Archived: Mont Calm Sturry

Updated 30 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The provider had been in receivership since January 2014 and a management company were acting as agents for the receivers and managing this service and others owned by the provider.

This inspection took place on 7 and 8 January 2015 and was unannounced. The inspection was carried out by one inspector. It was in response to concerns raised by a whistle blower; therefore a Provider Information Return (PIR) was not completed by the provider. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. A whistle blower is a current member of staff or a staff member that has recently left the service. Further visits were made on 19 January 2015 by two inspectors and on 20 January 2015 by one inspector.

Prior to the inspection we looked at previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law. We also exchange information with the local safeguarding team and commissioners.

We spoke with four people who used the service and four relatives. Other people were not able to communicate their views of the service provided. We spoke with the registered manager and six members of staff.

We undertook observations to help us understand the experience of people who could not express their views. We observed staff carrying out their duties, communicating and interacting with people. We reviewed people’s records and a variety of documents. These included four people’s care plans and risk assessments, staff recruitment files, the staff induction booklet, training and supervision schedules, staff rotas, medicines records and quality assurance documentation.

Updated 30 March 2015

The provider has been in receivership since January 2014 and the receivers have a management company acting as their agents and managing this service and others owned by the provider.

This was an unannounced inspection carried out on 7 and 8 January 2015. Further visits were undertaken on 19 and 20 January 2015. The previous inspection took place on 9 September 2014 and there were no breaches of the legal requirements.

Mont Calm Sturry provides accommodation and personal care for up to 16 older people. It specifically provides a service for older people who are living with dementia. At the time of the inspection there were 15 people living at Mont Calm Sturry. The service is a detached house with 14 single rooms and one shared room. One room has an ensuite and all other bedrooms have a wash hand basin. The service is set over two floors and there is a stair lift so that people could access their bedrooms. There is a main lounge, dining room and another small seating area on the ground floor. The third floor contains the office, staff room and laundry.

The service is run by a registered manager, who also managers another service in Margate owned by the same provider, which was also in receivership. 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. A full time acting manager had been appointed in October 2014 at Mont Calm Sturry to support the registered manager.

People and relatives felt medicines were handled safely. However we found shortfalls in medicine management. A medicine for one person was out of stock and had not been administered. We were unable to ascertain if one person had received their night time medicines one evening. Medicines were not always recorded properly when they arrived at the service. Sometimes where people were prescribed medicine “as required”, there was a lack of proper guidance to enable staff to administer these medicines safely and consistently.

Relatives felt the environment was “not one of the best” and that the place “had been run down previously. Further redecoration work had been completed and although some areas within the service were decorated to an adequate standard, other areas were not and required attention. Checks were done to ensure the premises were safe, such as fire safety checks. There were also shortfalls identified in relation to cleaning and infection control practices and procedures.

Risk associated with people’s care and support did not always reflect their current needs or action that was being taken was not recorded in assessments. One person that had recently moved in had not had any risks associated with their care and support assessed and therefore staff did not have any guidance about to manage these risks to ensure the person remained safe.

People were not protected by robust recruitment procedures. Staff files did not contain all the required information. New staff did not undergo a thorough induction programme or receive all the relevant training to their role. Staff had not received their annual appraisals.

Not all staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). One staff member was aware of the process, where people lacked the capacity to make their own decisions, to ensure these decisions would be taken in their best interests. An urgent DoLS application had been made and the assessment took place during the second day of the inspection. However other applications had not been completed or submitted.

People’s health care needs were not always met. Two people’s health was not monitored properly and a referral to health professionals was identified as required during the inspection.

People and relatives were involved in informal discussions about their care and support, although not always aware of the care plan. Care plans had recently been updated and included people’s wishes and preferences and skills and abilities. However they lacked detail and information about the care and support people required with health conditions, such as diabetes.

People and/or their relatives had been able to look round the service prior to people moving in. However assessment information regarding people’s needs was not always available or up to date when people moved in.

People and their relatives felt comfortable in raising any concerns, although stated that they did not have any concerns. Relatives told us that the management team were always available and approachable. However there were no formal systems in place so that the service could seek the views of people or those acting on their behalf and staff.

The management of the service was not effective. There was a lack of effective audits and checks to ensure people received a quality service and that shortfalls were identified and addressed on an on going basis. Staff were unaware of the values and vision of the service and were not involved in the development of the service.

People felt safe living at the service. Staff demonstrated an understanding of what constituted abuse and how to report any concerns. The service had safeguarding procedures in place. People had access to equipment to meet their needs.

People had their needs met by sufficient numbers of staff and although sickness levels were high the service was recruiting at the time of the inspection.

People were relaxed in staffs company and staff listened and acted on what they said. People’s privacy was respected. People told us they “like” the staff. Staff were kind and caring in their approach.

People said they “liked” the food. They had a variety of meals and adequate food and drink was available.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.