Background to this inspection
Updated
5 October 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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by one inspector.
Service and service type
Mulberry House 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. Mulberry House 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 a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 12 July 2023.
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 and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
During our inspection we spoke with 3 people who lived at the service. We also spoke on the phone with 3 relatives of people who use the service. We spoke with 2 care staff, a team leader, and the deputy manager.
Updated
5 October 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Mulberry House is a residential care home providing personal care to 8 people at the time of the inspection. The service can support up to a maximum of 8 people.
People’s experience of using this service and what we found
Right Support:
People did not always receive safe care and support, and the environment was not always safe or clean. People’s needs and preferences were not always met.
Risk assessments were not always in place to assess known risks.
People were not always supported to pursue their hobbies and interests. We did not see evidence that people were engaged with regular in activities of their choice
Staffing levels within the service were safe, and medicines were managed safely
People were supported to have 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 supported people to access health and social care services.
Right Care:
People did not always receive care that was person-centred, and people’s goals and activities were not always well documented. Staff were not always proactive in engaging with people in activity.
Staff understood safeguarding procedures. Staff had training on how to recognise and report abuse and they knew how to apply it.
People's care plans reflected their needs and wishes and promoted their wellbeing.
Right Culture:
The ethos and values within the service did not always promote good standards for people.
Systems and processes were not effective in picking up and responding to any problems within the service.
There was a poor morale within the staff team who told us that issues were not addressed, and communication was not good.
People and those important to them, including social care professionals, were involved in planning their care.
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 27 June 2019).
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.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mulberry House on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, person centred care, and good governance.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.