Morton Cottage Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This key question was previously rated requires improvement. The rating remains requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Safety events were not always investigated and reported as thoroughly as they could be, meaning lessons were not always learned to identify and embed good practices. Risks and safeguarding matters were acted on but improvements to the service were not always made following individual incidents.

People were consistently happy with their care and support but the provider needed to take a more proactive and systematic approach to risk management and oversight.

The registered manager had listened to advice from external partners and implemented some recent changes. They agreed the implementation of champions for specific areas (such as safeguarding, dementia, and fire) would be a way of ensuring staff knowledge of good practices improved.

One external professional said, “I think they are one of the better services in terms of knowing their risks and keeping on top of them. They always listen if we have advice around safe care.”

Policies and procedures needed to have more regard to national safety issues and good practice. The registered manager was responsive to signposting about recent best practice regarding falls management.

The provider worked with people and partners to establish and maintain safe systems of care. Staff worked hard to ensure continuity of care, including when people move between different services.

The service used an electronic care records system. This was well understood by staff and contained up to date information that could be shared with external clinicians when required.

Personalised Emergency Evacuation Plans (PEEPs) were up to date and detailed. The provider was responsive to advice to ensure these were more accessible to visiting emergency responders.

Regular checks of maintenance and safety equipment were in place, but needed improvement to demonstrate the provider was able to ensure the property was continually reviewed and updated in line with good practice.

The registered manager had maintained positive working relationships with local health and social care professionals. This helped ensure people’s experience of care was joined up.

The provider had not always ensured safeguarding matters were raised as promptly as they could be. For instance, where people had distressed reactions. The provider needed to take a more proactive approach to notifying external partners of incidents.

The provider concentrated on making people comfortable while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

People and their relatives felt able to raise concerns. One relative said, “The family all live away from Carlisle, so having the utmost trust in their care is essential.”

Policies, procedures and training were in place to ensure staff were equipped to recognise and escalate safeguarding concerns.

The provider had not always ensured risks were understood and managed holistically. Care needs were not always met in the safest way that enabled people to do the things that mattered to them. This was particularly noticeable where people were experiencing distress and there was at times a lack of a proactive approach.

Risk assessments were in place for core areas of health risks and staff understood these well for the most part. External professionals had confidence in the understanding and knowledge of staff. One said, “They keep people safe. They are really vigilant on things like skin integrity, I have to compliment them on that.”

People and their relatives confirmed they were involved in risk assessments and their ongoing review. One relative said, “We have never had concerns. It’s quieter than other places we have seen and [person] is relaxed here – I think that helps. They manage the risks well."

The provider did not always detect and control potential risks in the care environment. They did not always make sure that the equipment, facilities and technology supported the delivery of safe care.

Upstairs corridors were dark with no relevant signage to help people who may be confused orientate themselves. The carpeted section of one upstairs corridor was uneven and loose in places.

The provider needed to do more to ensure the environment was kept free from hazards. For instance at lunchtime people’s walking frames were stacked up in such a way that staff had to move them out of the way to safely move a person in a wheelchair into the room.

There had been little improvements to the service in terms of ensuring people living with a dementia were better able to safely move around and negotiate their environment. The activities co-ordinator had made some positive improvements to the feel of the environment in recent weeks but much more needed to be done by the provider.

The outdoor space was unsafe for people to access independently. The provider was responsive to feedback about how to make best use of the outdoor space and to review the internal environment to make it more accessible, appealing and safe.

The provider had not always done enough to ensure there were enough qualified, skilled and experienced staff, who receive training appropriate to their roles. They had not assured themselves of the training credentials of one member of staff and supervisions did not happen as regularly as planned.

People and their relatives were happy with the level of staffing, as were regular professional visitors. One person said, “It’s alright here, they do come if you push the buzzer, well as soon as they can. Oh yes, even at night.” One relative said, “There always seen to be enough staff around even when something unexpected happens.”

The provider completed appropriate recruitment checks for new staff to ensure the risks of unsuitable applicants working with people who may be vulnerable, were reduced. Records of interviews were limited, meaning we could not be assured recruitment processes were always values-led. Staff spoke positively about their ongoing support.

The provider had not always ensured people were protected as much as possible from the risk of infection; this was because premises and equipment were not always kept clean and hygienic. Two downstairs toilets had rusted handrails and there was significant damp damage in one of the living rooms, which made cleaning ineffective. Some hand gel dispensers were empty and there was no soap in either communal downstairs toilet.

Cleaning staff worked hard and the majority of the building was clean and odour free.

The provider had a range of improvements planned to the fabric of the building and recognised the challenges that came with having an old building.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

Visiting professionals raised no concerns about medicines management. One said, “The carers are always able to access their electronic MAR chart and have up to date, accurate information on medication being administered and stock levels. During medication reviews carers will highlight when there is an excess stock level.”

The person administering medicines was regularly interrupted by other staff and people who used the service. They did not wear a ‘do not disturb’ tabard and it took them longer than anticipated to finish administering medicines. The provider committed to reviewing these practices and ensuring medicines administration time was protected.