Mont Calm Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Inadequate. At this Assessment the rating has changed to Requires Improvement. This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of legal regulation in relation to person centred care.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders did not always make sure people were at the centre of their care. Whilst there were plenty of staff available, often the majority of care was task focused. We observed those people that were less likely to initiate a conversation were often ignored by staff for long periods of time. Whilst there were some meaningful activities taking place for some people, there were other people where they had no activities taking place and as such would doze in their chairs. There was some positive feedback from people about activities including, “We play games in here, skittles and dominoes. I feel like I’m on holiday” and “Activities are good. I like Bingo stuff and music now and again.” However, 1 person told us, “I used to play draughts and chess but there is no one who can play with me.”

We noted that the majority of the care plans lacked information on people’s life histories. When asked how they got to know people one member of staff said, “Usually when I am providing 1:1 care, they tell me about themselves. I feel I know quite a lot about some people.” However, not all people would be able verbalise their life history due to their cognitive impairment. Information staff did gain about people’s life history could have been shared with other staff or added to people’s care plans.

We did see there was some person centred information in people’s care plans around their preferred routines which staff were following. For example, in 1 person’s care plan it stated they liked to have a cushion to rest on when in their armchair in the lounge and we saw this happened. Another person’s care plan stated they liked sensory activities, and we saw this was done.

The provider understood the diverse health needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People were supported to access other health and social care services. The management team worked well with other professionals and ensured they communicated with them when needed, so people received integrated care.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Where people had cognitive impairments, there was not sufficient alternative communication aids used to assist them. During lunch, there were people that were able to make choices from the written menu. However, for those people unable to read menus, they were not shown meals in picture format despite these being available. One member of staff said, “Well, today I learnt we have pictures. I was never told that before. From today, I will be using them.” There was also lack of dementia friendly signs for people around the home to help orientate them.

However, people’s relatives told us staff communicated well with them. One told us, “If there is the slightest thing, they (staff) are on the phone to me.” People who were able, were able to review their care plans and relatives told us where appropriate they were also sent care plans to review. We saw in care plans there was guidance for staff on how people communicate. One person had difficulty with speech due to a health condition and staff assisted the person to communicate by writing information down.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. Leaders had not always ensured that people with a cognitive impairment were able to share their views. We saw that there were residents’ meetings however, these were not attended by many people. There had been a lack of consideration into how other people’s views could be gained such as one to one meetings.

However other people, relatives and stakeholders that were able were asked for feedback via surveys. There were action plans in place to address any areas for improvement. We saw where complaints had been received, these were investigated by the registered manager and changes made where necessary.

The provider did not always make sure that people could access the care and support they preferred. We noted that where people were able to independently get themselves up and dressed, they were not always woken early by night staff. However, for those less able to communicate their preference, night staff would routinely wake them up. We also noted that 2 people had been given a room to share despite there being available rooms for one of them to have their own space. We saw from their care plans both people lacked capacity to make decisions and there was no reference to any discussion taking place with them or their families around why it was in their best interest to share a room.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. During the inspection, we found the majority of the communal activities (including floor games) taking place was in 1 side of the service whilst there very little taking place in the other side. A member of staff told us, “It’s difficult at times with the activities. We used to have a list (of who did what and what activities could be done) but this was stopped. I’ve no idea why. Now there is no structure. No one knows what they are going, and the activities person isn’t here all week.” This increased the risk of social isolation for some people.

However, when people required health care support, leaders ensured all people had access to this. All people had an allocated key worker. A keyworker is a staff member who knows the person well and acts as an advocate and link between other staff and services. They also ensure the person is consulted, involved in their care and any changes in their needs are supported timely and effectively. We saw that key workers were involved in the reviews of people’s care and best interest decisions.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People’s support records included information on their wishes around end of life and advanced care planning where these were known.