12 July 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
One inspector and one assistant inspector.
Service and service type
The Mount is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed information already known about this service including previous inspection reports and any notifications about the service which are important events the service is required to tell us about. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, the deputy manager, the cook, and three care staff. We observed the care provided and spoke with five people using the service and a relative.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection –
We spoke with two relatives who had not been present during the inspection. We also attempted to gain feedback from health care professionals, one responded via email.
12 July 2019
The Mount is a residential care home providing personal and nursing care to 19 men. Most people living in the service were over 65 with mental health support needs. The service can support up to 22 people and accommodation is provided over two floors.
People’s experience of using this service and what we found
There has not always been strong management and oversight which has meant the service has not always been compliant with legislation. At the last inspection the service was rated requires improvement and the one before inadequate. At this inspection we saw a marked improvement and a rating of good has awarded.
The service had a new manager who was registered with the Care Quality Commission at the end of last year. They were clearly focussed on what they needed to do to ensure people received good outcomes of care and had worked hard to achieve it.
The service provided good outcomes for people which could be improved further to enhance people’s experiences. The registered manager took some immediate actions based on our feedback. We have made two recommendations about the provision of activities, and the training needs of staff.
Staff received the training and support necessary to help them carry out the regulated activity and there were enough staff to ensure people had timely support. People were observed throughout the day and were comfortable and there were no odours in the service.
Staff engagement was positive and people were asked daily what they would like to do and activities were planned accordingly. We however noted some people were not able to participate in social activity unless they were given sufficient support by staff who could anticipate their needs. Some people would not initiate what activities they would like to do and this had an impact on some peoples experiences. Most people were retired and did not routinely go out but sat doing activities in the house such as watching television, colouring and reading. We have recommended that activities are provided in line with people's assessed needs and on a more regular basis.
There was a calm atmosphere throughout the day and the environment suited people’s needs well. Some cosmetic improvements would improve the home environment.
People were supported to stay safe because the environment was well maintained, and risks were identified and where reasonably possible controlled. We have recommended improvements in how the staff document peoples needs in relation to challenging behaviours to help ensure a consistent staff approach.
People had the equipment they needed, and equipment was serviced to ensure it remained safe and appropriate to use. Staff were trained in health and safety, manual handling and infection control to help them ensure people’s safety.
People received their medicines according to prescriber’s instruction by trained staff who had been assessed as competent. Staff monitored people’s health and helped them access health care services as they needed them.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 30 May 2018) and there was one breach of regulation, Regulation 17: Good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Mount on our website at www.cqc.org.uk.