Background to this inspection
Updated
21 December 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and a specialist advisor who was a learning disability nurse.
Service and service type
Mortimer House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed all information available to us including notifications and any concerns raised with us.
During the inspection
We spoke with the registered manager and six members of staff, including a registered nurse. People in the home were not able to give us verbal feedback about their experiences; however, we made observations of their care and support throughout the day.
We reviewed a range of records including five people’s care records, medication records and documents relating to quality and safety monitoring.
After the inspection
We sought further information from the registered manager and obtained feedback from the local authority.
Updated
21 December 2019
About the service
Mortimer House is a residential care home providing personal and nursing care to 20 people with learning difficulties and/or dementia. The service can support up to 28 people.
The care home accommodates up to 28 people in one adapted building, over two floors.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 28 people. 20 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and being close to local amenities.
People’s experience of using this service and what we found
People received care from staff who were kind and caring in their approach. There was a high use of agency staff, however the impact of this was mitigated by the service using the same agency staff whenever this was possible. The service was actively recruiting to vacant posts. Our observations showed that staff treated people with respect. People received support in line with their identified needs at key times such as meal times.
Staff reported feeling happy with their training and support and told us staff morale was improving. They told us communication was getting better and that they had handovers at each shift to discuss key information.
Staff worked with health and social care professionals to ensure people’s needs were met. Community health professionals held a clinic at the home once a fortnight to review and advise on people’s nutritional and eating and drinking needs. There had been some concerns around how well staff were following these guidelines; however shortly after the inspection, we received feedback that this was improving. During our inspection we observed a meal time when people received good support.
Staff knew and understood people’s individual needs well and told us about their likes and preferences. Care plans were written in a person centred manner and had been recently updated. People had opportunity to take part in activities both on an individual basis and in group settings such as arts and crafts.
We saw improvements in the home since the last inspection and it being rated as requires improvement. The registered manager was being supported by the organisation to make improvements. There was an action plan in place. The provider had been working with the local authority safeguarding team due to concerns raised by health professionals. We made one recommendation under Well Led to continue to review record keeping, due to inconsistencies we found in some people’s care plans.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of registering the right support.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk