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Mountside Residential Care Home Requires improvement

We are carrying out checks at Mountside Residential Care Home. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 February 2018

We inspected Mountside Residential Care Home on 14 November 2017, this inspection was unannounced. The inspection was carried out by two inspectors and two experts by experience. An expert by experience is a person who has personal experience of using, working with or caring for someone who uses this type of care service.

Mountside Residential is a care home, providing both permanent residential and respite care for up to 52 older people. At the time of the inspection there were 48 people living at the home. Mountside Residential Care Home is an adapted Victorian property with an extension added in 2014. There are a number of communal areas and access to a large terrace and gardens.

We previously carried out a comprehensive inspection at Mountside Residential Care Home in October 2016. We found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because we identified concerns regarding medicines management and systems and processes to monitor and improve the service were not effective. We also found areas of practice that required improvement. This was because risks to people’s safety had not consistently been assessed, training needed to improve, mental capacity decisions were not robust and care plans did not include sufficient guidance. The service received an overall rating of ‘requires improvement’. After this inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to these breaches.

We undertook this unannounced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan and that the service was now meeting legal requirements. We found improvements had been made in relation to medicines, however further breaches of regulation were identified. The overall rating for Mountside Residential Care Home has remained as ‘requires improvement’. Details of the breaches identified can be found at the end of the report. We will review the overall rating at the next comprehensive inspection, where we will look at all aspects of the service and to ensure sufficient improvements have been made.

Mountside Residential Care Home 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.

Risks to people had not been assessed and reviewed to ensure their safety was maintained at all times. Care plans did not fully reflect people’s physical, mental, emotional and social needs. Records relating to the care and treatment of each person were not accurate, complete or updated without delay when changes occurred, or included relevant information recorded to ensure people received care that was person centred. People’s weights had not been consistently documented or actions recorded to show how the registered manager had responded when people’s weights had changed.

Staff had a limited understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Mental Capacity assessments had not been completed regularly or updated. Decisions around people’s capacity and who was legally entitled to be involved in decisions was not recorded in line with legislation.

Staff training had not been maintained to ensure all staff were suitably trained to meet people’s health needs effectively. Although identified within the PIR completed by the registered manager, at the time of the inspection, training records showed that many areas of staff training were out of date or had not been completed. Therefore it was unclear how the provider had assured themselves that staff were appropriately trained and competent to carry out their roles.

Quality assurance systems to audit and monitor the service were not robust. Issues identified during the inspection in relation to documentation and records not being maintained appropriately had not been identified in audits completed.

Medicines had been improved with further work on-going to ensure PRN protocols were in place.

Appropriate staffing levels had been maintained by using regular agency staff, as the provider had struggled to recruit staff. Recruitment processes had been followed when new staff were employed.

Staff understood their responsibilities to report safeguarding concerns to ensure people’s safety. People’s privacy and dignity were respected and care records were kept securely. Staff supported people receiving end of life care to remain comfortable, offering support when needed. People were supported to have access to healthcare services when they requested them. This included GP visits, chiropodist and community nurses.

People were supported to eat and drink a variety of food and enjoyed the meals provided. Staff treated people with kindness, understanding and patience. People spoke positively about staff and the way they supported them to maintain relationships with family and friends and were supported to make their own decisions and choices throughout the day. People’s independence was encouraged.

There was a varied range of activities taking place which people enjoyed. People’s involvement was sought to ensure future activities were based on things they wished to do. A complaints policy in place and people and visitors told us they would raise any concerns with staff.

People’s feedback about the home was sought. Minutes were recorded to show that residents, relative and staff meetings had taken place.

Inspection areas

Safe

Requires improvement

Updated 6 February 2018

Mountside Residential Care Home was not consistently safe.

Risks to people had not been assessed and reviewed to ensure their safety was maintained at all times.

Medicines had been improved with further work on-going to ensure PRN protocols were in place.

Appropriate staffing levels had been maintained by using regular agency as the provider had struggled to recruit staff. Recruitment processes were followed.

Staff understood their responsibilities to report safeguarding concern.

Effective

Requires improvement

Updated 6 February 2018

Mountside Residential Care Home was not consistently effective.

Staff had a limited understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Capacity assessments had not been completed regularly or updated. Decisions around people’s capacity and who was legally entitled to be involved in decisions was not recorded in line with legislation.

Staff training had not been maintained to ensure all staff were suitably trained to meet people’s health needs effectively.

People were supported to eat and drink a variety of food and enjoyed the meals provided.

People were supported to have access to healthcare services when they needed them.

Caring

Good

Updated 6 February 2018

Mountside Residential Care Home was caring.

Staff treated people with kindness, understanding and patience.

People spoke positively about staff and the way they supported them to maintain relationships with family and friends.

People were supported to make their own decisions and choices throughout the day and their independence was encouraged.

People’s privacy and dignity were respected. Records were kept securely.

Responsive

Requires improvement

Updated 6 February 2018

Mountside Residential Care Home was not consistently responsive.

Care records did not include relevant information to ensure people received care that was person centred. Care plans did not fully reflect people’s physical, mental, emotional and social needs.

There was a varied range of activities taking place which people enjoyed. People’s involvement was sought to ensure future activities were based on things they wished to do.

Staff supported people receiving end of life care to remain comfortable. Offering support when needed.

There was a complaints policy in place and people and visitors told us they would raise any concerns with staff.

Well-led

Requires improvement

Updated 6 February 2018

Mountside Residential Care Home was not consistently well- led

Quality assurance systems had not identified issues found during the inspection. Systems used were not robust.

Records relating to the care and treatment of each person were not accurate, complete or updated without delay when changes occurred.

People’s feedback was sought. Residents, relatives and staff meetings took place.