Background to this inspection
Updated
30 June 2018
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 is 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.
This inspection site visit took place on 14, 15 and 16 May 2018 and was unannounced. On the first day of our visit the inspection team consisted of two adult social care inspectors, one specialist advisor and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day the inspection team was one adult social care inspector, one specialist advisor and two Experts by Experience and on the third day one adult social care inspector
Before the inspection, we looked at information we held about the provider and home. This included their Provider Information Return (PIR) which was submitted on 4 April 2018. This is a form that asks the provider to give some key information about the service. Providers are required to send us a PIR at least once annually to give us some key information about the service, what the service does well and improvements that plan to make. We also contacted five health and social care professionals to obtain their views on the delivery of care. We only received one response.
During the inspection we spoke with the peripatetic manager [manager], regional manager, nine care staff, activities organiser and chef. We also spoke with 11 people living at the home and five visiting relatives.
Some people were not able to verbally communicate their views with us or answer our direct questions. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We looked at the provider’s records. These included five people’s care records, eight staff files, training and supervision records, a sample of audits, satisfaction surveys, staff attendance rosters, and policies and procedures. We also pathway tracked five people. This is when we follow a person’s experience through the service and get their views on the care they receive. This allows us to gather and evaluate detailed information about the quality of care.
Updated
30 June 2018
This inspection site visit took place on 14, 15 and 16 May 2018 and was unannounced.
Mountwood 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.
Mountwood accommodates 39 people in one adapted building. There were 29 people living at the home at the time of our inspection.
The service did not have a registered manager. 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 condition of registration is for the service to have a registered manager. The service has not had a registered manager in post since November 2017 and therefore we have applied a ratings limiter to the Well Led section of this report.
We last inspected this service on 27 and 28 March 2017 and found the provider was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a requirement notice in respect of the breach. Following our inspection the provider sent us an action plan on 30 June 2017 to tell us about the actions they were going to take to meet these regulations.
During this inspection, we found that sufficient action had been taken to meet the requirements of the regulation the service had breached at the inspection in March 2017 however we identified a further two breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The provider had failed to ensure they had deployed sufficient numbers of staff to ensure people were safe and their care needs met.
The provider had failed to ensure that staff had received supervision or appraisal as is necessary to enable them to carry out the duties they are employed to perform.
People received their medicines safely, accurately, and in accordance with the prescriber’s instructions. Medicines were stored safely.
The provider had taken appropriate steps to protect people from the risk of abuse, neglect or harassment. Staff understood their responsibility to safeguard people and the action to take if they were concerned about a person's safety.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.
People had access to and were supported with their healthcare needs, including receiving attention from GPs and routine healthcare checks.
People were comfortable and relaxed in the company of the staff supporting them.
Staff treated people with dignity, respect and kindness.
People were supported to maintain relationships with their friends and relatives.
We have made two recommendations to the provider in the responsive section of this report. The service seek to ensure people are not at risk from social isolation and recognise the importance of ensuring activities promote social contact and companionship. People with a disability or sensory loss are given information in a way they can understand.
We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.