Archived: Morvern Care Centre

Morvern Care Centre is a residential care home providing accommodation and personal care for up to 60 people aged 65 and over. At the time of inspection there were 43 people living there.

The care home comprised of three hotels converted into a residential accommodation on three floors. There were three separate units, two of which had been joined together and supported people living with dementia.

People’s experience of using this service and what we found

This inspection identified substantial and widespread failings in respect of fire safety arrangements and in the leadership and governance of the service to prevent, identify or address these shortfalls. This posed serious risk to life.

Training for staff in fire safety and evacuation procedures was inadequate. People were not safe in the event of a fire or a fire alarm sounding at Morvern Care Centre. Staff told us they had received basic fire safety training, however had not participated in fire drills.

The provider’s representative was present at the home during our visit and worked positively with the authorities to address our concerns during and after the inspection.

Rating at last inspection and update

The last rating for this service was Inadequate (published 24 November 2020).

The overall rating for this service was ‘Inadequate’. The service was in ‘special measures.’ This means we keep the service under review. Special measures and remaining breaches will be followed up at the next rated inspection.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns we had received from Lancashire Fire and Rescue Service. The inspection was prompted in response to concerns received about fire safety management, means for detecting and giving warning in the event of a fire and the means of escape. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Morvern Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance.

CQC served notice under Section 31 of the Health and Social Care Act 2008 to suspend the provider's registration. This notice of urgent suspension was served because we believed that a person would or may have been exposed to the risk of harm if we did not take this action.

Morvern Care Centre is a residential care home registered to provide accommodation and personal care for up to 60 people aged 65 and over. At the time of inspection there were no people living there.

The care home comprised of three hotels converted into a residential accommodation on three floors. There were three separate units, two of which had been joined to support people living with dementia.

People’s experience of using this service and what we found

This inspection identified continued substantial and widespread failings in respect of the environment; the premises and equipment and in respect of fire safety arrangements. Systems and processes had not been considered and improved in preparation to reopen the premises.

Whilst action had been taken since the September 2020 inspection, no further action had been taken since people were relocated in December 2020. The premises had been assessed in January 2021 for fire safety, however the risk remained substantial and was inhabitable at the time of this inspection.

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 inadequate (published 24 November 2020) and there were multiple breaches of regulation. At this inspection we found some actions had been addressed however the provider remained in breach of regulations.

Why we inspected

We undertook this targeted inspection to review the current situation at Morvern Care Centre following two inspections at the location in September and December 2020. The overall rating for the service has not changed following this targeted inspection and remains inadequate.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches at this inspection in relation to safe care and treatment, premises and equipment and good governance.

Since the inspection visit to Morvern Care Centre on 22 April 2021, there has been a change to the provider’s registration with CQC. CQC has cancelled the provider’s registration.

Morvern Care Centre is a residential care home providing personal and nursing care to 48 people aged 65 and over at the time of the inspection. The service can support up to 60 people.

The care home accommodates 60 people across three separate units. Each unit had its own separate facilities. Two of the units had been joined together at the time of this inspection and supported people living with dementia.

People’s experience of using this service and what we found

Although people told us they felt safe living at Morvern Care Centre, the service was not safe. Risk was not always assessed and managed to protect people from exposure to harm. Safeguarding processes were not always followed to minimise the risk of abuse. We could not be fully assured people got their medicines as directed. Medicines were not always managed safely and in line with good practice. Staffing levels were not always appropriate to meet the needs of people who lived at the home.

The service was not well-led. We found widespread and systemic failings throughout the service. . Oversight from the management team was inconsistent. . Audits were not effective in driving forward improvements within the home. Policies and procedures were not consistently followed to maintain safety. Records were not always accurate, up to date and reflective of people’s needs. . Staff told us morale was low.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Care was not always effective. Processes to ensure people consented to care and treatment were not always followed. When people required support with eating and drinking, we could not be assured peoples dietary needs were consistently met. The environment within the home was poorly maintained and did not always meet people’s needs. Staff did not always have the appropriate training and skills to keep people safe. Health needs were not always met in a timely manner. We have made a recommendation about this.

Although we observed some positive interactions and staff spoke fondly of people, we found staff were not always caring and responsive to people’s needs. Dignity and respect were not always considered and promoted. We could not be fully assured autonomy was promoted and people were consulted with. We have made a recommendation about this.

We could not always be assured people received person-centred care. According to records, people were not always offered baths and showers in a timely manner in line with their preferred needs and care plans. People told us activities took place and said they looked forward to activities. However, there were no organised activities when the activities coordinator was on leave. Additionally, we noted large amounts of time when people on the dementia unit were not provided with stimulus and activity.

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 21 April 2020.) The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about the management of risk, safeguarding and the condition of the living environment. A decision was made for us to inspect and examine those risks.

We undertook a focussed inspection to follow up on the specific concerns we had received about the service. We inspected and found there were significant concerns, so we widened the scope of the inspection to become a comprehensive inspection which included all key questions.

We have found evidence that the provider needs to make improvements. Please see the full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, staffing, consent, safeguarding, person-centred care, dignity and respect and good governance.

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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Morvern Care Centre is a residential care home, providing personal and nursing care to up to 60 older people. At the time of the inspection, the service was supporting 50 people, some of whom who were living with dementia. The service is an adapted three storey building on the promenade at Cleveleys, with lift access to all floors.

People’s experience of using this service and what we found

We have made a recommendation about ensuring staffing levels are sufficient to meet people’s needs safely. Staff managed people’s medicines well and kept the home clean and tidy. Staff managed risk and had plans to follow in case of emergencies. The service had systems to protect people from the risk of abuse and improper treatment. People felt safe.

The service was led by a registered manager was described as approachable and caring. The culture at the service was open and inclusive. Staff understood their roles and responsibilities. The provider monitored the quality of the service using a range of systems, however, these had not identified and addressed the issues we found during this inspection.

The service put people at the heart of the care they received. Staff used detailed assessments to identify people’s needs and preferences and worked to ensure people were happy with the care they received. We have made a recommendation about ensuring people’s plans of care are accurate and consistent. The service made sure people were supported to communicate and planned activities to enhance people’s wellbeing.

People were supported to have maximum 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.

The service met people’s nutritional needs and worked with them to make sure food provision also reflected their preferences. Staff supported people with their healthcare needs and worked well with external healthcare professionals. People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively, following good practice guidance.

People were treated well, with kindness and compassion by staff who respected their privacy and dignity and promoted inclusion.

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 15 March 2017) and there were two breaches of regulation. 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 some improvements had been made. However, the provider was still in breach of one regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach of regulation in relation to assessing, monitoring and improving the service, and record keeping.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had deteriorated in some areas since our last inspection.

People’s medicines were managed safely and properly. However, protocols were not in place for medicines where a variable dosage could be administered or medicines for use ‘as and when required’. There were areas of the home and items of furniture that did not meet infection prevention and control guidelines. People received personalised care that was responsive to their needs and preferences. However, we found care plans were not always accurate and up to date. We received mixed feedback about staffing levels from people who used the service and staff. People’s capacity to consent had not been assessed in line with legal requirements. There were areas of the home which required maintenance and decoration. The provider had auditing systems to ensure they met legal requirements. However, these had not identified the shortfalls we identified during our inspection

We received positive feedback from people about Morvern Care Centre. People told us it was safe and that staff were kind and treated people well. Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence. People had opportunity to access a range of activities including access to the local community. Staff had built positive caring relationships with people they supported and their families. Staff liaised with other health care professionals to ensure people's safety and meet their health needs. We received positive feedback about how the service was managed.

More information is in the full report.

Rating at last inspection: Good (Report published 20 July 2017).

About the service: Morvern Care Centre is registered to provide care for up to 60 older people. It is situated on the promenade in Cleveleys. The home is a large converted hotel which is split into three distinct areas; one residential and two for people who are living with dementia. Lifts provide access to each floor. There is a communal lounge and dining area in each part of the home.

Why we inspected: This inspection was brought forward due to concerns raised by the local authority about the environment and infection prevention and control issues.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Although a number of people had limited verbal communication and were unable to converse with us, we were able to speak with nine people who lived at the home and three people visiting their relatives. People who lived at the home told us they felt safe and were happy with their care and liked the staff who looked after them. We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and supported people in their care safely. One person who lived at the home said, “I have been here some time now and is suits me as the staff are excellent.”

We saw staff assisting people with mobility problems. They were kind and patient and assisted people safely.

The service had sufficient staffing levels in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People who lived at the home told us staff were responsive to their needs.

We found staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. Staff spoken with told us they were happy with the training they received.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

People who lived at the home had access to advocacy services. This ensured their interests were represented by professionals outside of the service to act on their behalf if needed.

Staff knew people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and relative surveys to seek their views about the service provided.