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Inspection Summary


Overall summary & rating

Good

Updated 29 September 2018

The inspection took place on 14 May 2018 and was unannounced. At the last inspection we rated the home overall as ‘Requires Improvement.’ There were also regulatory breaches in safe care and treatment, staffing, dignity and respect and good governance. At this inspection we found the required improvements had been made. The new overall rating for this service is now ‘Good’ and within the responsive section we found the home to have achieved a rating of ‘Outstanding’.

Morton Grange 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. The home specialises in supporting people living with dementia and providing end of life care. The home is divided into three separate parts each with its own distinct name, we have referred to these within the report as units. Each unit provided accommodation and communal spaces in relation to a lounge area and dining space. One unit had an enclosed garden which was accessible to people from all three units. The home benefits from large open grounds, which had a range of shelters and people were encouraged to enjoy the surroundings. The service was registered to provide accommodation for up to 66 people. At the time of our inspection 52 people were using the service.

Morton Grange has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager and provider had been in post for over 15 years, which this demonstrated stability and consistency to the service.

The provider ensured that each individuals needs were identified and considered in the programme of events. People were supported to have value based activities and to explore new areas of interest. The large outdoor spaces which were available people embraced and had also been encouraged to access events outside the home. The community was encouraged to be part of the home and strong links had been made to engage with different generations. Some events were planned; however, there was the enthusiasm for spontaneous events to capture the moment or an opportunity.

The care plans contained details of people’s needs, history and preferences which enabled the care to be delivered in a person centred way. Consideration was made in how information was provided to people and a range of methods were used to support ways to communicate. People’s cultural needs were considered and respected. Religious opportunities were available for people to maintain their spiritual connections. Information was provided in a range of formats and the areas of the environment considered to support people living with dementia when moving around the home.

People were integral to the decision making and this included all aspects of their care requirements. When people neared the end of their life the home ensured that all aspects and considerations were available to make this time reflective of the individuals wishes. Staff had received training and the home had achieved the platinum award in the National Gold Standard Framework for End of Life Care.

A monthly newsletter shared information which included activities and how people or relatives could be included in the home. This also reflected initiatives the home had taken part in and the benefits this had provided to people.

The provider had increased the staffing levels to provide a good level of support, which ensured people’s needs were met. Staff had received the necessary training in how to protect people from potential harm and knew how to report any concerns.

When risks had been identified these had

Inspection areas

Safe

Good

Updated 29 September 2018

The service was safe

The provider had increased the staffing levels to provide a good level of support, which ensured people�s needs were met. Any risks had been identified and guidance provided. People had received training on how to protect people from harm.

Medicines were managed safely and the home protected people from the risk of infection. Lessons had been learned and communicated effectively to support and drive improvements.

Effective

Good

Updated 29 September 2018

The service was effective

People were supported to make decisions when they lacked the capacity.

New and existing staff members both received a wide range of training and support which supported and benefited their roles.

People were able to choose their meals and their dietary requirements were supported. People�s health care was supported to enable them to maintain their wellbeing. The environment of the home was inclusive and supported people to orientate within their environment.

Caring

Good

Updated 29 September 2018

The service was caring

People had established positive relationships with staff and felt they received kind and inclusive care.

Consideration was made for people�s privacy and their dignity was maintained. When people required the support of an advocate this was available.

Responsive

Outstanding

Updated 29 September 2018

The service was very responsive

People�s life experience was used to provide opportunities to receive activities and attend events. They were able to continue to use their own skills and embrace new interests. Care plans were inclusive and reflected people�s preferences, cultural needs and methods of communication.

When people required care at the end of their lives this was offered by staff who had the skills and understanding to ensure this was done in accordance with people�s choices.

Complaints had been addressed to provide people with an apology and outcome. Compliments had been received and shared with the staff to foster best practice.

Well-led

Good

Updated 29 September 2018

The service was well led

People without exception enjoyed the atmosphere of the home. Staff felt supported by the provider and registered manager. People, relatives and staff had all been involved in the developments of the home to drive improvements.

Audits had been used to reflect on the quality of the home and had been part of changes made to enhance the environment and people�s experience.

The registered manager understood their registration with us and completed notifications and displayed their rating as required. Partnerships had been developed to provide additional input in respect of health care and community links.