Archived: The Mount Residential Home

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 changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of 1 legal regulation in relation to the lack of consistent person-centred care.

This service scored 46 (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 did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Records shared with us did not always provide staff with detailed guidance about people’s individual needs. Where people’s needs had changed care plans were not always updated to reflect this. For example, in relation to people’s dietary requirements, or following incidents where people had fallen. There was no evidence to support the provider worked in partnership with people and their relatives to decide how to respond to these changes in people’s needs.

People’s care records lacked detail about their individual preferences, likes and dislikes. This meant staff lacked clear guidance to meet people’s individualised wishes. For example, about people’s routines, hobbies, food and drink preferences.

The environment had not been adapted to meet the needs of the people the provider supported. For example, the environment was not conducive to supporting or promoting the independence of people living with dementia. Signage was poor to help people navigate the service and locate key areas such as lounges and dining rooms. Menus and meal choices were not pictorial to enable people to make choices about what to eat.

The provider did not ensure people, or their relatives were involved in developing or updating person-centred care plans. Relatives did tell us they were kept informed if something had happened to their loved one. One relative told us, “The staff do keep me up to date if something happens, but we are not routinely involved in their care planning.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People were not supported to access the community unless they were supported by their relatives. People did not attend any community-based activities or groups.

Staff did not receive enhanced training on supporting people with complex dementia to enable staff to gain the skills and knowledge to fully meet people’s needs.

Rota's did reflect people were overall supported by a consistent staff team. Where agency staff were used, they worked alongside experienced staff. A person told us, “I know the staff that support me, some of them have been here for years so they do know me and what help I need.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care records had moved from paper based to electronic held records in a written format. The provider had not taken account of people’s communication needs and their ability to access their records when considering the impact of this change. Relatives we spoke told us they were not aware of this change and informed about how they may be able to access their loved one’s care plan.

The communication needs of people who lived with dementia had not been considered to see if alternative formats would benefit them, this included information such as the planned menu. People had access to some information in a paper based written format such as the complaints procedure and a service user guide.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Although people and their relatives told us they knew how to complain, not all concerns hadbeen recorded or addressed in a timely manner and feedback provided. One relative told us, “I raised concerns to the previous manager, but I did not feel listened to, and I did not receive a good response, it did not meet my expectations. I ended up having to go to the provider to sort it and finally get the response we needed.” Another relative told us about some concerns they had shared with the previous manager about their loved one’s care. However, when we looked in the complaints folder these and the other concerns had not been recorded. When we asked, the provider told us no complaints had been shared since 2024 other than the ones CQC had referred. The provider confirmed a system to review and analyse any complaints for patterns and trends was not in place.

There was limited evidence shared with us to show people and their relatives were routinely asked to provide feedback either through meeting or surveys. The new manager had recently sent out surveys to people and their relatives to gain their feedback. Those that had been returned reflected positive comments about the care people received. The new manager developed an action plan to address the areas for improvement such as the environment and lack of meaningful activities.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

The provider could not share with us records to support people had routine access to healthcare professionals such as dentists, opticians and chiropodists. The new manager told us she was also unable to find records and had started to plan for these professionals to visit people in the home.

People did have access to other healthcare professionals when needed such as dieticians and speech and language professionals. There was a GP linked to the service, and they or an advanced nurse practitioner carried out weekly consultations. A staff member told us, “The seniors prepare a list of who we think needs to be reviewed that week. We then discuss our concerns or any changes in their needs so we can seek advice. The GP will then make referrals to other professionals if needed.” We found these discussions were not always recorded in people’s notes to ensure all staff knew the advice that had been shared.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The provider failed to recognise the inequalities people they supported may face. These inequalities and people’s needs were not always considered. People were not supported to access their community. Reasonable adjustments had not been made to the environment to enhance the independence of people living with dementia. The activities provided were not catered for people living with dementia or for people who were cared for in bed. This meant action had not been taken or considered to address and remove barriers ensuring people had equal opportunities to live a full and varied life.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

At the time of the assessment the provider was supporting one person on the end-of-life pathway, however the person had recently improved and was currently ‘doing well’. There were many people living at the home who were at different stages of this journey. We found there was brief information in people’s care records about their end-of-life wishes. For most people this consisted of information about their wishes to not be resuscitated or treated in hospital if they were on the end-of-life pathway.

Where people or their relatives were not ready to discuss planning for their future care, this was not clearly documented and there was no system in place to ensure this was revisited at suitable intervals.

The training records showed 4 staff had completed training in First Aid or basic life support. Staff told us in cases of emergency they would ring 999 and follow instructions. Most staff knew which people had chosen not to be resuscitated.

We received positive feedback from relatives about the care provided to their loved ones when they had not been well. One relative said, “The staff have been amazing they have not left [person] side, they have kept us informed when we were not able to be there. We could not have asked for more.” Another relative told us, “When [person] was poorly the staff rallied round and looked after [person]. They kept checking in on [person] and now [person] is back to their good old self thanks to the staff.”