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Montclair Residential Home Good

Reports


Inspection carried out on 10 March 2020

During a routine inspection

Montclair Residential Home is a care home providing personal care to 15 people aged 65 and over at the time of the inspection. Montclair Residential Home can accommodate up to 15 people in one adapted building, specialising in supporting people living with dementia.

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

Staff were knowledgeable in safeguarding adults’ procedures and reported concerns appropriately to the local authority and, if required, the police. Risks to people’s safety had been identified and managed. We identified some environmental risks on the day of our inspection and staff took immediate action to address those concerns. There were sufficient staff to meet people’s needs and safe recruitment practices were followed. Staff adhered to infection control procedures and safe medicines management was in place.

Staff received regular training and supervision to ensure they had the knowledge and skills to support people. Staff were aware of people’s dietary requirements and people had access to food and drink throughout the day. Staff supported people to access healthcare professionals and followed advice provided. 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. An accessible, clean and homely environment was provided.

Staff had built good working relationships with people. People and the relative we spoke with were complimentary about the staff and felt they were well cared for. Staff were respectful in their interactions with people and spoke to them politely. Staff respected people’s privacy and dignity, and supported them to be as independent as possible. People were involved in decisions about their care and staff asked people’s permission before providing support.

People received personalised care that met their needs. Staff were aware of people’s communication methods and spoke clearly to aid understanding. Staff were aware of who was important to people and supported them to maintain those relationships. They provided a range of activities to protect people from the risk of social isolation. The service had reviewed their practices to ensure they were aware of people’s end of life choices and end of life care plans had been developed. A complaints process was in place. People and the relative we spoke with had not needed to make a complaint.

The management team had been reviewed and strengthened since our previous inspection to provide greater oversight and clarity over lead roles. People, their relatives and staff were regularly asked for their feedback about the service and improvements were made in response to the feedback received. The manager had processes in place to review and improve the quality of service delivery. The manager was aware of their CQC registration requirements and submitted notifications about key events as required. They had also ensured that the service’s CQC rating was clearly displayed at the service and on their website.

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 18 September 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 22 August 2017

During a routine inspection

Montclair residential home provides accommodation and support to up to 15 older people, many of whom are living with dementia. At the time of our inspection the service was full with 15 people receiving support. Some people had been living at the home for over 20 years.

At our last inspection on 17 March 2015 the service was rated 'good' overall and for each key question. At this inspection the service remained rated ‘good’ overall.

Systems and processes remained in place to keep people safe. There were sufficient staff to meet people’s needs and safe recruitment practices were followed. Staff identified and mitigated risks to people’s safety and escalated any concerns as required, including reporting to the local authority safeguarding team when necessary. People continued to receive their medicines as prescribed and accurate records were kept in regards medicines management.

Staff had the knowledge and skills to undertake their duties and were supported to participate in regular training courses, including obtaining additional relevant qualifications. Staff adhered to the Mental Capacity Act 2005 and followed lawful practices for those that did not have the capacity to consent to aspects of their care. Staff continued to support people with their nutritional and health needs.

Caring relationships were established between people and staff. Staff respected people’s individual differences, supporting them to practice their faith and maintain relationships with relatives. Staff offered people choices and respected their decisions. People’s privacy and dignity was maintained.

People continued to have their needs met. Staff were knowledgeable about the people using the service and the level of support they required. Clear care plans were maintained and on the whole updated in line with changes in people’s needs. There continued to be a complaints process in place which ensured people’s concerns were listened to.

The provider continued to have systems in place to monitor the quality of service delivery and obtain feedback from people, relatives and staff. The provider was due to undertake their annual review of service delivery and informed us they would use learning from participation in local research projects to further enhance the quality of care. The provider was not aware of their responsibility to clearly display their CQC rating on their website, as well as at the service. At the time of our inspection the information on the service’s website did not sufficiently display their CQC performance rating. The provider informed us they would ensure this was corrected.

Inspection carried out on 17 March 2015

During a routine inspection

This inspection took place on 17 March 2015 and was unannounced.

At the last inspection, which we carried out on 8 October 2013, we found the service was meeting all the regulations we looked at.

Montclair is a residential home that provides accommodation for up to 15 people with personal care and support needs. There were 14 people using the service when we visited. The home specialises in supporting older people living with dementia. When we visited, 13 people using the service were living with dementia and one person had a past or present experience of mental ill health.

The home is owned by an individual provider and run by him and his wife. The provider is also the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 Montclair was a comfortable place to live. We saw the environment was well maintained and safe. People could access most areas of their home and move around it freely.

However, we saw some equipment, such as mobile hoists and wheelchairs, were not appropriately stored when they were not in use. This meant the communal space people using the service and their guests could use to relax in or pursue social activities was significantly reduced.

We have made a recommendation that moving and handling equipment such as mobile hoists and wheelchairs are kept stored away in an area which does not affect people’s ability to enjoy their communal space.

People told us they felt happy and safe living at Montclair. They also told us staff looked after them in a way which was kind, caring and respectful. Our observations and discussions with people using the service and their relatives supported this.

People’s rights to privacy and dignity were respected and maintained when receiving personal care from staff. People were encouraged to participate in meaningful social and leisure activities both at home and in the local community. People were also supported to maintain social relationships with people who were important to them.

People had a choice of meals, snacks and drinks and staff actively encouraged and supported people to stay hydrated and to eat well. Staff supported people to keep healthy and well through regular monitoring of their general health and welfare. Where they had any issues or concerns they sought appropriate medical care and attention promptly from other healthcare professionals. People received their medicines as prescribed and staff knew how to manage medicines safely.

Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed by the services management. Staff were given appropriate guidance on how to minimise identified risks and keep people safe from avoidable harm or injury. The service also managed accidents and incidents appropriately and suitable arrangements were in place to deal with emergencies.

There were enough staff to meet the needs of people using the service. Staff received appropriate training and support and the registered manager ensured their skills and knowledge were kept up to date. The service also ensured staff were suitable to work with vulnerable adults by carrying out employment and security checks before they could start work.

People’s consent to care was sought by the service prior to any support being provided. People and their relatives were supported to make decisions and choices about their care and support needs. People agreed to the level of support they needed and how they wished to be supported. Where people's needs changed, the provider responded and reviewed the care provided.

The registered provider understood when a Deprivation of Liberty Safeguards (DoLS) application should be made and how to submit them. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

The registered provider encouraged an open and transparent culture. People and their relatives felt able to share their views and experiences of the service and how it could be improved. People and their relatives also felt comfortable raising any issues, concerns or complaints with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately.

There were effective systems in place to monitor the safety and quality of the service and the registered provider/manager took action if any shortfalls or issues with this were identified through routine checks and audits. Where improvements were needed, action was taken.

Inspection carried out on 8 October 2013

During a routine inspection

Because of the frailty and cognitive impairment of the people who used this service it was not possible for most of them to be involved in discussions about their care. However, we saw that they all looked happy and showed signs of positive wellbeing and engagement with the staff. Some people, who were able to express a view, told us �it�s nice here�, �I�m quite happy� and one told us �it�s a lovely home; I have no complaints at all�. The service was relatively small, and as such, had a feeling of being quite homely.

We found that care plans accurately reflected the support that people needed. People�s relatives had been involved in compiling them, and they were reviewed regularly.

Appropriate procedures were in place to ensure that people�s medication was safely administered to them.

Robust recruitment procedures were in place in order to help prevent those people who had been judged as being unsuitable to be caring for vulnerable people from doing so.

Premises were safe and well maintained and records showed that equipment and services were checked and serviced according to current guidelines

Inspection carried out on 13 February 2013

During a routine inspection

There were fifteen people living at the home at the time of our inspection they were all at home. Some were relaxing in the lounge and others were taking part in activities. They were all suffering from dementia and so it was not possible to have many in depth conversations but we spent time with a number of people in their lounge. Everyone was very positive about the service and said they liked living there. One said the food was very good and that you got plenty. Another said �it�s very nice here�.

We observed detailed care plans, training records and policies and procedures. We spoke to two members of staff who said thy liked working at the home and that the manager was �passionate about quality�. We also spoke to an NVQ assessor who was visiting the home and they also said that the staff were very competent and knowledgeable. All staff had either achieved or were working towards NVQs. The provider had put processes in place for keeping people safe and had appropriate policies for safeguarding, whistleblowing and complaints. Staff were aware of these policies and said they knew how to use them.

Inspection carried out on 8 March 2012

During a routine inspection

The people who live in this home like to be known as known as residents. Those we spoke with told us "I am very happy here" �it�s a nice place to live in�, and �I have a lovely room�.

They told us that they were free to spend their days as they wished and we were able to see that there were activities for them to join in with, if they wanted to. Those who were not able to communicate showed signs of positive engagement with both their surroundings and the staff who were caring for them.

We asked residents what they thought about the food that was served to them. All of them agreed that they liked it, and told us �it�s very nice�, I always enjoy it�.

Reports under our old system of regulation (including those from before CQC was created)