Morton Manor

Morton Manor is a nursing home providing personal and nursing care to up to 30 people. At the time of our inspection there were 19 people using the service. The service provides support to people under and over 65 with varying needs, including some people living with dementia. Accommodation is within 2 adapted buildings, a large house and a cottage.

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

The provider did not always promote a safe environment which put service users at risk of potential injury. We identified some infection prevention and control concerns which put people and staff at risk of cross infections.

Medicines were not always safely managed. We found concerns in relation to the storage and safe administration of medicines.

Care plans did not always contain information that was important and relevant. This meant staff did not have the appropriate information and guidance to ensure they were supporting people in line with their needs and preferences.

Risk assessments did not provide sufficient guidance for staff to know how to mitigate risk and keep people who were supported safe.

There were some management systems in place to assess, monitor and improve the quality-of-service people received. However, these were not always effective and did not identify the shortfalls we found during inspection.

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.

Staff were observed to be kind and caring. People told us they were happy with the support they were receiving.

Staff were safely recruited. The provider carried out the required checks on newly appointed staff before they started working at the home. Staff had received training that was appropriate to their role and the people they were supporting.

People had access to healthcare services and staff worked proactively with other organisations.

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

This service was registered with us on 5 June 2019 when it changed provider. The last focused inspection (published 31 January 2022) meant the service did not receive an overall rating 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 the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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 have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. The provider has taken action to mitigate risks following our inspection.

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.

Morton Manor is a residential care home providing personal and nursing care for up to 30 people aged 65 and over in two buildings, the main house and The Cottage. At the time of this inspection the service was supporting 19 people.

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

In the absence of a registered manager, the provider had not consistently maintained effective oversight of the safety and quality of the service.

Routine daily safety checks had not consistently been completed. Infection prevention and control risks were not always assessed and mitigated.

Quality and safety audits had not always identified or prioritised risks to people’s safety.

The provider had action plans in place for environmental improvements. However, the work had not been prioritised and there were no clear timescales for the work to be carried out.

People were treated well by staff and did not have to wait to have their needs and wishes met. Medicines were managed in a safe way and people received their medicines as prescribed.

The provider worked well with external agencies and there were enough safely recruited and trained staff to meet people’s needs.

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 requires improvement (published 3 March 2021).

Why we inspected

We received concerns in relation to management of the service, infection prevention and control arrangements, staffing levels and recruitment procedures. 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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Morton Manor is a residential care home providing personal and nursing care to 20 people aged 65 and over at the time of the inspection. The care home can accommodate 26 people in two buildings, the main house and the bungalow.

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

Staff had access to personal protective equipment and followed national guidance around donning and doffing. However, we found staff were not consistently wearing masks in a safe manner. The service was clean and there were effective cleaning schedules in place being followed by the housekeeping staff. A refurbishment programme had been carried out. The service had not allowed visitors inside the building since March 2020. We have made a recommendation about visiting.

Quality monitoring arrangements were in place. Arrangements were in place to manage people’s medicines however documentation for ‘as required’ medicines was not always in place.

The risks to people’s care were assessed and measures were in place to mitigate these risks. Environmental factors had not always been risk assessed.

People were not consistently supported with adequate numbers of staff. Some staff had not consistently received training for their roles. New staff were recruited safely.

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.

Staff knew how to keep people safe from abuse and were confident to raise concerns with the registered manager or external agencies. When required, notifications had been completed to inform us of events and incidents.

People and their relatives knew how to raise a complaint and would feel confident to do so if needed.

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 the service under the previous provider was requires improvement, published on 11 September 2018.

Why we inspected

We received concerns in relation to staffing and environment. As a result, we undertook a focussed inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

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 coronavirus and other infection outbreaks effectively.

Follow Up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.