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Archived: Montrose Good

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All reports

Inspection report

Date of Inspection: 2 February 2012
Date of Publication: 23 May 2012
Inspection Report published 23 May 2012 PDF

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Not met this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

How this check was done

Our judgement

The system in place to regularly assess and monitor the quality of service that people receive is ineffective. There was no evidence of identified learning from the quality assurance process to improve practice.

Overall Montrose Care Home was not meeting this essential standard.

User experience

People who live in the home and visitors we spoke with told us that they would approach the registered manager if they had any concerns.

Other evidence

The registered manager showed us the quality assurance programme which was in place. This included monthly audits of care plans, accidents/incidents and infection control. Audit reports were produced but there was no evidence of identified learning points or how learning as a result of the audits was shared with staff to improve practice.

We were told that monthly quality assurance questionnaires were given to residents and reported on. We did not see that this information about quality and safety was acted upon and fedback to people in the home

We were told that no meetings had been held with relatives of people living at Montrose in the last 12 months but one was planned for the end of March 2012. We saw a poster on the notice board in the hall with the dates for residents meeting in 2011.

The registered manager showed us minutes of a resident’s meeting held in January 2012. Eight residents attended this meeting and discussed their views on staffing, activities and mealtimes. The meeting minutes recorded that five people expressed the view that more staff were needed to meet everyone's needs.

We reviewed the complaints folder which showed that complaints were not monitored and analysed. There was no evidence that any learning takes place as a result of a complaints investigation.

During the inspection visit we were unable to see any documentation relating to the operational management of the kitchen as all records had been taken off site. We did not have any evidence with regard to the monitoring of fridge temperatures, food serving temperatures or kitchen cleaning rotas.