Background to this inspection
Updated
4 July 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.
Inspection team
The inspection was carried out by 2 inspectors 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
Morley Manor 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. Morley Manor 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.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced.
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. The provider had been 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 spoke with 7 people who used the service and 5 relatives about their experience of the care provided. We gathered feedback from 9 staff members including the nominated individual, director, supporting manager from the providers other home and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records, this included 3 peoples care plans, 5 staff files in relation to recruitment and people’s medicines records. Following the site visit, we reviewed further information and evidence from the provider. This included policies, training records, meeting minutes and auditing information.
Updated
4 July 2023
About the service
Morley Manor is a residential care home providing personal care for to up to 33 people. At the time of our inspection there were 22 people using the service. The service provides support to people with a range of needs, including those living with dementia.
People’s experience of using this service and what we found
There was no effective leadership or oversight in place to monitor the quality of care delivered. The providers action plan did not support improvements at the service. Quality assurance systems had failed to identify the areas of concern we highlighted during our inspection around management of medicines, recruitment and provision of safe care.
Medicines were not always administered safely as prescribed. The provider had not always followed their medicines management policy to ensure staff administering medicines were competent.
People’s risks were not always effectively managed. Risk assessments and guidance in place for people at risk of choking was not always followed by staff. Staff deployment was not effective to ensure people's needs were met in a timely way.
People were supported to make decisions about their care. People living at the home had appropriate DoLS and decision specific best interest decisions in place. Care plans and risk assessments reflected people’s needs. Care plans were reviewed regularly to ensure accurate records of people's care was maintained. Relatives were informed about and involved as and when people's care needs changed.
People were supported to have enough to eat and drink. Relatives were positive about the care their loved ones received. People and relatives told us staff were kind and responded well to people's needs and preferences. The provider worked with a variety of health care professionals to help improve and meet people's care needs.
We observed staff interactions between people to be positive and respectful. Communication tools were used to communicate with people where needed.
People were supported to have maximum choice and control of their lives and staff supported /did 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 and update
The last rating for this service was inadequate (published 28 September 2022) and there was 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.
At our last inspection we recommended that the provider reviews their application of the principles of The Mental Capacity Act 2005 (MCA) and applies relevant best practice guidance. At this inspection we found the provider had made improvements in relation to the principles of MCA.
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.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to medicines, risk management, staffing, recruitment 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 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.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.