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Inspection carried out on 5 April 2018

During a routine inspection

We undertook an unannounced inspection of Quarry Mount Care Home on 5 April 2018.

Quarry Mount is a care home, which provides accommodation and personal care for up to 30 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of the inspection 26 people were being supported.

Accommodation was located on the ground, first and second floor of the building and there was a bungalow located alongside the rear garden. The bungalow accommodated two people, who are able to live more independently than those in the main home.

There was a registered manager in post. 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.

At the previous inspection in January 2017 the service was rated as Requires Improvement.

At this inspection we found the service had made improvements and was rated as Good overall.

On the day of the inspection Quarry Mount Care Home was experiencing a large number of cases of influenza affecting people and staff. In spite of this we found that care was continuing to be delivered appropriately, and staff were warm, welcoming and supportive of the inspection process.

People and their relatives complimented the compassionate nature of staff and told us staff were caring. On the day of our inspection we saw examples of kind and compassionate interactions that demonstrated staff knew people well. People's dignity, privacy and confidentiality were respected.

People told us they were safe. Staff knew what to do if they had safeguarding concerns and were aware of the provider's whistle blowing policy. People were supported by sufficient staff to keep them safe and the provider ensured safe recruitment practices were followed. Staff training was ongoing and the records confirmed staff received supervisions.

People's care plans contained risk assessments that covered areas such as falls, mobility or nutrition. Where people were at risk, their records outlined management plans on how to keep them safe.

People's medicines were stored securely and administered safely by trained staff.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. 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.

People were supported to maintain good health and access health professionals when required.

People were complimentary about the food, and they were provided with choices at every meal.

People were assessed prior to coming to live at Quarry Mount Care Home and people told us staff knew them well. People's care files gave details of the level of support required and people's wishes and choices. These also contained information about people's personal histories, medical information, their likes and dislikes.

Information on how to complain was available to people and the provider had a complaints policy in place.

The registered manager ensured various audits were being carried out, where improvements were identified we found evidence that these had been carried out.

We saw that the service had a team that worked cohesively, supported each other and were well-supported by the registered manager. All staff we spoke to were committed to putting the needs of people first and providing a homely environment.

Inspection carried out on 10 January 2017

During a routine inspection

Quarry Mount is a care home, which provides accommodation and personal care for up to 30 people. At the time of our inspection, 26 people were resident at the home. Accommodation was located on the ground, first and second floor of the building and there was a bungalow located alongside the rear garden. The bungalow accommodated two people, who are able to live more independently than those in the main home.

This inspection took place on 10 January 2017 and was unannounced. We returned on 11 January 2017 to complete the inspection. Quarry Mount was last inspected in September 2014 and was found to be meeting all of the standards assessed.

There was a registered manager in post. 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. The registered manager is responsible for the day to day management of the home and was available throughout the inspection.

People’s medicines were not always safely managed. The medicines trolley was not stored securely and staff had not consistently signed the records to show they had given people their medicines. In addition, instructions for the use of topical creams were not clear and information did not inform staff how to properly manage medicines to be taken “as required”.

Whilst there were enough staff to support people effectively in the morning, this was not the case, in the afternoon and evening. The registered manager had identified this and was in the process of employing additional ancillary staff. They said the addition, would enable care staff to concentrate more on supporting people, rather than undertaking ancillary tasks.

Staff were not always responsive to people’s needs. This was particularly apparent at lunch time on the first day of the inspection. Care plans contained detailed information but this was not always applied in practice. Some of the information did not clearly inform staff of the support people required.

Records showed some people did not have the capacity to consent to their care. The information did not show the Mental Capacity Act 2005 had been properly taken into account within the decision making processes. Staff had undertaken training in this area and were aware of their responsibilities to provide care in the least restrictive manner.

There were a range of audits to assess the safety and quality of the service. Whilst these had been regularly undertaken, some audits, such as accidents and incidents required further analysis to minimise additional occurrences. As part of the quality auditing processes, people and their relatives were encouraged to give their views about the service they received. Their feedback was readily considered and used to further improve service provision.

People received regular support from health care professionals. Detailed information described each person’s current health and medical history. People received a well-balanced diet although portion sizes were large. People said they enjoyed the meals and had sufficient choice and variety. People received regular food and drink throughout the inspection.

People felt safe and were complimentary about the staff, the registered manager and provider. There was a clear ethos of providing good quality care, which was cascaded throughout the staff team. Staff knew people well and were aware of their needs. They said they felt valued and well supported. Staff received a range of training to enable them to do their job effectively.

During our inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 19 September 2014

During a routine inspection

This service was inspected by a single adult social care inspector. In order to answer the questions below we spoke with twelve people who used the service, three relatives, two healthcare professionals, two members of staff and the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. We also reviewed four people’s care records. There were twenty seven people using the service at the time of our inspection.

Is the service safe?

The service was safe. People told us they were happy with the care delivered. People told us they felt able to approach staff with any concerns or complaints. There were sufficient numbers of staff on duty to meet the needs of the people and there was always a senior member of staff available to manage any emergencies. People were supported in a clean environment.

Is the service effective?

The service was effective. Staff had a good understanding of people’s support needs. Staff told us their training was useful for them to support people to the best of their abilities. All complaints received had been dealt with promptly. People told us they felt the service was suitable for them.

Is the service caring?

The service was effective. We saw staff listened to people in the service and gave encouragement when supporting them. People told us the staff were kind and patient with them. One person told us, “I’ve never been rushed.” People confirmed to us staff offered them choices of activities and meals every day. A relative said, “They’re all very kind here.”

Is the service responsive?

The service was responsive. Systems were in place to allow people choice, involvement and independence. Care records recorded people’s preferences and care was provided in accordance with each person’s wishes. We saw people’s care records had been regularly reviewed and updated in the event of a change in the person’s support needs. People had access to activities they liked and wanted to be involved in.

Is the service well-led?

The service was well-led. There was a professional atmosphere to the service when we visited. We saw a robust quality assurance system in use. Staff told us they were clear about their roles and responsibilities and felt well supported by the manager.

During a check to make sure that the improvements required had been made

We found the provider had made improvements to meet the assessed needs of people who used the services. These included effective management of staff hours based on the assessed needs of the people who lived in the home.

Improved records were completed to identify individual’s changing needs and associated risks.

Staff training had been reviewed and they had received updated training to improve records and to meet the assessed needs of the people who used the services.

Inspection carried out on 24 July 2013

During a routine inspection

People who used the services told us they were happy living in the home and were complimentary about the staff team. They told us they felt safe, cared for and that staff respected choices they had made. Comments included, “Yes they always check if I have enough drinks, I only need to say to staff to top my glass up”, “It’s nice here, but I would prefer to be at home; nothing wrong with it”

People told us they enjoyed the range of internal and external activities provided. We found that some people would benefit from more one to one support for their chosen activities.

We spoke with relatives of people who used the services. They told us they were kept informed, were listened to and given opportunity to give their view of the services provided. Comments included, “yes I received a questionnaire a few days ago” and “staff are brilliant, they really care about what is happening”.

We found staff were knowledgeable of people's specific health and personal care needs and had received training to update their skills and knowledge. We found there were not enough staff to meet people’s needs at all times and that some records used for the purpose of monitoring and assessment were not complete.

Staff told us they felt supported by the provider and management team.

Inspection carried out on 3 May 2012

During a routine inspection

People living in the home told us they felt safe and were well treated by the staff. People said they were treated with dignity and respect and were satisfied with the personal care they received.

We were told that a variety of activities were supported, with people having a choice whether to participate or not.

People said they enjoyed the food and that individual preferences were catered for.

People’s needs were attended to promptly and staff had a good knowledge of the individual people living in the home.

Everyone had up to date care plans in place that were being regularly reviewed and updated.

Staff were undertaking regular training and were well supported by the managers and worked well as team.

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