Morton Cottage Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This key question was previously rated requires improvement. This key question remains requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The provider was in breach of regulation in relation to governance.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service. A core team of staff, who had been at the service a number of years, delivered compassionate care to people they respected and treated with dignity. There was a positive atmosphere and staff were supportive of each other. Equality and diversity amongst staff were respected.

Relatives consistently told us the service had dealt openly and supportively with any concerns. One relative said, “Its lovely, it’s a home from home and I think that’s why [person] is so settled.”

Policies and procedures had regard to person-centred care principles, equality, diversity, human rights and inclusion. The provider needed to review the mix of people’s needs and dependencies, and set out a clear vision for how they wanted the service to improve and meet these needs. For instance, there were people living with a dementia, but the provider had done little to ensure the service had regard to a range of dementia friendly good practice.

Leaders supported the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively. They do so with integrity, openness and honesty. Whilst there were areas for improvement identified, leaders were passionate about delivering better quality care to people who used the service.

External partners had confidence in their commitment and ability. One told us, “We undertake a weekly care home ward round on behalf of the GP surgery. Staff are always friendly, welcoming, helpful and grateful for our input.The senior is a credit to herself, the organisation and her patients.They go above and beyond for their patients, their families and her staff.”

Staff always felt supported, with workplace needs and if and when they needed some support with experiences outside of work.

There was a positive culture where people felt that they could speak up and that their voice would be heard. People we spoke with were comfortable raising any issues with staff or management. Relatives felt likewise – there was no fear of how concerns might be handled and there was trust in the leadership of the service.

The provider needed to do more to ensure there were a range of more formal means for people and relatives to speak up. For instance, more regular meetings, surveys or questionnaires.

Staff all felt they could raise concerns with the registered manager or other leaders.

The registered manager welcomed the diverse strengths of their staff team. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

The registered manager needed to demonstrate a greater focus on assessing values during the recruitment process.

Staff were well supported and there was no evidence of discrimination or bullying.

At our last inspection we identified concerns regarding governance (particularly with regard to staffing records). The provider had not made sufficient improvements in terms of governance and oversight and remained in breach of this regulation.

Some staffing records still lacked appropriate levels of documentation. Relevant notifications had not always been made in a timely way to external partners, including CQC. The registered manager committed to reviewing their approach to reporting incidents and learning lessons from them.

A range of governance processes were not up to date at the time of inspection, despite input and support from external partners. This included auditing of care planning information, staff supervision and reviewing lessons learned. This meant we could not be assured that people were receiving the best care outcomes. Incidents and accidents were not suitably analysed, making accountability more difficult.

The provider did not always utilise or explore links with local organisations and businesses to ensure the service remained outward-looking. Links were limited at the time of inspection. The provider understood their duty to collaborate and work in partnership with others, so that services could work well for people. The provider shared information with partners and collaborated with them for improvement.

Where one person celebrated a significant milestone, the provider went to significant lengths to celebrate this and reach out to the wider community. They needed to build on this kind of activity and make it part of regular practice, particularly as they had recently employed an activities co-ordinator. The provider needed to ensure they had the ongoing support and resources required to make further improvements to the provision of activities.

People we spoke with were comfortable, safe and happy in their home.

Learning and improvement was not always effective. There had been a lack of improvement in the governance and auditing processes since our last inspection. Opportunities to share learning, such as supervision meetings with staff, had not taken place as regularly as the provider had planned. Care records were up to date and reflective of people’s needs for the most part. Where improvements were needed the provider was responsive to signposting and advice.

There was a day-to-day focus on meeting people’s immediate needs and keeping them safe. What was lacking was clearer approaches to learning lessons, trying out and embedding new good practices, and clarifying the service’s strengths.

Staff felt they were supported to develop their careers within a supportive environment.

The provider did not attend provider forums at the time of inspection. The registered manager and other leaders did have strong relationships built with local clinicians, who were a source of advice regarding good practice.