Archived: Mountford

We found the following examples of good practice

• The service was only allowing visitors inside the care home in exceptional circumstances. However there was space in the grounds for people to meet with their friends and families. Thorough procedures were in place to facilitate visits in a safe way. Staff had also helped people to stay in touch with family and friends through phone calls, and through the internet.

• The service had identified an area of the building which could be used for people who needed to isolate, and /or who were admitted to the service. This ensured there was minimal risk from infection to other people at the service. Robust admission procedures were in place for example the service requiring documentary evidence of Covid-19 test results before people move in, followed by a period of self isolation, followed by a further test before the person being able to mix with others.

• The service was providing a range of social activities for people to help to keep them entertained and occupied. The service had a dedicated activities organiser who provided one to one, and group activities. We noted the service had some newspapers and periodicals which people could access. The service used the grounds of the building well. For example we met one person who was working to cultivate plants in a green house, and who told us she was involved in the upkeep of raised beds. This helped to maintain some sense of normality during this difficult period.

• Staff had received suitable training and guidance regarding infection control, and how to respond to the Covid 19 pandemic. All staff received regular reminders for example of ‘donning and doffing’ techniques at handover. Throughout the inspection we observed staff demonstrating suitable knowledge of good infection control practice.

• The service was very clean, and had effective cleaning routines to ensure risks were minimised and people were kept safe.

• There was a warm, friendly atmosphere, between staff and people who used the service, on the day of the inspection. The registered manager said staff sickness throughout the period of the pandemic had been minimal, and, “Everyone had pulled together,” to ensure high standards of care had been maintained, and the anxiety caused by the pandemic had been minimised.

Mountford is a residential care home providing personal and nursing care to 36 people, some of whom are living with dementia. At the time of the inspection 33 people were receiving support.

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

Some people were not able to tell us verbally about their experience of living at Mountford. Therefore, we observed the interactions between people and the staff supporting them.

People's needs were met in an individual and personalised way by staff who were exceptionally kind, caring and responsive to their changing needs. People felt listened to and knew how to raise concerns. The service was highly responsive and innovative in looking at ways of meeting people’s social needs.

The service had continued to develop an exceptional response to people entering the end of their life. Peoples needs had been significantly considered.

Enough staff who had been recruited safely were available to meet people's needs and we observed staff respecting people's privacy and protecting their dignity.

People were safeguarded from the risk of abuse. People received safe care and treatment in line with national guidance from nurses and care staff who had the knowledge and skills they needed.

There were enough nurses and care staff on duty and safe recruitment practices were in place.

People were supported to take medicines safely and lessons had been learned when things had gone wrong.

Good standards of hygiene were maintained and people had been helped to quickly receive medical attention when necessary.

People enjoyed the meals and their dietary needs had been catered for. This information was detailed in people's care plans. Staff followed guidance provided to manage people's nutrition and pressure care.

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.

Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.

Effective governance systems were in place, ensuring people received consistent care.

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 5 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 inspection programme. If we receive any concerning information we may inspect sooner.

Mountford is a care home providing nursing care for up to 38 people some of whom are living with dementia. The service is set in a residential area of Truro. It is a single storey purpose built service. There were a range of aids and adaptations which were suitable to support people. The service is close to local amenities and a transport network. The garden area has been developed as a sensory area which is suitable for people with mobility needs. At the time of the inspection visit there were 34 people living at the service.

At the last inspection in July 2015 the service was rated overall ‘Good’.

Staff demonstrated an exceptionally caring, compassionate and kind attitude towards people who lived at the service. People told us staff were very respectful and spent quality time with them or their relative. There were numerous examples of how caring attitudes of staff had a very positive impact on people’s lives. For example, staff were supporting people who were entering the end stages of their life. Staff made sure they knew what people wanted, including experiencing events of their choice, having personal items around them and listening to specific pieces of music. Comments we received included, “Nothing is too much trouble, its 24/7. We were supported as well as (Person),” “Absolutely excellent. Just couldn’t have asked for more. The support from staff was exceptional” and “We were encouraged to visit anytime. It was very important especially for the grandchildren.”

Systems were in place to help ensure staff had up to date information on how best to support people at this stage of their lives. People received individualised person centred care that was designed to meet both their health needs and their social needs and individual preferences. The management team lead by example when delivering care and support and displayed a commitment and passion for the service they provided. The service had achieved a national award for providing end of life care. Staff told us they were very proud of the support and care they give to people and their families as they are coming to the end of their lives.

Health professionals we spoke with told us how they felt the service provided outstanding care. They were impressed with the knowledge of staff with their attention to end of life care.

There were enough staff to help ensure people’s health and social needs were met. Staff were effectively deployed across the service to ensure people’s needs were being met. In general call bells were responded to quickly. However we observed one occasion when a call bell was not answered promptly. When informed the management team responded immediately to address the issue.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse. Incidents were logged, investigated and action taken to keep people safe. Risks to people’s health and safety were assessed and clear plans of care put in place to help keep people safe.

Staff were aware of their responsibilities to protect people from avoidable harm. Staff had received adult safeguarding training and had information available of the action required to respond to any concerns that may be raised. The management team had taken appropriate action when safeguarding incidents had occurred to reduce further risks.

Recruitment procedures were safe to help ensure staff were of suitable character to work with people who may be vulnerable.

We observed people receiving their medicines as prescribed. The system for storing medicines was safe. There were suitable storage systems for keeping medicines safe and secure. Only staff with responsibility for medicine administration had access to medicines. It was clear from the medicine records that people received them as prescribed. Regular medicines audits were taking place to identify if any errors occurred.

Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. Any accidents and incidents were recorded and audited to help ensure the risk of re-occurrence was reduced.

The organisation Cornwall Care had a robust training programme in place to ensure staff were appropriately trained to meet the needs of the people using the service. More specialised training specific to the needs of people using the service was being provided, for example, end of life care training. Staff were supervised in their roles to aide their personal development.

People were provided with a healthy and varied menu to meet their nutritional needs. 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 support this practice. This meant the service was effective in meeting people’s needs.

People were supported by kind and attentive staff. Staff responded to people’s needs in a respectful dignified manner. Staff discussed interventions with people before providing support. Staff understood people’s abilities and preferences, and were knowledgeable about how to communicate with people.

People's rights were mostly protected because staff acted in accordance with the Mental Capacity Act 2005. Some consent forms were signed by the person themselves. Where a person was unable to do this, the consent was not always signed by a person with the legal power to sign on behalf of another, such as a lasting power of attorney for care and welfare. The registered manager was aware of the need for this and was taking action to ensure families would inform them who held such legal powers. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly. 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 provided with choices and their wishes were respected.

People and relatives said they were highly satisfied with the service and felt able to talk to the registered manager about any concerns or complaints.

There was a broad range of activities available to suit people’s needs. An activity co-ordinator arranged regular events for people and had the knowledge and skills to support people living with dementia. These included singing, crafts and visits to the local area. The service had developed a programme to support people to experience activities that they hope to accomplish in their lifetimes. For example, the service had supported a person to watch surfers in the sea and for a person to attend a gliding club.

The registered provider had a robust quality assurance process in place to drive improvement.at Mountford. These included regular audits of the service, annual surveys, resident meetings and staff meetings to seek the views of people about the quality of care at the service. There was also evidence of the service engaging with external quality assurance organisations which showed the service was open and transparent.

People were protected by a clean environment and medicines were well managed. The care home adhered to a robust recruitment procedure in order to protect people.

We saw that staff were supported, both by their colleagues and seniors, and also by Cornwall Care Limited.

Records were not always accurate or up to date.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We saw people's wishes were respected. We observed people moving around the home without restriction.

Care plans and associated documentation provided sufficient detail to direct and guide staff of the action they needed to take in order to meet people's assessed care needs. People's records were personalised and provided clear information about the person's wishes and abilities.

People were protected from abuse and staff were trained to carry out their roles. Staff were not fully supported with supervision.

We observed the home was clean, tidy and free from odours. People were protected from the risk of infection. People lived in a warm and comfortable home and appeared well looked after with clean and pressed clothes.