Montague House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

At our last assessment, the provider was in breach of the legal regulation related to governance. At this assessment we found improvements had been made and the provider was no longer in breach.

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.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an understanding of the challenges and needs of people and their communities. A relative said, "I see staff being kind in the way they talk to other residents in the home."

We found a strong and positive culture throughout the service. People were at the centre of how care was delivered, and staff understood the provider's values around dignity, wellbeing and person-centred care. There was a clear focus on supporting people to live meaningful lives and maintain connections with the people, interests and experiences that mattered to them. A person told us, "They can't do enough for us all."

People, relatives and staff were encouraged to contribute to the ongoing development of the service. Staff morale appeared positive and numerous people described improvements which had taken place within the home. We found a culture which promoted inclusion, involvement and continuous improvement. A person's friends told us, "Our friend is very well looked after and receiving excellent care."

The provider had exceptionally inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of the organisation. Leaders demonstrated the skills, knowledge and experience required to lead effectively and consistently acted with integrity, openness and honesty. A relative said, "Whenever I go there, I never feel a bad vibe, they are really friendly and welcoming."

Feedback regarding the registered manager was consistently positive from staff, people and relatives. A recurring theme throughout the inspection was the registered manager's visibility, approachability and involvement in the day-to-day life of the home. A relative said, "We are happy with how the home is run." Staff described a leader who was supportive, accessible and had developed positive relationships with both people living at the service and the staff supporting them. A staff member said, "The home has changed significantly since the last inspection. A lot of that is down to [Registered Manager's] influence. Residents and relatives know her well because she is highly visible and approachable."

The registered manager had a detailed knowledge of people's individual needs, preferences and life circumstances and was able to speak about people in a personalised and meaningful way. There was evidence leaders worked alongside staff and responded flexibly to people's needs. Although improvements were required within some governance systems, leaders were open about the concerns identified, understood where improvements were needed and responded positively to feedback throughout the inspection. A relative told us, "The manager has put a lot of good things in place and the processes are better."

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they felt comfortable speaking up and were confident concerns would be listened to and acted upon. Systems including meetings, supervision, reflective practice sessions and day-to-day discussions supported open communication throughout the service.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff told us they were supported and treated fairly. Staff were encouraged to undertake additional training and qualifications and demonstrated a good understanding of people's diverse needs, backgrounds and preferences. A staff member told us, "We actively celebrate diversity through events such as EDI week, national dress days, cultural food sharing and talent competitions."

We identified some areas where governance systems could be strengthened. This included safeguarding recognition, assurance around repositioning, aspects of care planning documentation and medicines management. The provider responded positively throughout the assessment and took immediate action to review incidents, strengthen monitoring arrangements and improve oversight where concerns were identified.

The provider maintained a range of governance systems including medicines audits, clinical governance processes, stock monitoring, pharmacy reviews and Resident of the Day reviews. These systems provided oversight of quality and safety across the service and supported ongoing improvement.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. A relative told us, "Yes, I’m invited to care reviews, I’m able to read (care plans) and make suggestions." People were supported to maintain connections with healthcare professionals, community groups, volunteers, religious organisations and local initiatives important to them.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. There was evidence of reflective practice, lessons learned reviews, falls reviews, medication reviews, group supervision sessions and opportunities to share learning across the service. Staff were encouraged to reflect on practice and identify opportunities for improvement.