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Monson Retirement Home Requires improvement


Inspection carried out on 26 August 2020

During an inspection looking at part of the service

Monson Retirement Home is a residential care home providing personal and nursing care for up to 50 older people. At the time of our inspection there were 27 people living at the home.

People’s experience of using this service and what we found

Relatives we spoke with felt their family members were safe at the service and that the service was being managed well. Staff were provided with safeguarding training and understood their responsibilities in relation to keeping people safe from harm.

People were protected from the risks of infection as the registered provider had processes in place to minimise the risks of the spread of infection.

The registered provider had improved the arrangements in place to monitor and review the care people received and ensure care plans and risk assessments reflected people's needs.

Staff were recruited safely and people were supported by adequate numbers of staff. Staff had received training and appropriate levels of supervision for their roles. People’s medicines were managed safely.

Relatives told us they were involved in their family member’s care. Staff worked with health professionals to support the people and ensure care was delivered in a joined-up way. A range of management systems and quality audits were in place to enable the home to continue to keep improving the care people received.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was Requires Improvement (published 11 February 2020). There were multiple breaches of regulations. The registered 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 registered provider was no longer in breach of regulations.

Why we inspected

We carried out this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 (1) (safe care and treatment) and Regulation 17 (1) (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

In addition to the warning notice we had also previously found that the registered provider was in breach of Regulation 18 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led.

This report only covers our findings in relation to the key questions safe and well-led and the breaches of regulations identified at the last comprehensive inspection. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained at requires improvement. This is based on the findings at this inspection.

As part of this inspection we also looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 3 December 2019

During a routine inspection

About the service

Monson Retirement Home is a residential care home for up to 50 older people and people living with dementia. At the time of inspection there were 31 people living at the home.

People’s experience of using this service and what we found

Monson Retirement Home had changed owners in May 2019. There had been a Registered Manager who deregistered in October 2019. The new provider had failed to provide enough oversight of the home between June and October 2019. This led to systems to assess, monitor and improve the quality and safety of the home not being implemented or embedded.

Since November 2019 the provider employed an experienced management team who had begun the process of implementing procedures to improve all areas of the home. For this reason, all the planned systems and processes were in their infancy and required completion or embedding into practice.

The provider had an action plan for all the areas they had identified and those we identified at this inspection. Their action plan required time and resources to complete. The provider continued to commit the resources required.

People’s risk assessments and care plans did not always reflect their current needs. The management team were training staff in a new care planning system and had yet to transfer people’s records to this. Staff did not always have information about people’s current needs, which put people at risk of not receiving all the care they needed. The management team put measures in place to inform staff of people’s needs at handover.

The provider was supported staff to improve their skills and knowledge in safeguarding and reported and acted upon concerns.

The provider did not have access to historical records of staff training, supervision or appraisals. This meant they could not be sure what training staff had received. They had implemented a programme of training and supervision which would take time to complete.

The provider did not have all the systems and processes in place to assess, monitor and improve all areas of the home. The management team were setting up a programme of planned audits.

Following an independent external audit in August 2019, the provider was undertaking fire safety and electrical works to comply with fire regulations. These had not been completed at the time of the inspection.

The home required changes to the environment to be suitable for people living with dementia.

There were enough staff deployed to provide people’s care, there were care staff vacancies that were being covered by agency staff. People received their medicines safely. Staff identified when people became unwell and referred them to medical professionals promptly.

Permanent staff knew people well and had formed good relationships. People were regularly engaged in activities they enjoyed and involved people from their local community.

The management team responded to complaints, they followed the provider’s complaints policy. The provider held their first meeting with people using the service and their relatives; they implemented suggested changes and improvements to the home.

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.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was Good (published 10 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.


We have identified three breaches in relation to risk assessments, safety of the environment, staff training, supervision of staff and management oversight. Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added

Inspection carried out on 30 January 2017

During a routine inspection

This inspection took place on 30 January and 3 February 2017 and was unannounced. Monson retirement home provides accommodation and personal care for up to 50 people with and without dementia. On the day of our inspection 34 people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 received excellent care that was individualised and person centred. Their choices and wishes were promoted and respected. People had formed excellent relationships with staff and were encouraged to maintain relationships with their family and friends.

People were actively supported by staff who promoted their independence, and managed their privacy and dignity in a sensitive manner.

Staff understood their responsibility to protect people from the risk of abuse and appropriate action was taken in response to any incidents. Risks to people’s health and safety were regularly assessed and action taken to reduce the risks.

There were sufficient numbers of staff employed and people’s needs were met in a timely manner because staff were organised and well deployed. People received their medicines when they needed them and medicines were stored and recorded appropriately.

Staff received regular and appropriate training for their roles and understood their responsibilities in obtaining consent when providing care for people.

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were protected from the risks of inadequate nutrition as staff had a good knowledge of people’s dietary requirements. Mealtimes were a sociable and supported time with staff working together to ensure it was an enjoyable experience.

People health needs were managed well with staff working with health professionals to ensure all concerns were managed in a co-ordinated and timely way.

People received care from a group of staff who were caring and kind. They promoted people’s independence and worked with people to ensure they achieved the best level of independence they could.

People were supported by staff who treated them in a respectful and inclusive manner and their opinions and views on their care were recognised and acted upon.

People were encouraged to remain socially active and the service provided a wide range of supported activities for people and their families.

People felt they could report any concerns to the management team and they would be taken seriously. The management team were approachable and proactive in developing the quality of the service for the benefit of the people who lived there.

Inspection carried out on 13 January 2015

During a routine inspection

This inspection was carried out on 13 January 2015 and was unannounced. The last inspection took place on 29 October 2013 during which we found there were no breaches in regulations.

Monson Retirement Home provides care and support for up to 40 people, some of whom may experience memory loss associated with conditions such as dementia. At the time of our inspection there were 34 people living at the service.

There was a registered manager in post. 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 were happy with the service they received. Staff were respectful and were kind and compassionate towards people who used the service. People could make their own decisions about what they wanted to do and staff respected people’s right to privacy so their dignity could be maintained.

On the day of our inspection there was enough staff on duty to meet people’s needs. Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s diverse needs and work in a way that were safe and protected people.

Staff had also been trained and had the skills and knowledge to provide support to the people they cared for. They understood the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS), which meant they were working within the law to support people who may lack capacity to make their own decisions.

Staff had a good understanding of people’s needs, wishes and preferences and staff had been trained to provide effective and safe care which met people’s individual needs. We also found there were clear arrangements in place for ordering, storing, administering and disposing of medicines.

Staff supported people to carry out person-centred activities on a regular basis and encourage them to maintain their hobbies and interests. People were provided with a choice of nutritious meals. When necessary, people were given extra help to make sure that they had enough to eat and drink. People had access to a range of healthcare professionals when they required specialist help.

People and their relatives were able to raise any issues or concerns and action was taken to address them. People had been consulted about the development of the service. The provider had completed quality checks to make sure that people reliably received the care they needed in a safe setting.

The management at the service was well established and provided consistent leadership. The provider was regularly available for people to speak with and they encouraged people and staff to speak out if they had any concerns.

Inspection carried out on 29 October 2013

During a routine inspection

Prior to our inspection we reviewed all the information we had received from the provider about the home and spoke with the local authority about a recent visit they had completed.

As part of our inspection visit we spoke with six people who lived at the home and the relative of one person. We also spoke with the manager and four staff members.

People told us staff were caring and responded to their changing needs. One person said, �I have to say the care is excellent and staff keep coming when I call them.�

We found people were supported to undertake a range of activities. One person said they liked playing games and enjoyed listening to music. The person said. �There always seems to be a lot happening and I don�t have to join in if I don�t want to.�

People told us they enjoyed all the meals they had and there was always plenty to drink when they wanted it. A relative we spoke with said, �A good range of food is provided. XXX needs a special diet and they sort that out.�

Staff we spoke with told us they felt they had the right levels of management support, supervision and training to meet people�s needs.

There were systems in place for the provider to regularly monitor and assess the quality of care people received. The home owners and manager demonstrated they took action to address any issues or concerns raised and learned lessons from them.

Inspection carried out on 2 May 2012

During a routine inspection

People told us that they liked living at the home and one person said �I�m quite happy�. They also said the home was spacious and had a wider outlook in doing things in comparison to the previous home they lived at.

A relative told us that they had no worries and concerns about the home and that the staff were very good.

People told us that the rooms were nice and wanted to show us their rooms.

One person did say that they weren�t happy and that they missed cooking their own food. They said that they didn�t get a choice at mealtimes and could do better themselves. Other people told us that the meals were good.