CQC report explained · a residential care home
What the CQC found at Morning Stars
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed and reviewed, staffing was sufficient, recruitment checks were completed and medicines were administered safely.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff were trained, people were supported with eating and drinking, and healthcare referrals were made promptly.
- Caring?
- Good
- Staff were described as kind and caring. People were supported with dignity, privacy, independence and involvement in decisions about their care.
- Responsive?
- Good
- Care was personalised and considered people's communication, cultural and religious needs. People were supported to choose activities, access the community and raise complaints.
- Well-led?
- Requires improvement
- The registered manager was approachable and encouraged person-centred care, but quality checks did not always identify problems with records, medicine administration, fridge temperatures or accident trends.
What inspectors found, October 2019
Rated Good overall, but inspectors found the home's well-led arrangements required improvement, especially its quality checks and records.
This was an unannounced inspection by two inspectors. They spoke with seven people, three relatives and six staff. They also reviewed eight care records, medicine records and management documents.
The inspectors found good arrangements for safety, effective care, kindness and personalised support. People said they felt safe. Staff were safely recruited and trained, medicines were administered safely, and people were supported with healthcare, food, activities and their own choices.
The main weakness was leadership and checking systems. Some audits did not identify missing or outdated information, including emergency evacuation plans, medicine records and accident trends. The overall rating was Good, with Well-led rated Requires Improvement.
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report possible abuse, and risks were reviewed when people's needs changed.
“People told us they felt safe. Systems were in place to keep people safe and staff understood how to protect people from abuse.” from the report
Kind and respectful care
Staff treated people with kindness and respected their privacy, dignity and independence. People were encouraged to make their own choices.
“People were supported by kind and caring staff. People were encouraged to express their views and be involved in making their own decisions.” from the report
Personalised support
Care plans considered individual needs, communication, culture and religion. Staff knew people well and adapted their approach.
“People were supported by staff who knew them well and who provided personalised care to meet their specific needs.” from the report
Improvement since the last inspection
The report says the home had made enough progress to end the previous breaches. Four key question ratings improved from Requires Improvement to Good.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Quality checks did not catch all problems
needs fixingAudits did not always identify that care records and emergency evacuation plans needed updating when people's needs changed. This was the reason Well-led was rated Requires Improvement.
“Audit systems were not always effective in checking the quality of the service and ensuring that all documentation was up to date.” from the report
Medicine audit records
needs fixingMedicine audits did not identify that creams were administered by one staff member while another staff member had signed for them.
“Medicine audits failed to identify that creams were being administered by a different member of staff to the one who had signed for administration.” from the report
Accident and incident information
needs fixingThe home recorded accidents and incidents, but did not analyse the information to identify possible patterns and take further action.
“Systems were in place to monitor accidents and incidents but information was not analysed so that trends could be identified in order for appropriate action to be taken.” from the report
- 01How do you now check that Personal Emergency Evacuation Procedures are updated when a person's needs change?
- 02How do you make sure the staff member who gives a cream is the staff member who signs the medicine record?
- 03What required temperature ranges are used for the fridge, and what happens if a reading is outside them?
- 04How do you analyse accidents and incidents to identify trends and prevent them happening again?
This was a planned, unannounced inspection covering all five key questions; the report says the home had improved from its previous rating. This explanation was written from the published report of 2 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Rated Requires Improvement; inspectors found safeguarding, dignity and management failures, with the well-led rating Inadequate.
The inspection was unannounced on 5 February 2019. Two inspectors and an assistant inspector reviewed records, medicines, care plans, recruitment and complaints. They spoke with four people, staff, managers and health and social care professionals, and observed care.
The home was not consistently safe, effective, caring or responsive. Inspectors found weaknesses in safeguarding, staff understanding of the Mental Capacity Act, respect for privacy and dignity, meaningful activities, and responding to people's concerns.
There were some positive findings. Staffing levels and recruitment were suitable, medicines were managed safely, people enjoyed the food and had access to healthcare. However, the home's systems for checking quality were ineffective, so the well-led rating was Inadequate.
The home was rated Requires Improvement overall. It had also been rated Requires Improvement in August 2017, and the provider was still not meeting the regulation on good governance.
Medicines
People received their medicines as prescribed. Medicines were stored securely and stock matched the medicines administration records.
“We found medicines in the service were stored safely and securely.” from the report
Staffing and recruitment
Inspectors found enough staff to protect people from harm. Recruitment checks, including identity, references and DBS checks, were completed before staff started.
“People were supported by sufficient numbers of care staff in order to protect them from harm.” from the report
Food and healthcare
People said they were happy with the food and had choices. The home supported people to access doctors, dentists and other healthcare professionals.
“People were given access to drinks and snacks during the day.” from the report
Some positive relationships
Inspectors saw warm interactions in some parts of the home. People were comfortable approaching the registered manager and staff.
“We saw positive relationships were in place and people felt comfortable approaching the registered manager and other care staff within the service.” from the report
Safeguarding was not reliable
seriousA person who was not meant to leave alone went missing, but the home did not follow its procedure or notify the police, safeguarding authority or CQC. Other incidents were also not always identified and reported.
“People were not protected by robust safeguarding systems that ensured all relevant concerns about people living at the service were reported to the local safeguarding authority.” from the report
Staff knowledge and training
needs fixingStaff and management did not understand some legal requirements about capacity and restrictions. Recent training on the Mental Capacity Act had not produced effective knowledge.
“Care staff did not have effective knowledge around the Mental Capacity Act 2005 (MCA) despite them having recently received training in this area.” from the report
Privacy, dignity and independence
seriousInspectors saw staff enter a room without knocking, heard disrespectful language and saw medicines given through a hatch. People were not always supported to get drinks or do their laundry independently.
“This was a breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Dignity and respect” from the report
Limited activities
needs fixingSome people enjoyed going out, but others said they were bored. Activities were limited and were not consistently based on people's individual interests or needs.
“We saw people had access to some leisure activities such as Zumba and colouring, but further opportunities were very limited.” from the report
People's concerns were not acted on
needs fixingPeople gave mixed views about whether staff listened. Concerns about being woken and standing outside in the rain had not been identified or addressed.
“People shared concerns because they did not always feel their voices were heard or listened to.” from the report
Weak management checks
seriousThe quality monitoring system did not identify important problems, including a person's weight loss, medicine storage temperatures and worn furniture. The home also failed to submit all required statutory notifications.
“They had failed to ensure that effective quality assurance processes were in place and remained not meeting the regulation around the effective governance of the service.” from the report
- 01What changes have been made to ensure every safeguarding concern is recognised, recorded and reported to the correct authority?
- 02How do you check that staff understand the Mental Capacity Act and Deprivation of Liberty Safeguards in practice?
- 03How are privacy, dignity and respectful language monitored, including when medicines are given?
- 04What individual activities are now available for each person, and how do you check that people are not becoming bored?
- 05What action has been taken to make quality checks effective and to ensure people's complaints and feedback lead to change?
This was an unannounced comprehensive inspection covering all five CQC questions, including the overall rating and the home's governance, care and safety arrangements. This explanation was written from the published report of 21 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Morning Stars
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 1 March 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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