Montague House

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 good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.
People were supported with flexible meal arrangements, finger foods for people who preferred not to remain seated for extended periods, additional cooked breakfasts for people experiencing disorientation around mealtimes and tailored approaches to supporting emotional wellbeing.

Staff were celebratory of people's life histories, achievements and experiences and were able to tell us about these in detail. They used their knowledge of people's histories, preferences and emotional needs to tailor support, particularly for people living with dementia. We observed person-centred therapies and interventions including Namaste sessions, doll therapy, validation approaches and staff entering people's reality when they were living with more advanced dementia, rather than correcting or challenging them. Staff adapted their communication styles to reduce distress and provide meaningful emotional support.

The provider also supported people to maintain connections with interests, community groups, religious services and aspects of their identity that were important to them. A person told us, “I've recently had a big birthday, and the home organised a birthday party for me. It was the best party ever.”
 

The provider had a strong understanding of people's diverse health and care needs, so care was joined-up, flexible and supported choice and continuity. The service supported continuity through dedicated residential, nursing and dementia communities. People benefited from consistent long standing staff teams who knew them well and understood their needs. A person told us, "The staff are very good." The provider's admission processes promoted belonging and continuity through personalised introductions, involvement of families and ongoing reviews following admission.

The provider supplied appropriate, accurate and up-to-date information in formats tailored to individual needs. Care records contained information about people's communication needs and preferences to support staff to deliver personalised care. Information was shared through care reviews, newsletters, meetings and discussions with people and their families. The provider promoted communication and engagement through regular newsletters which celebrated activities, achievements and important events within the home.

The provider enabled people to share feedback, ideas and contribute to the development of the service. Staff involved people in decisions about their care and support and sought feedback about their experiences. There was strong evidence of co-production throughout the service. People were supported to participate in resident meetings, committees, feedback forums and day-to-day discussions about the service. Feedback had influenced menus, activities and environmental improvements. People were also involved in recognising staff achievements through nomination schemes and opportunities to celebrate positive practice. The provider promoted transparency and encouraged people and their relatives to contribute to service development. This helped people remain involved in decisions which affected their lives and the running of the service. A relative told us, "They are very proactive. If I'm worried about something they reassure and support."

The provider made sure people could access the care, support and treatment they needed when they needed it. People had access to healthcare professionals, specialist services, activities and community opportunities which reflected their needs and preferences. The service had established links with a range of external professionals and organisations and made referrals when concerns were identified. People were supported to access meaningful occupation, healthcare services and activities which promoted wellbeing and supported positive outcomes. A relative told us, "The home is as good as we could ever have hoped for."

Staff and leaders actively listened to information about people who may be more likely to experience inequality in experiences or outcomes and tailored care, support and treatment in response. The provider recognised and responded to people's differing needs. The dementia community demonstrated a person-centred approach, with environmental adaptations, therapeutic activities and personalised interventions designed to support people living with dementia. Staff demonstrated an understanding of how dementia affected people on an individual basis and adapted support to reduce anxiety, distress and exclusion. A person told us, when reflecting on how valued they felt, "It feels like I'm a favourite."

People were supported in ways which promoted inclusion and enabled them to access activities, relationships and experiences that were important to them. Care and support were adapted to reflect people's individual needs and preferences, helping people remain engaged in meaningful activities and reducing the risk of social isolation.

Our findings relating to how the provider supported people to plan for the future were mixed. Care plans did not always demonstrate people had been supported to plan for, or consulted about, their end-of-life wishes and preferences. This increased the risk of people's wishes and choices not being fully reflected within their records. We made the provider aware of this and they planned and undertook further work to improve the personalisation of end-of-life documentation. The provider also provided assurance that none of the people whose records we reviewed were imminently approaching the end of their lives.

However, there was positive evidence of family involvement, compassionate support and resources available to people approaching the end of their lives. The service demonstrated a culture which recognised the importance of dignity, comfort and family involvement during these periods. We reviewed letters and cards from relatives which praised the service for the compassionate and dignified care their loved ones had received at the end of their lives. A relative told us, "They have listened to our wishes on end-of-life care."