17 October 2023
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 Health and Social Care Act 2008.
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.
The inspection was carried out by 2 inspectors. An Expert by Experience made telephone calls to relatives to request feedback about the care and support their family member receives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Morton Manor is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Morton Manor is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager. A new manager was in post but had not applied to register at the time of inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We requested feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who used the service and 7 relatives about their experience of the care provided. We spoke with 5 members of staff including care staff, nurses, the manager, compliance manager and the operations manager.
We reviewed a range of records. This included 5 people’s care records and 5 medicine records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
17 October 2023
About the service
Morton Manor is a nursing home providing personal and nursing care to up to 30 people. At the time of our inspection there were 19 people using the service. The service provides support to people under and over 65 with varying needs, including some people living with dementia. Accommodation is within 2 adapted buildings, a large house and a cottage.
People’s experience of using this service and what we found
The provider did not always promote a safe environment which put service users at risk of potential injury. We identified some infection prevention and control concerns which put people and staff at risk of cross infections.
Medicines were not always safely managed. We found concerns in relation to the storage and safe administration of medicines.
Care plans did not always contain information that was important and relevant. This meant staff did not have the appropriate information and guidance to ensure they were supporting people in line with their needs and preferences.
Risk assessments did not provide sufficient guidance for staff to know how to mitigate risk and keep people who were supported safe.
There were some management systems in place to assess, monitor and improve the quality-of-service people received. However, these were not always effective and did not identify the shortfalls we found during inspection.
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.
Staff were observed to be kind and caring. People told us they were happy with the support they were receiving.
Staff were safely recruited. The provider carried out the required checks on newly appointed staff before they started working at the home. Staff had received training that was appropriate to their role and the people they were supporting.
People had access to healthcare services and staff worked proactively with other organisations.
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
This service was registered with us on 5 June 2019 when it changed provider. The last focused inspection (published 31 January 2022) meant the service did not receive an overall rating and there were 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 the provider remained in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last focused inspection, by selecting the ‘all reports’ link for Morton Manor on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance at this inspection. The provider has taken action to mitigate risks following our inspection.
Please see the action we have told the provider to take at the end of this report.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.