CQC report explained · a residential care home
What the CQC found at Morton Close
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2023
Rated Requires Improvement; medicines remained unsafe and leadership was unsettled, although caring improved and special measures ended.
This was an unannounced focused inspection. Inspectors visited on 18 July 2023 and reviewed care records, medicines records, staffing, training and management records. They spoke with people, relatives and staff, and observed care.
The home had made significant improvements since its previous Inadequate rating. People were treated with kindness and respect, staffing was generally enough, infection control had improved, and risks were assessed more clearly.
Important problems remained. Some medicines were given incorrectly or at the wrong time, and waste medicines were not stored safely. There was no registered manager, and systems for identifying problems, reporting incidents and driving improvement were not always strong.
The overall rating rose from Inadequate to Requires Improvement. The home remained in breach of Regulation 12, but it was no longer rated Inadequate or in special measures.
Kind and respectful care
Staff treated people with compassion and respect. They responded warmly when people were confused or upset.
“We observed caring interactions between staff and people. Staff treated people with compassion and respect and engaged them in fun and meaningful conversations.” from the report
Improved risk records
Care records were clearer and risk assessments were updated when people's needs changed. Weight monitoring had also improved.
“However, the care records we reviewed were organised, clear and had some personalised information.” from the report
Improved infection control
Inspectors were assured that the home had suitable measures for preventing and managing infections, including the safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff training and recruitment
Staff had training in key safety areas, and inspectors saw moving and handling equipment being used appropriately. Recruitment checks were robust.
“Robust recruitment processes were in place. The provider completed pre-employment checks to ensure staff's suitability for the role and safety in working with vulnerable people.” from the report
Medicines were not always safe
seriousSome people received medicines or creams incorrectly, including one person who did not receive the correct dose. Some time-sensitive medicines were not given as directed, and waste medicines were not stored securely.
“Some people did not have their medicines and creams administered safely because staff failed to follow the prescribers' or the manufacturers' directions properly.” from the report
Safeguarding and learning needed improvement
needs fixingStaff did not always recognise when safeguarding referrals were needed, and professionals said the home was not always proactive in learning from problems.
“We recommend the provider operates consistently robust safeguarding processes and a proactive approach to learning lessons.” from the report
Staffing cover was not always reliable
needs fixingThe home's assessed safe staffing level was not always met when staff were sick because usual bank staff could not be found.
“There were some occasions where the provider's assessed safe staffing levels had not been achieved.” from the report
Feedback was not consistently acted on
minorResidents' meetings had not been held since January 2023. People said food and some activities still needed improvement, and earlier feedback had not all been addressed.
“Some areas of feedback from the last meeting had not been fully addressed.” from the report
- 01Who is currently responsible for the home while there is no registered manager, and how often are they present?
- 02What has changed to make sure every medicine is given at the correct dose and time?
- 03How are waste medicines now stored and checked?
- 04What contingency arrangements are in place when staff are off sick?
- 05How will residents' feedback about food and activities be recorded, acted on and reviewed?
This was a focused inspection of Safe, Caring and Well-led, with infection control also checked; Effective and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 2 September 2023 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, January 2023
Rated Inadequate and placed in special measures; inspectors found serious risks involving staffing, medicines, safety, dignity and management.
This was an unannounced focused inspection on 8 and 17 November 2022. Inspectors observed care, spoke with people, relatives and staff, and checked care records, medicines, staffing information and management records.
The home was not safe. There were too few staff, medicines were not always given or recorded correctly, risks such as falls, pressure sores and weight loss were not managed well, and the home was not clean. Fire safety and some environmental risks also needed urgent attention.
Inspectors found that people were not always treated with kindness, dignity or respect. Care was described as task-focused, communication was poor, and people and relatives were not consistently involved in decisions. The home’s management systems had failed to identify and fix serious problems.
The overall rating was Inadequate. Safe, Caring and Well-led were also rated Inadequate. Effective and Responsive were not inspected during this visit, so their previous ratings were carried forward.
Safe recruitment
The report says staff recruitment was managed safely and the required checks were completed.
“Staff recruitment was managed safely, and all required checks were completed.” from the report
Mental capacity safeguards
Inspectors found that the home was working within the principles of the Mental Capacity Act. Capacity was assessed and applications were made where people might be deprived of their liberty.
“The provider was working within the principles of the MCA.” from the report
Action after inspection
The provider responded to the inspection findings with an action plan and said it had added management support, training and extra night staffing.
“The provider sent us an action plan and assured us they would take action to mitigate the urgent risks to people” from the report
Approachable manager
People and relatives gave positive comments about the registered manager being approachable and supportive, despite the wider management concerns.
“Staff, people and relatives spoke positively about the registered manager and said they were approachable and supportive.” from the report
Unsafe staffing
seriousThere were not enough staff to respond promptly when people needed help, including after a fall and when people were incontinent. Staffing calculations did not reflect people's current needs.
“People were at risk of harm as there were not enough staff to keep them safe.” from the report
Medicine errors
seriousSome people received the wrong dose or did not receive medicines as prescribed. Records were incomplete or inaccurate, and insulin was stored outside the recommended temperature range.
“Medicines were not always given as prescribed.” from the report
Poor cleanliness and infection control
seriousThe building was not consistently clean, there were strong smells, cleaning records were incomplete and staff did not always use protective equipment correctly.
“The overall cleanliness of the building was poor. There were strong malodours throughout the home.” from the report
Dignity and kindness
seriousPeople were not always treated respectfully or supported with personal care. Inspectors saw dirty or unsuitable clothing, missing clean bed sheets and staff failing to respond to distress.
“People were not treated with respect, dignity and compassion.” from the report
Weak management oversight
seriousAudits and records did not identify or fix serious problems. Accidents and incidents were not consistently recorded, investigated or used to reduce future risks.
“Quality audits were not effective in identifying issues and securing improvements.” from the report
- 01How many staff are now on each shift, including at night, and how is this based on residents' current needs?
- 02What checks now ensure every medicine is given at the correct dose and time, and that records are complete?
- 03How are falls, pressure sores, weight loss, choking and moving and handling risks assessed and reviewed?
- 04What has been done to improve cleanliness, infection control, water temperatures and fire safety?
- 05How are residents and relatives now involved in care decisions and kept informed when accidents or other incidents happen?
This was a focused inspection of Safe, Caring and Well-led only; Effective and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 18 January 2023 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 Morton Close
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2023Inadequatedown from Requires improvementSafe: InadequateCaring: InadequateWell-led: Inadequate
- April 2019Requires improvementdown from GoodSafe: Requires improvementCaring: GoodWell-led: Requires improvement
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 13 April 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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