The Moreton Centre

We undertook this responsive assessment to check on specific concerns we had received about peoples' safety and well-being, staff deployment, the culture and the management of risk in the service. The Moreton Centre was last inspected in April 2025 and rated Requires Improvement. At this inspection the rating has remained Requires Improvement. We found two breaches of regulation, safe care and treatment and governance.

Due to the immediate actions taken by the provider risk to people’s health, safety and well-being was mitigated.

People’s safety and well-being were not consistently considered because staffing levels did not meet their individual needs and risks were not managed proactively. Although care plans were detailed, they were not always updated to reflect changes in people’s needs, and some included incorrect names and ages. Parts of the environment and some equipment were poorly maintained and could place people at risk of harm. We also observed unsafe moving and handling and restrictive care practices. We reported these concerns immediately to the registered manager, who took action to mitigate risks to people.

Governance and oversight did not ensure safe, consistent care. Staff concerns about staffing levels had not been escalated, leaving staff under pressure, with low morale and feeling unsupported and unheard. Audits and governance systems were not consistently robust and had not identified all the shortfalls found during the inspection, including gaps in staff supervision. Records of lessons learnt from incidents did not clearly show actions taken to prevent recurrence or reflect their impact. Staff did not find managers approachable, and opportunities to discuss incidents and service improvements were missed.

People may only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this is managed through the Deprivation of Liberty Safeguards (DoLS) under the Mental Capacity Act 2005 (MCA). We found staff and management worked within the MCA and understood when to apply for DoLS. The provider worked with external health professionals to deliver joined-up care and support safe transitions between services. Staff were recruited safely. People enjoyed their meals and were supported to lead healthy lifestyles. Despite staffing and time constraints, staff treated people with understanding and compassion and supported one another. Independence was promoted on an individual basis and staff spoke of how they encouraged people to remain independent. Most care plans and risk assessments were person-centred, activities reflected people’s interests, and people and families could share their views at meetings. Staff spoke about care delivery at peoples end of life and confirmed that they received training and support from the GP and hospice team.

We have asked the provider for an action plan in response to the concerns found at this assessment.