Morden College

About the service

Morden College personal care service provides care and support to people within the Morden College Charity Community. The charity supports older people through a range of services within their community so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were four people using the personal care service.

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

Some medicines were not always safely managed as staff did not always follow best practice guidance.

The system to oversee and monitor the quality of the service was not always effective at identifying issues.

There had been several changes of manager at the service since the last inspection. An improvement plan had been put in place which the new manager and clinical lead were working on.

People felt safe using the service. Staff knew how to recognise and report concerns or abuse. They were confident the management team would act to safeguard people if needed. Incidents and accidents were reported, and the registered manager reviewed them and took action to reduce the risk of repeated concerns.

Risks to people were assessed and management plans were put in place to reduce the risk from happening. Risk plans had not been reviewed but there was a plan to address this.

Staff were recruited safely and there were enough staff to meet people’s needs. Staff understood and followed safe infection control procedures.

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 told us their views about the service were asked for and that they were consulted and involved in their care. The service worked with health and social care professionals to ensure people's needs were safely met.

There was an empowering and positive culture at the service. People were supported to access facilities to reduce social isolation and engage their interests. The manager and staff demonstrated a commitment to their roles.

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

Rating at last inspection

The last rating for this service was Good (published 2 April 2019).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Morden College on our website at www.cqc.org.uk.

Why we inspected

This inspection was prompted by a review of the information we held about this service. we inspected the key questions safe and well led as a result of the information we held. The overall rating for the service has now changed to requires improvement.

Enforcement and Recommendations

We have found breaches of regulation in respect of managing medicines and the oversight and monitoring of the service. The manager took action to start to address issues we found at the inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This announced inspection took place on 7 February 2019. At our last inspection in July 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. 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.

Staff knew signs to recognise abuse and how to report any concerns appropriately. Staff followed infection control procedures. Staff supported people with their medicines in line with safe medicine administration and management procedures. Risk assessments were completed and management plans were developed reduce harm to people. There were sufficient staff available to care for people as required. Recruitment procedures were robust and safe. Staff knew to report incidents and accidents to the registered manager.

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. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. People consented to their care and support before they were delivered.

Staff told us and record showed that they were supported to be effective in their roles through induction, supervision, appraisal and regular training programmes. People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. People were supported to access healthcare services they needed to maintain good health. Staff liaised appropriately with social care and health care professionals to ensure people received the support they required. People’s care and support needs were assessed to establish what support they needed.

People told us staff treated them with kindness, compassion and respect. People were involved in their care delivery and their choices were respected. Staff supported and encouraged people to be as independent as possible. Staff understood and promoted equality and diversity.

People had care plans in place which detailed their needs and what support they required to meet those needs. Care plans were up-to-date and reflected people’s current needs. The provider made information accessible to people. People’s end of life wishes were noted in their care plans.

The views of people and their relatives were sought about the quality of the service provided. People, relatives and staff told us that the service was well managed. People and their relatives knew how to complain about the service and the registered manager understood their role in investigating and responding to complaints in line with the provider’s procedure. The registered manager continued to meet the requirements of their registration.

Staff felt they had the support and leadership they needed to carry out their roles. The quality of the service was regularly reviewed through spot checks and audits. Where concerns were identified, actions were taken to address them. The service worked in partnership with other organisations.

Morden College domiciliary care service and the provider Cullum Welch Court are part of Morden College, a long established independent charity, which among other areas, provides accommodation to older people.

This service Morden College domiciliary care is currently offered to beneficiaries of the charity who live independently in the charity community and who have personal care or support needs. They can then choose to have these needs met from this service or from another provider. At the time of this inspection there were ten people using the service.

There was a registered manager; 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.

People told us they felt safe from harm and well cared for by the service. Care workers had received training on safeguarding adults, so they knew the signs of possible abuse. Possible risks to people were identified and guidance was in place to reduce risk. There were suitable arrangements to deal with a range of emergencies if needed.

People told us that their care workers were caring and kind and often went out of their way to support them. Most people had a small group of care workers, who they said knew their needs and preferences well. People said they were involved in decisions about their care and they were treated with respect and dignity at all times. There was a strong sense of mutual respect and of belonging to a community from people and the staff.

There were enough care workers and office staff to meet people’s needs and the provider followed safe recruitment policies. Staff received suitable training and support to carry out their roles. People were asked for their consent before care was provided and staff was aware of their responsibilities under the Mental Capacity Act (2005). People’s dietary needs were met, where they needed support to manage this. The service linked with health professionals to ensure people’s changing health needs were addressed.

People had an assessed and written plan of care available in their homes; these were up to date and people told us they reflected their needs and individuality. People said they were involved in reviewing the plans and that any changes were updated in the care plan. There was a complaints procedure and people knew how to raise a complaint.

People and their relatives told us the service was efficient and provided consistently good care. It was a small service with a stable management team who were in frequent contact with people and could be involved in the delivery of care. They were therefore familiar with people’s needs. There were robust communication systems about people’s needs and staff felt well supported in their roles. People told us they were asked for their views about the service and felt listened to and that the service considered any improvements that could be made. The registered manager and scheme coordinator were proactive in looking to improve the quality of the service.