their experience of the care provided. We gathered feedback from 6 staff members including care staff, senior care staff and the operations manager. We reviewed a range of records. This included 5 people’s care records and 9 people's medicines records. We looked at 2 staff recruitment files, staff rotas and other records relating to staff training. We reviewed a variety of records relating to the management of the service, including policies, procedures and quality assurance records.

Updated 2 September 2023

About the service

Morton Close is a residential care home providing personal care and accommodation up to a maximum of 40 people. At the time of our inspection there were 16 people using the service. The care home accommodates people in one adapted building with bedrooms on the ground and second floor and the main communal areas on the third floor.

People’s experience of using this service and what we found

Since our last inspection the provider had invested significantly in many improvements which reduced risks and helped improve the quality of care people received. Despite this there were some areas where further improvements were required.

Medicines were not always managed safely which placed people at increased risk of harm.

There was no registered manager. A registered manager was required to ensure staff received appropriate direction and support and to ensure improvements were embedded, sustained and further developed.

The provider was not always proactive in identifying and driving improvements and learning lessons. We made a recommendation about this. It was too early to assess the sustained effectiveness of the revised care records and audit processes because work to improve these areas was still ongoing. However, the actions taken so far showed improvements were being made.

Overall, there were enough staff to meet people’s needs and keep them safe. On some occasions the provider’s assessed safe staffing levels had not been met due to staff sickness. We made a recommendation about this. Staff received training to carry out their roles. Robust recruitment processes were in place.

People’s personal emergency evacuation plans not always clear and personalised. We made a recommendation about this. Significant improvements to the safety and cleanliness of the environment and management of infection had been made since the last inspection.

Further improvements were needed to ensure safeguarding incidents and CQC notifications were consistently identified and reported by staff. We made a recommendation about this. People felt safe. Risks were assessed and staff put measures in place to reduce risks to people’s safety, health and wellbeing. The analysis and recording of accidents and incidents had improved.

Staff were caring and treated people with respect and dignity. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives were involved in making decisions about their care. Further work was required to ensure people’s feedback was consistently acted upon.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 18 January 2023) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made. However, the provider remained in breach of 1 regulation.

This service has been in Special Measures since 18 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 8 and 17 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, dignity and respect, staffing and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Morton Close on our website at www.cqc.org.uk.

Enforcement

We have identified a continued breach in relation to the management of medicines. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.