Morton House

Updated 27 February 2020

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

The inspection was carried out by one inspector.

Service and service type

Morton house 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.

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 unannounced.

What we did before the inspection

We used the information the provider sent us in the 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with eight members of staff including the provider, registered manager, deputy manager, team leader, two shift leaders and three support workers. We observed staff interactions and engagement with people. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with them during feedback on the inspection.

We reviewed a range of records. This included three people’s care records and four medicine administration records. We looked at staff recruitment files for two volunteers and for one permanent staff member. We also looked at evidence of recruitment and assessment of a staff member who had been promoted within the service. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training, supervision data and quality assurance records. We sought and received feedback from professionals who regularly visit the service. We received written feedback from three elatives and spoke with four relatives.

Updated 27 February 2020

About the service

Morton house is run by the Epilepsy Society. It is a residential care home providing accommodation and personal care to fourteen people. At the time of the inspection twelve people were living there.

Morton house accommodates fourteen people in one adapted building. People have their own bedrooms but share the communal bathrooms and showers. The service has a separate kitchen, dining area, sitting room and laundry room. The bedrooms are set over the ground and first floor. The bedrooms on the first floor can be accessed by a lift.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 14 people. Twelve people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs (apart from the house name), intercom, cameras or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were happy with their care and felt safe. They had positive relationships with staff and got the support they required. Relatives felt confident people received safe care. They described the care as “Excellent and fantastic”. A relative commented “We are very mindful and grateful for the care [family members name] gets. If only all people with similar needs could be so lucky”. Another relative commented "We cannot thank everybody at Morton House enough for the care that [family members name] has received for all the years they have spent there. They consider it to be their home, is contented and happy and feels free to ask for anything they need or want".

Safe medicine practices were not consistently promoted. The issues identified were addressed during the inspection. We have made a recommendation for the provider to effectively monitor to ensure they are working to best practice in relation to medicine administration.

Systems were in place to safeguard people and risks to them were identified and mitigated. Accident and incidents were recorded and reviewed to promote learning and prevent reoccurrence.The home was free from odour and had a homely feel to it. However, the home was outdated and no longer suitable for people’s needs. The provider confirmed a refurbishment plan was in place with work scheduled to commence at the end of February 2020, to improve the service.

Systems were in place to audit the service. Actions from audits were not routinely signed off as completed. The registered manager agreed to do that to evidence the progress.

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. People’s health and nutritional needs were identified, and they had access to other health professionals to promote their health, well- being and safety.

Staff were suitably recruited, although volunteers did not have all of the required records in place. The nominated individual agreed to address this. The service had an established staff team and continuity of care was provided. Staff were inducted and trained. Staff felt well supported but regular one to one supervision was not taking place. This had been identified by the service and was being addressed.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Staff were observed to be kind, caring and had a good knowledge of people which enabled them to provide person centred care to people. They promoted people’s privacy, dignity and encouraged their independence. People were provided with equipment to promote their independence.

People had person centred care plans in place which were kept under review and updated. People’s communication needs were identified, and their end of life wishes explored. Some activities were provided, and people choose whether to get involved in them or not. Systems were in place to enable people and their relatives to raise concerns.

The service had an experienced manager. They supported staff on shift and empowered the staff team to develop and learn. Staff felt valued and worked well as a team to benefit people. People and their relatives were complimentary of the registered manager. A relative commented " The“[Registered manager name] is magic, he is absolutely dedicated and committed to the people living there".

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

Rating at last

The last rating for this service was good (28 June 2017) .

Why we inspected

This was a planned inspection based on the previous rating.

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.