The Moreton Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People and visitors told us they liked the staff, comments included, “Staff are kind, I like them here,” “Knowledgeable and professional” and “I like it here.” Some comments were not very positive, but there were reasons due to the person’s anxiety and these were shared with the registered manager.

Staff were seen to respond to people with kindness, but we saw staff were rushed. Staff told us they cared about people but felt they were too busy and were not able to spend the time with people that they needed.
Respect and dignity were not always considered, we saw that staff did not always identify and respond promptly when people required personal care. One person was seen to be sat in stained clothing in the communal lounge for some time, another had bare feet that were cold and discoloured. Staff had not responded until it was brought to their attention. We observed some staff were kind and would sit with people, but several staff appeared task focused and did not always interact with people effectively. For people who were having 1 to 1 support, we saw that not all staff providing this, interacted with the person unless the person became distressed. We observed limited interaction with some people who were sat in the communal lounge all day. This pertains to two units, Maple and Ash specifically and they are the most complex units.

However, we did get positive feedback from families regarding the kindness of staff and the way they supported people. Comments included, “Very kind, seem to be able to understand people well” and “Lovely staff, kind and courteous.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.
Care plans identified people's emotional wellbeing needs, social interests, communication preferences and preferred routines. Daily records, however focused mostly on physical care tasks with limited evidence of how emotional wellbeing, social engagement or personal goals/outcomes were being supported and evaluated.
For some younger people, their mental health was their primary reason for living at The Moreton Centre and whilst their mental health needs were identified within care plans there were no clear outcomes recorded as to promoting life skills in preparation for them to move on. There was also limited reflection in their daily care records on their mental health. This increased the risk of task-based care rather than care centred on the whole person. We did, however observe staff using people's preferred names and supporting them according to their individual preferences. Family involvement was encouraged and visitors were seen to visit their loved ones at times that suited them. People were supported to participate in activities based on their interests when they wished to.

The provider did not always promote people's independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.
People and relatives told us decisions affecting people were not always discussed or consulted on. Visitors and people told us that changes within the home, including environmental arrangements, were often directed by the management team and that people had limited influence over decisions. For example, on one unit, the quiet lounge, had had, all the soft furnishings, including, curtains, television, radio, books removed due to the actions of one person, leaving it a cold and uninviting room which was now seldom used by other people. Families and other people had not been consulted regarding this. We also noted that one person had had some of their belongings moved to an area outside the unit they lived in and had restricted access to their belongings. Whilst the reason for this were explained, there was no best interest meeting held or recorded that this was in the person’s best interest. We were also told a decision had been made to reduce monies taken out whilst shopping to prevent a person buying clothes. Whilst this may be in the person’s best interest, we could not find this reflected within in their care plan or risk assessment.
Staff were observed respecting people's day-to-day choices and supporting them in accordance with their preferences. Where staff could not support their choice or wishes, staff dealt with this in a respectful and pleasant way.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

We mostly saw people being supported when they required it, for example, helping them to activities, to their room or to the bathroom and assisting them to eat and drink. We have already reported on staffing deployment impacting on some peoples’ needs not being met under safe staffing. However, staff did react promptly to peoples’ anxiety and prevented escalation of anxieties as they occurred.

Staff also reacted to people’s health needs to ensure appropriate healthcare was sought in a timely way. Relatives told us, “The staff pick up when my loved one is unwell or not quite right and let me know and keep me informed” and “Excellent staff, really knowledgeable and caring.”

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Feedback from staff was not positive relating to the support they received from the management team and their approach to their welfare and wellbeing. Some staff told us that they had felt unsupported and not listened to, specifically regarding staff rotas and staff delegation. Whilst we received minutes of staff meetings, they did not list staff attendance or feedback from staff to the agenda list which included staff rota changes. Staff also said, “I feel that we are not listened to, which doesn’t make me feel very valued” and “Staff morale is low and staff don’t feel supported, we are all worried about our jobs if we grumble.” Feedback received was shared with the provider regarding staff feeling undervalued and unsupported.

The staff team, however were extremely supportive of each other, which was very important to them.