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Morton Close Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 April 2019

Morton Close is a ‘Care Home’, it is a large detached property, situated in the Cross Flats area of Bingley, approximately two miles from the town centre. The home is registered to provide residential care only for up to 40 older people. On the day of our inspection there were 23 people living at the home including one person admitted on a respite care basis. 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.

There was a registered manager in post. 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.

This inspection took place on 21 November and 6 December 2018 and was unannounced. Our last inspection took place on 27 June 2017 at that time the service was rated ‘Good’ overall with no breaches or regulations.

Policies and procedures were in place to ensure people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and they were confident they knew how to recognise and report potential abuse. However, we found the correct procedure had not always not been followed.

People’s needs were assessed before they moved into the home. However, the assessment documentation we looked at was not always show how the provider concluded they were able to meet people’s needs.

The care plans in place provided staff with information about people’s needs and preferences and identified specific risks to people’s health and general well-being, such as falls, mobility, nutrition and skin integrity. However, some care records we looked at required updating and there was evidence staff did not always follow recommendations made by other healthcare professionals.

Appropriate recruitment checks were carried out to make sure only people suitable to work in the caring profession were employed. However, we recommended the provider reviewed the staffing levels on the evening shift to ensure there are sufficient staff on duty to meet people’s needs.

Staff told us there were now clear lines of communication and accountability within the home and they were kept informed of any changes in policies and procedures or anything that might affect people’s care and treatment.

Private accommodation and communal areas of the home were generally well maintained and there was a planned programme of refurbishment in place.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act 2005 (MCA). This helped to make sure people’s rights were protected.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services and systems were in place to ensure people received their medicines safely and as prescribed.

There was a range of leisure activities for people to participate in, including both activities in the home and in the local community. However, people's views differed regarding the activities available on a daily basis.

We saw the complaints policy was available. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

There was a quality assurance monitoring system in place that was designed to continually monitor and identified shortfalls in service provision. However, we found some concerns highlighted in the body of this report had not been identified through the quality assurance monitoring system.

Inspection areas

Safe

Requires improvement

Updated 18 April 2019

The service was not consistently safe.

Staff knew how to recognise and report any allegations of abuse although correct procedures were not always followed.

Staffing levels on the evening shift should be reviewed to ensure there are sufficient staff on duty to meet people�s needs.

Risks to people's health, safety and welfare were not always identified and safely managed.

Effective

Requires improvement

Updated 18 April 2019

The service was not consistently effective.

People received support from healthcare professionals to maintain their health and wellbeing when it was required. However, staff did not always follow their recommendations.

The service was compliant with the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Pre-admission assessments were not always sufficiently detailed and did not show how the provider had concluded staff had the necessary skills and resources to meet people�s needs.

Caring

Good

Updated 18 April 2019

The service was caring

People told us they were supported by staff who were kind and considerate.

Staff knew individual people well and were knowledgeable about their needs, preferences and personalities.

People were supported to maintain relationships that were important to them.

Responsive

Requires improvement

Updated 18 April 2019

The service was not consistently responsive

Care plans were in place to ensure staff provided care and support in line with people�s preferences. However, some care records we looked at required updating.

There was a range of activities for people to participate in, including activities in the home and in the local community. However, more could be done to ensure people enjoyed a full and active life.

People felt confident they could raise concerns and complaints, and these would be listened to and dealt with promptly.

Well-led

Requires improvement

Updated 18 April 2019

The service was not consistently well-led.

Systems were in place to assess and monitor the quality of care provided. However, they were not always sufficiently robust and had not identified some shortfalls in the service highlighted in the body of the report.

There were systems in place to seek the views of people who used the service and others and to use their feedback to make improvements.