McMorrow House

McMorrow House is a residential care home providing accommodation and personal care for up to 13 people with mental health conditions. At the time of the inspection 10 people were receiving support. The property is a large two storey building with individual bedrooms and communal living areas with a large garden to the rear of the property. The service also provides 2 flats for people to live independently within the property. The service offers 24-hour support.

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

We saw excellent examples of how people were supported to remain safe at times when they were at significant risk. People used words like ‘life saving’ and ‘above and beyond’ to describe the support they received. Through robust safeguarding training and comprehensive policies, staff were able to keep people safe at times when their lives were in crisis.

The provider's robust recruitment processes for staff, along with the matching process, had exceptionally positive outcomes for people. Medicines were managed safely and people were supported to be as independent as possible with their medicines.

There was an open and transparent culture in relation to accidents and incidents and they were used as opportunities to learn and lessen risks. A comprehensive and empathic understanding of people who lived at McMorrow House, and their health conditions, enabled the registered manager to seek bespoke training to prevent incidents occurring.

People were supported to live healthier and more active lives in line with their wants, goals and aims. People had overcome challenges with addiction and self-harm and had embraced the support offered to them by the provider to achieve ambitions such as education and employment opportunities.

People's needs were met through robust assessments and support planning. We saw outstanding examples of when the service had worked with other healthcare professionals to achieve positive outcomes for people and to improve their quality of life. Staff had excellent knowledge and skills and the training made available to them ensured people's needs were extremely well met.

People were always supported to have maximum choice and control of their lives and staff always supported them in the least restrictive way possible and in their best interests; the policies and systems in the service always supported this practice.

People with complex health needs received care and support which was positive, consistent, and which improved their quality of life. The provider’s ethos was nothing was ‘off limits’ and people were creatively supported to overcome barriers to achieve their aims and goals. Person centred care planning fully explored and mitigated risks through expert assessment and training.

The registered manager planned and promoted holistic, person-centred, high-quality care resulting in excellent outcomes for people. The values and culture embedded in the service ensured people were at the heart of the care and support they received. Staff told us they received excellent support from management and that they were extremely proud to work for the service. There was a very open and transparent culture and people were empowered to voice their opinions. Without exception, people told us the service was well-managed.

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 requires improvement (published 24 August 2023) and there were breaches of regulation. 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 and the provider was no longer in breach of regulations.

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. The overall rating for the service has changed from requires improvement to outstanding based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

McMorrow House is a residential care home providing accommodation and personal care for up to 13 people with mental health conditions. At the time of the inspection 10 people were receiving support. The property is a large two storey building with individual bedrooms and communal living areas with a large garden to the rear of the property. The service offers 24-hour support.

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

The provider did not always follow their own policies and procedures. Where risks had been identified the registered manager had amended and updated policies to ensure people remained safe however the provider chose not to adhere to them.

The provider was not clear on their roles and responsibilities within the organisation. This meant a culture had started to develop where people and staff were uncomfortable formally raising concerns. Staff were unclear about hierarchy of the management structure which resulted in conflicting guidance and instructions being received.

The registered manager had followed their duty of candour and reported relevant safeguarding events appropriately, however at times these were challenged by the provider resulting in the provider not assessing the risks highlighted or following actions implemented.

Care plans and risk assessment were person centred and reflected people’s personal goals and ambitions. Staff were knowledgeable about people needs and had built trusting relationships. Staff were supported with effective guidance, training and development to support people in the manner they chose.

Everyone we spoke with at the home praised the staff and registered manager. People told us they felt safe and ‘at home’ since living at McMorrow House.

Medicines were administered and stored safely. People were supported to remain as independent as possible with their medicines and were actively encouraged to participate in planning of their care and medicine reviews.

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.

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

Rating at last inspection

The last rating for this service was good (published 31 May 2019).

Why we inspected

We received concerns in relation to the provider and the culture they created for people and staff as well as adherence to GDPR guidelines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report. The provider took taken action to ensure the risks identified have been mitigated and will work towards ensuring these changes long term.

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

Enforcement

We have identified breaches in relation to management and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service: People living at McMorrow House received a good quality support service. Staff worked to ensure people were active partners in their care and that they were actively supported to make decisions about all aspects of their lives.

People felt safe and staff understood how to report any concerns. Risks were assessed, and risk reduction plans put in place to support people to lead the lives they wanted in as safe a way as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were involved in developing support plans and had access to their care records which they could openly challenge if they felt the need to do so. Some information in relation to how people expressed distress or anxiety was limited so we have made a recommendation about this.

Medicines were managed safely. Improvements had been made following a medicine error to minimise the risk of reoccurrence. No one came to any harm as a result of this error.

Safe recruitment practices were followed. Staff were matched with people so they had shared interests and hobbies. There was a culture of supporting people to have active lives, where they were motivated to follow their interests and become active members of the community. It was acknowledgement that this supported people to maintain positive mental health and lead happy and healthy lives.

People were supported with attending health appointments, where needed and were involved in decisions about diet and nutrition. Menu planning, shopping and cooking was actively encouraged so people could learn and develop skills with the aim of moving to a more independent environment when people felt ready to do so.

The provider worked in partnership with Rotherham college so staff attended in-depth training courses to ensure they had the necessary knowledge and skills to support people appropriately. Staff said they felt well supported by the registered manager and felt able to speak with them about anything.

The management of the service was open and transparent. We were told everyone worked well as a team. Audits were completed, and action plans developed to continuously improve the service. A new manager was being inducted so they could become the registered manager which would allow the current registered manager to have a more strategic role as they were also the provider.

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

Rating at last inspection: This was the providers first inspection since registration.

Why we inspected: This was a scheduled inspection based on the date the location was first registered with the Commission.

Follow up: We will continue to monitor the service and complete a further inspection in line with the rating of good. If any information of concern is received, we may inspect sooner.