Morton Gardens LTD

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People were involved in assessing their needs and able to state their choices and preferences for how their care and support was provided. People’s care and support was planned and delivered in line with current practice, legislation and standards. Staff understood how people’s needs should be met. They worked well with each other and partners to make sure people experienced positive outcomes in relation to their care and support needs. Staff supported people to stay healthy and well. They monitored people’s health and wellbeing and made sure people received timely support if they became unwell or needed extra support from professionals with their healthcare needs. Managers reviewed the care and support people received to make sure this remained effective and helping people achieve positive outcomes. The provider had improved their arrangements and was now working within the principles of the Mental Capacity Act (MCA).

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People needs and preferences were understood and met by staff. Relatives told us staff knew their family members well and delivered care and support that met their needs. A relative told us, “I do think the staff are very good with [family member] and they know them very well and they are good at anticipating their needs.”

Staff knew people well and understood how people’s needs should be met. A staff member told us, “I read people’s care plans and understand what people need. I’ve worked with people a long time and I have a very good understanding of people’s needs.” Managers supported staff to provide care and support in line with people’s needs. The registered manager told us, “I observe the care that is being provided and if this is in line with people’s care plans. I look for things like how people are dressed and if they are wearing the clothes people want. Staff have to read the care plan and risk assessments. We go through this with staff to help them understand what they need to do.” People’s needs were assessed and reviewed at regular intervals to make sure people continued to receive effective and appropriate support. People were involved in assessments and reviews and their individual preferences informed how their care and support was provided. The registered manager told us, “We ask staff to feedback people’s experiences and we use that to inform reviews of care and risk assessments. When there are formal reviews people and their family are involved.”

Systems were in place to assess and review people’s care needs at regular intervals, to ensure people received effective and appropriate support for these. Managers undertook assessments and reviews with people and others involved in their care, to obtain the information they needed to plan and deliver the care and support people required. This included information about people’s medical history, current healthcare conditions, their care needs and the outcomes they wished to achieve from the support provided. People’s care plans were current and reflected their choices about how and when support was provided.

People received care and support in line with legislation and good practice standards. Care and support had been planned for people based on their choices and preferences. Risk management plans were in place to make sure this was delivered safely and effectively by an appropriately skilled and experienced staff team. People’s nutrition and hydration needs had been assessed and staff made sure people ate and drank enough to meet their needs.

Staff were supported to stay up to date with legislation and good practice standards. This helped to ensure care and support provided to people was helping people achieve positive outcomes based on latest evidence. The registered manager told us, “In team meetings we discuss any new guidance and learning. We attend the [local] forums and we get a lot of updates and information from the council and share this with people and staff. We engage with any initiatives.”

The provider used systems and tools to support them to deliver care and support in line with legislation and good practice standards. Through regular assessments, monitoring and reviews of people’s care needs, managers ensured people’s care and support was safe and effective and helping people to achieve positive outcomes. Managers used good practice tools to undertake regular checks of people’s health and wellbeing to help them recognise signs of physical deterioration in people’s health in a timely manner, so that appropriate support could be sought for them.

People experienced continuity of care when they started to use the service because the provider worked with them, and the people and agencies involved in their care, to assess their needs and have care plans in place to meet these. A relative of a person that recently started using the service, told us, “[Family member is] setting in here. I was quite surprised and it’s been much better than expected…There was a good handover (with the previous care provider).”

Staff were supported to deliver the care and support people required as soon as they started to use the service. Managers made sure staff had access to information about people’s care and support needs and were well informed about how people’s needs should be met.

Staff worked well with partners to make sure people received consistent care and support when they started to use the service. A healthcare professional involved in the move of a person who recently started using the service, told us the service had worked well with them, the person and their family to make sure there was a smooth transition and continuity in care was maintained. They told us the person had experienced positive outcomes as a result of this. They said, “[Person using the service] could recognise the voice of their key worker who provides them with their cultural needs. This was a positive sign of intensive communication to promote [person using the service’s] communication skills.”

Systems were in place to ensure people who started to use the service or were moving on to other services, would be supported to transition safely and effectively whilst maintaining continuity in their care. This included robust assessments involving people and others involved in their care which ensured information was shared in a timely way, to help people make informed decisions about their move and how they would like their needs to be met.

People were supported to stay healthy and well. People attended their scheduled healthcare appointments and annual reviews and checks ups of their healthcare needs with staff’s support. This was done in line with people’s choices and preferences. One person preferred to have healthcare professionals visit them at home and staff made sure their preference for this was met. A relative told us, “[Registered manager] makes sure that [family member] attends all their appointments and then will let me know how that went.” Another relative said their family member had experienced positive health and wellbeing outcomes due to the support provided by staff. They told us this was because staff understood what their family member needed and made sure this was met through the care they provided. When people became unwell, staff sought prompt support for them and acted on recommendations from healthcare professionals to help people get better. A relative told us, “If [family member] is unwell [registered manager] calls straight away and lets me know and what they are doing about this.”

Staff and managers understood how people should be supported to stay healthy and well, in line with their assessed needs and preferences. They knew when and how to seek support for people if they were unwell. A staff member told us, “I make sure [person using the service] has a good diet and lots of fibre. We do a lot of health checks on people to monitor people and make sure they are ok. If they are not well, we call the GP.” The registered manager said, “We take temperatures and oxygen for people every day and you use that to monitor people’s general health and we have guidance what to do and where to get support if those readings are not normal.”

There were arrangements in place to make sure information about people’s healthcare needs were assessed and reviewed at regular intervals. This ensured staff had access to up to date information about people’s healthcare needs which helped them support people to stay healthy and well. Systems were in place to seek support for people when they became unwell. The registered manager had oversight of this and made sure prompt responses were received from the relevant healthcare professionals to ensure people received timely support.

People experienced positive outcomes using the service, particularly in relation to their health and wellbeing needs. A relative told us their family member had been very ill in hospital recently and the relative was advised by the hospital that they may not recover. However when their family member was sent home from hospital, staff supported their family member to fully recover from their illness. They said, “[Family member] was so unwell and we thought we were going to lose them. Now [family member] is much more like themselves. [Staff] care about the people there. The staff really do care.” A healthcare professional involved in another person’s care said, “After 6 weeks of placement, I arranged for a meeting and was impressed that [person using the service] was looking better.”

Staff monitored the care and support provided to people and took appropriate action if any improvements to this were required. A staff member told us, “We do pulse, temperature and oxygen checks. Weight we do monthly. We are very focused on people’s needs.” Managers acted on feedback from staff about improvements that could be made to the way care and support was delivered to people. The registered manager told us, “Staff told us that one person’s bedroom was becoming quite cramped with all the equipment they needed. So we repositioned the room to make this more spacious and comfortable for the person and staff can work more safely and freely in the room to support them.”

Systems were in place to monitor the care and support provided to people to ensure this remained effective. Staff maintained daily records of the care and support they provided to people and their observations about people’s health and wellbeing. Managers reviewed these records at regular intervals and used this to inform their ongoing assessment, monitoring and review of people’s care and support needs, and made changes where these were required.

We observed people were supported to understand the care and support staff wished to provide them with. This enabled people to consent to this if they wished. People could refuse to receive care and support if they wished and staff respected their decisions about this.

Staff empowered people to make their own decisions about how their day to day care and support was provided. They understood people’s capacity to make decisions about their care and support through verbal or non-verbal means. A staff member told us, “We can explain to people in simple language and in the ways people understand to tell people what we would like to do. Most people can say yes if they are happy for us to do this.” Another staff member said, “I speak to [person using the service] and communicate what I would like to do. I always start with a good morning and how are you. I ask [person using the service] if they are ready to have a wash and get ready and I wait for them to respond. They will clap to say yes and this means they are happy.”

The provider was now working within the principles of the Mental Capacity Act (MCA). Systems were in place to ensure mental capacity assessments had been completed with people and others involved in their care. People’s capacity and ability to consent was taken into account, and people had been involved in planning their care and support. Where people could not make decisions and consent to their care, processes were in place to make sure any decisions would be made in their best interests.