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The Mount & Severn View Requires improvement

We are carrying out checks at The Mount & Severn View. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 October 2017

This inspection took place on 24 August 2017 and was unannounced. At our previous inspection, in February 2015, no improvements were identified and we had rated the home as Good. At this inspection we have changed the rating to Requires Improvement.

The Mount & Severn View is a nursing home. It provides accommodation with nursing and personal care for a maximum of 58 people. On the day of our inspection 55 people were living at the home. People’s bedrooms are over two floors and these are accessed by stairs or a passenger lift. There is a six bedded wing dedicated to the care of people living with dementia within the home called the Memory Lane unit. People have access to communal areas within the home and access to the home’s gardens.

The registered manager had retired the day before our inspection. The provider had already moved a registered manager from another one of their homes and they had applied to become registered manager at The Mount & Severn View. They are referred to as the new manager in this report. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People, relatives and staff all expressed concern to us about there not being enough staff at the home. People’s call bells were not always answered in a timely manner because staff were helping other people. This had impacted on people’s dignity, safety and the way in which staff were able to meet their needs when they needed help. Improvement was needed to make sure staff were always available to support people when they needed it.

Managers were not aware of staffing concerns or the effect this had had on people and their dignity. People's needs were assessed to establish how many staff were needed, but this had not been effective in ensuring people received support when they needed it.

People could be at risk of not having their right to make their own decisions upheld. Staffs' knowledge about how to support people who did not have capacity to make their own decisions was good. But the records of the processes they had to follow did not reflect this level of knowledge.

People and relatives had opportunities to give feedback about the service provided. Relatives who raised concerns informally did not always feel these had been resolved. The provider had a complaints policy in place, which people and relatives were aware of. Complaints were investigated and responded to, in a formal manner, as per this policy.

People and relatives thought staff were well trained and understood how to support them. Staff had received training to give them the skills and knowledge needed to support people's individual needs. Some staff felt they needed more specialised training to help them understand people’s health conditions better. Training had already been identified for this to happen.

Staffs’ experience of the support they received in their roles was varied. Some staff felt involved in what happened at the home whilst others did not.

Staff had received training in and understood how to protect people from any avoidable harm and abuse. Staff knew how to and were confident in reporting any concerns they may have about a person’s safety. However, managers told us they had not been made aware of staff concerns about staffing levels.

People continued to have their health needs met. People had access to a range of healthcare services, when required.

Risk to people had been identified and assessments reflected how care should be provided to the person to minimise any risks to them. Staff knew what they needed to do to help reduce risk to people and keep them safe.

People were supported to take their medicines when they needed them. Medicines were stored safely and the processes in place helped to make sure they were managed safely.

People felt they had good relationships with staff and that staff respected their privacy. They were happy with the care and support they received and gave praise and positive comments about the staff at the home.

Systems were in place to assess and monitor the standards of care delivered at the home. The standards of care were assessed against our key questions. Action plans identified areas for improvement but had not identified the concerns we found at our inspection and what people, relatives and staff told us about the staffing levels.

The management team were receptive to our feedback and kept us updated on the improvements they planned to make after our inspection.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which relates to the staffing at the home. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 10 October 2017

The service was not always safe.

There were not always enough staff to safely meet people’s needs. Staff had been trained to protect people from harm and abuse and knew how to report concerns. People were supported to take their medicines when they needed them.

Effective

Requires improvement

Updated 10 October 2017

The service was not always effective.

Staff respected people's right to make their own decisions and supported them to do so. When some people could not make their own decisions about their care their records were not clear on why or how the decisions made were in their best interests. Where required, people were supported to eat and drink enough and access healthcare from other professionals.

Caring

Requires improvement

Updated 10 October 2017

The service was not always caring.

Staff were kind and caring but there were occasions when people's dignity was compromised due to there not being enough staff. People felt involved in their own care and treatment and had positive relationships with staff.

Responsive

Requires improvement

Updated 10 October 2017

The service was not always responsive.

People received the care they needed but this was not always delivered in a way that was personal to them because there were not always enough staff. People and relatives had opportunities to give feedback and make complaints but did not always feel their concerns were resolved.

Well-led

Requires improvement

Updated 10 October 2017

The service was not always well-led.

People were positive about the support they got but felt there was not enough staff around when they needed them. Staff did not always feel involved in, supported or kept up to date with what happened at the home. Systems were in place that monitored the quality of the service provided.