Montague House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, the provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People's needs were assessed across a broad range of areas including nutrition, mobility, communication, emotional wellbeing, skin integrity, falls, emotional needs and mental capacity. Staff demonstrated a good understanding of people's needs. We signposted the provider to areas where care plans could be improved to further promote consistency, accuracy and ensure people's needs and preferences were fully reflected.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.Staff worked alongside healthcare professionals and adapted support to people's individual needs. Examples included adapted nutritional support, dementia-informed approaches and specialist clinical support. Staff demonstrated an understanding of people's support needs and how to support them safely.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing assessments and relevant information with healthcare professionals involved in their care. People had been supported to access a range of healthcare professionals. Relatives also provided examples of health concerns being recognised promptly and appropriate referrals being made. A relative told us staff were, "Lovely and reactive." Another said, "They picked up [My Relative] had a chest infection very quickly and got them antibiotics."

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support.

Nutritional care was highly personalised and responsive to individual needs. Examples included flexible meal arrangements, adapted nutritional support and easy access to snacks and fortified foods where required. Staff worked closely with dietitians and speech and language therapists to support people's nutritional needs. A person told us, "I can have a cooked breakfast every day if I want to, I never used to have that at home!"

The provider adapted support around people's individual preferences and routines rather than expecting people to adapt to service-led routines. This helped people maintain their health and wellbeing whilst promoting choice and independence. People were supported to participate in a range of activities which promoted their physical wellbeing, including exercise sessions, yoga and physiotherapy-led interventions. During our inspection, we observed a physiotherapist delivering a session with people which included discussions around hydration and maintaining good health. In relation to the support they received; a person told us they were, "Not at all disappointed." A relative told us, "Quality of care, food is excellent, the home is exceeding our expectations."

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The provider maintained a range of monitoring systems including falls trackers, MUST monitoring, weight monitoring, skin integrity monitoring, medication reviews and care plan reviews. Action was taken when concerns were identified and people were referred to healthcare professionals when required.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider maintained clear oversight of Mental Capacity Act and Deprivation of Liberty Safeguards requirements. Records demonstrated decision-specific capacity assessments, best-interest decision making, monitoring of authorisation expiry dates and oversight of conditions attached to authorisations. Staff demonstrated an understanding of consent and people's rights. A relative told us, “They listen and they put [my Relative’s] wishes first."