Background to this inspection
Updated
9 December 2021
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 Care Act 2014.
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
The inspection team consisted of one inspector and one specialist advisor. Two Experts by Experience made calls to people’s relatives remotely. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Mornington Hall Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection and the action plans the provider had submitted. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 10 members of staff including the registered manager, the clinical lead, the deputy manager, the area director, two nurses, a senior nursing assistant, one domestic team member and one care worker and the chef. We made observations of the service.
We reviewed a range of records. This included five people’s care records, multiple medication records and staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at records relating to the management of the service. We spoke with three staff members by telephone.
Updated
9 December 2021
About the service
Mornington Hall Care Home is a nursing home providing care to 47 people at the time of the inspection.
The service can support up to 120 people. The home is divided into four communities, two for people with
nursing needs and two for people without. At the time of the inspection a residential and a nursing community were unoccupied and closed. Many of the people living in the home experience dementia.
People’s experience of using this service and what we found
People’s relatives told us there had been lots of changes at the service and care had improved. There was a new registered manager, clinical lead and deputy manager in post since the last inspection who had a strong vision about increasing the quality of care and to make all staff responsible for high standards within the service. Some staff expressed that they did not feel listened to and the provider was working towards ensuring staff would feel heard during this improvement process.
The provider had systems to monitor the quality of the care provided including audits and internal inspections. We made a recommendation that the provider increase oversight during weekends and nights to check consistency of work.
People’s relatives and staff told us staff were stretched and very busy, particularly at weekends, but that staff did come quickly when people needed immediate support.
The provider had implemented a range of new activities led by an engaging team. Relatives told us they would like to see further activities embedded at the service.
Risks people faced were identified, assessed and reviewed. Risk assessments and care plan documentation for people with behaviour that challenged required further improvement such as schizophrenia documentation. Staff had a good understanding of how to mitigate risks people faced, including mobility, pressure sores and diabetes.
Medicines were well-managed. Improvements were needed to meet best practice including the implementation of pain scales and accurate recording of topical creams.
Relatives told us staff were caring and respected people’s dignity and privacy. Staff were safely recruited to ensure they were suitable to work in the caring profession. Relatives told us staff knew how to support their loved ones. Care records captured people’s likes and dislikes and were personalised.
The provider had implemented infection prevention and control measures to respond to the pandemic.
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.
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 09 October 2019) and there were multiple 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 22 July 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report covers our findings in relation to all the Key Questions which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mornington Hall Care Home on our website at www.cqc.org.uk.
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.