Morton Gardens LTD

Updated 9 February 2022

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.

Inspection team

Our inspection was completed by one inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours' notice of the inspection. This was because it is a small service and we needed to be sure the registered manager would be available to support the inspection. We also needed to seek consent from people using the service for us to visit the supported living setting. The registered manager confirmed people lacked capacity to consent so made the decision for us to visit the scheme as this was in people’s best interests through consulting with others involved in their care.

The inspection activity started on 5 November 2021 by visiting the supported living scheme. We met with the three people using the service, the registered manager and two support workers. We then made phone calls to two relatives and inspection activity ended on 19 November 2021.

What we did before the inspection

We reviewed the information we had received about the service since they registered with us, including any statutory notifications received. The provider submitted a provider information return. This is information providers are required to send us with key information about their service, what they do well and improvements they plan to make. We used all this information to plan our inspection

During the inspection

We were unable to gather verbal feedback from people using the service. Therefore, we carried out observations to help us understand their experience of receiving care. We spoke with the registered manager, deputy manager, two support workers and we reviewed a range of records. These included care and staff records and records relating to the management of the service.

After the inspection

We spoke with two relatives of people using the service about their experiences of the care provided. We continued to seek clarification from the provider to validate evidence found.

Updated 9 February 2022

About the service

Morton Gardens Ltd is a supported living service. It provides personal care to people living in a supported living setting with shared communal facilities and staff on site all time. At the time of the inspection three people were using the service who were also receiving personal care. People live in a detached house in a residential street and the service is run from a separate location which is registered with CQC. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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

The registered manager had not ensured people were always supported to have maximum choice and control of their lives and staff may not have supported people in the least restrictive ways possible and in their best interests. The registered manager was experienced, having owned and led this service for several decades under different providers with different directors. They understood their role and responsibilities overall, as did staff, although their knowledge of the Mental Capacity Act 2005 (MCA) could be improved. In addition, while there were good quality assurance processes in place to oversee the care people received, these were not always used effectively and had not identified the issues relating to the application of MCA, that we found during the inspection.

People received the right support in relation to risks, such as those relating to eating and drinking. There were enough staff to support people safely and most staff had worked in the service for many years so people benefited from consistency of care. The provider checked staff were suitable to work with people through recruitment checks. Staff received training in infection control, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID-19 transmission. People received the right support in relation to their medicines and the registered manager had good oversight of this with checks and audits.

Staff felt well supported by management and received the training and supervision they needed to meet people’s needs. People were supported to maintain their mental and physical health and advice from health and social care professionals was followed. People received food and drink they enjoyed, and staff monitored people’s weights to identify any concerns promptly.

People were comfortable with the staff who supported them, and staff knew people’s needs well. Staff treated people with dignity and respect. People were involved in their care and their care plans were based on their individual needs and preferences which the registered manager knew from working with them for many years. Care plans were person-centred and contained reliable information for staff to follow. Relatives and visitors were encouraged to raise any concerns or complaints. The registered manager engaged and consulted staff through team meetings and supervision and with relatives through regular contact.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This was the first comprehensive inspection since the service registered with us March 2020.

Why we inspected

This inspection was prompted because services which are operational require an inspection at least after the first year following registration with us.

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.

The overall rating for the service is requires improvement. We have identified a breach in relation to the need for consent. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit when our monitoring systems indicate the need to do so. If we receive any concerning information we may inspect sooner.