Morton Close is a ‘Care Home’, it is a large detached property, situated in the Cross Flats area of Bingley, approximately two miles from the town centre. The home is registered to provide residential care only for up to 40 older people. On the day of our inspection there were 23 people living at the home including one person admitted on a respite care basis. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This inspection took place on 21 November and 6 December 2018 and was unannounced. Our last inspection took place on 27 June 2017 at that time the service was rated ‘Good’ overall with no breaches or regulations.

Policies and procedures were in place to ensure people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and they were confident they knew how to recognise and report potential abuse. However, we found the correct procedure had not always not been followed.

People’s needs were assessed before they moved into the home. However, the assessment documentation we looked at was not always show how the provider concluded they were able to meet people’s needs.

The care plans in place provided staff with information about people’s needs and preferences and identified specific risks to people’s health and general well-being, such as falls, mobility, nutrition and skin integrity. However, some care records we looked at required updating and there was evidence staff did not always follow recommendations made by other healthcare professionals.

Appropriate recruitment checks were carried out to make sure only people suitable to work in the caring profession were employed. However, we recommended the provider reviewed the staffing levels on the evening shift to ensure there are sufficient staff on duty to meet people’s needs.

Staff told us there were now clear lines of communication and accountability within the home and they were kept informed of any changes in policies and procedures or anything that might affect people’s care and treatment.

Private accommodation and communal areas of the home were generally well maintained and there was a planned programme of refurbishment in place.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act 2005 (MCA). This helped to make sure people’s rights were protected.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services and systems were in place to ensure people received their medicines safely and as prescribed.

There was a range of leisure activities for people to participate in, including both activities in the home and in the local community. However, people's views differed regarding the activities available on a daily basis.

We saw the complaints policy was available. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

There was a quality assurance monitoring system in place that was designed to continually monitor and identified shortfalls in service provision. However, we found some concerns highlighted in the body of this report had not been identified through the quality assurance monitoring system.

This inspection took place on 27 June 2017 and was unannounced. At the last inspection on 17 February 2016 we rated the service as ‘Requires improvement’. We found two regulatory breaches which related to medicines and good governance. Following the inspection the provider sent us an action plan which showed how the breaches would be addressed. This inspection was to check improvements had been made and to review the ratings.

Morton Close provides accommodation and personal care for up to 40 older people. There were 30 people using the service when we visited. Accommodation is provided over three floors with lift access to each level. There are twenty-five single bedrooms and five double rooms. There are two separate lounges and a large dining area with a kitchenette on the top floor.

The home has a registered manager who has been in post for several years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was present on both days of this inspection.

People told us they felt safe, as did relatives we met. Staff understood safeguarding procedures and how to report any concerns. Safeguarding incidents had been identified and referred to the local safeguarding team and reported to the Commission. Risks to people were assessed and managed to ensure people’s safety and well-being.

Medicines management had improved which ensured people received their medicines when they needed them.

People told us there were enough staff to keep them safe and meet their needs and this was confirmed in our observations during the inspection. People’s dependencies were assessed and staffing levels were increased as and when required. Staff recruitment processes were robust and ensured staff were suitable to work in the care service. We found staff received the induction, training and support they required to carry out their roles.

The home was clean and well maintained and records showed systems were in place to make sure the premises and equipment was safe and in good working order. However, we found some hot water temperatures were exceeding the maximum temperature recommended by the Health and Safety Executive which put people at risk of scalding. Following the inspection the registered manager confirmed thermostatic valves were being fitted to mitigate the risks to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We saw improvements in the care records which were up to date and provided more detailed information about people’s care needs. People had access to healthcare services and this was reflected in their care records.

People told us they enjoyed the food. We saw mealtimes were managed in a way that ensured people had a pleasant and relaxed dining experience. People were offered choices and given the support they required from staff. People’s weights were monitored to ensure they received enough to eat and drink.

People praised the staff who they described as ‘excellent’, ‘lovely’ and ‘friendly’. People spoke positively of the care they received and we saw staff treated people with respect and ensured their privacy and dignity was maintained.

A range of activities were provided and we saw people were able to move freely around the home. There was a relaxed and happy atmosphere as people occupied themselves chatting with one another, meeting with visitors, looking at magazines, watching television or following their own particular interests.

The complaints procedure was displayed and records showed complaints had been investigated and dealt with appropriately, with

We inspected this service on 17 February. The inspection was unannounced.

We last inspected this service in January 2014 and found it was meeting all of the regulations inspected at that time.

Morton Close Care Home is a large detached property situated approximately two miles from Bingley town centre. The home is registered to provide residential care for up 40 people. Most of the people who use the service are older people, some of whom live with dementia. On the day of our inspection 25 people lived at Morton Close. Accommodation is on three floors with single and some double rooms available. The communal lounges and dining areas are all situated on the top floor. The home is well served by public transport. There is level access into the home and one passenger lift to all floors.

There was a registered manager who had been in post for a number of years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We reviewed the medicines management systems in place and although we saw some good practice we also identified areas where improvements were needed to ensure medicines were managed in a safe and proper way.

We saw mealtimes were a positive and relaxed experience. Overall we found people were provided with appropriate encouragement and assistance to eat. People told us the food was good and plentiful.

We found care records did not always contain accurate and complete information. We also found a lack of information within care records to demonstrate that risks were being appropriately assessed, monitored and mitigated.

People told us they felt safe and we saw robust procedures were in place to protect people from the risk of abuse.

Staff received appropriate training and development to enable them to deliver effective care.

Staff sought consent at the point of care delivery and worked in line with the requirements of relevant legislation such as the Deprivation of Liberty Safeguards (DoLS).

The majority of people we spoke with told us staff provided them with timely support. Our observations during the inspection confirmed this. However, we concluded minor improvements were needed to ensure staffing levels were consistently sufficient.

People told us staff were kind and caring and treated them with respect. Despite the limited information within people’s care records we saw staff knew people well and used this knowledge to deliver person centred care. Staff adapted the running of the service to respond to people’s changing needs and preferences.

People who used the service and their relatives were asked for their views and were listened to. Where people raised concerns or complaints these were promptly investigated and resolved.

Where quality assurance systems were in place these were not sufficiently robust and did not always prompt improvements to be made. There were some areas where comprehensive audits were not in place but were required to ensure appropriate action was taken to monitor and improve the service. Despite this, people spoke positively about how the service was run and told us the registered manager provided good leadership and generated positive staff morale.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We found the provider had a clear consent process and this enabled people to be clear about the service being provided and formally sign-up to their plan of care and support.

We spoke with three people who used the service and they told us they enjoyed living at the home and were very complementary about the care and support provided by the manager and staff.

We spoke with a relative of a person who used the service and they told us about the standard of care their relatives received. They said "I have no concerns at all."

We found staff were well supported in their role and were provided with an appropriate level of support and training in order for them to carry out their role effectively.

We also found the provider had an accurate Statement of Purpose (SoP) and it contained the necessary information including aim and objectives, the kinds of services provided, names of key individuals working for the service, legal status of the provider and details of the office address.

During the visit we had the opportunity to speak with five people who used the service and two relatives. Everyone told us they were "very happy" with the care and support provided at Morton Close. They said the staff were "very good and friendly." People told us they could make choices and decisions about how they wanted to spend time at the home and staff encouraged them to be fully involved in making decisions about their care and treatment. A relative told us they were involved in discussions and decisions about their relatives care needs and were kept informed about any changes. They said "my relative is settled and loves it here; the care is brilliant and the staff are great. It's a lovely home it's always clean and tidy." People who lived in the home and their relatives said the food was very good and the home was clean, nice and comfortable.

We spoke with three people who use the service and they told us staff are friendly and helpful. They also told us they are offered choices and that staff listen to them.

One person told us that they can take part in activities but preferred to stay in their room and listen to the radio. They also told us that they recently went for a meal and looked forward to visiting a garden centre next month.

The people we spoke with told us that they are given a choice at mealtimes and that staff would provide them with an alternative if they did not like the meals on offer.

People told us that if they had any concerns or complaints, they would speak to staff or the manager.

The people we spoke with told us that they were generally happy with the care being provided. They also told us that staff were friendly and that they had no issues or concerns relating to staff.

They also told us that they felt there were enough staff around and they had never had an instance where a member of staff was unavailable to assist them.