Mountview Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The provider had pre-admission assessment processes in place to ensure these were sufficiently robust and helped to identify people’s needs, wishes and preferences. Processes had also been developed to identify if the service was able to meet people’s needs prior to any admission. People, their relatives and relevant agencies were involved and consulted as part of the assessment processes. Staff were provided with information and guidance through handovers and care plans.

The provider had systems and processes in place to monitor the weight, food and fluid intake of people and act where required. However, we found staff did not always follow robust monitoring to ensure people were supported to change their positions in line with their assessed need to mitigate the risk of developing pressure wounds. Additionally, where people required monitoring of their sleep, records were not completed consistency which did not support effective oversight of people’s needs. The registered manager told us they would review these issues following our inspection site visit.

People spoke positively about meal choices overall, with comments including, “The meals are always enjoyable. There is no pressure to eat in the dining room; I have my meals in my room as that is what I prefer” and “Breakfast time is flexible and you can have a hot drink at any time.” Several people requested a weekly copy of the menu plan rather than just the daily menu available in the dining room. People told us, "I would prefer to have a menu each day, or week, so that I know what meals I can choose from before going to the dining room at lunch times” and “I would like to see a menu for the week ahead so I can consider what I would like to have each day.” We shared this feedback with the registered manager who told us they would follow this up with people. We saw people were given choices as to where they wanted to have their meals and the dining room supported a positive dining experience. Staff assisted people who needed support or prompting to eat their meals, and snacks and drinks were provided throughout the day.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Care plans included personalised information to enable person led support. Staff shared their knowledge with each other through handovers and with relevant medical professionals where appropriate. Staff were able to recognise where people's needs were changing and gained the involvement of relevant professionals, if required. Staff described positive teamwork and support which helped them work effectively as a team in meeting people’s needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People were encouraged to make choices and supported to remain as independent as possible. We observed staff encouraging people and supporting them to safely move around the service as they wished. People were supported to continue regular routine health checks with dentists, opticians and chiropodists. A person told us they had requested to see the GP and staff had added them to the ward round. The registered manager told us the GP undertook ward visits and/or video consultations as and when people needed this.

The provider monitored and responded to changes in people’s needs to improve care and treatment. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Although we found inconsistencies in monitoring records, there was evidence that people were supported to achieve positive outcomes from their care. These included maintaining their independence and health and wellbeing. People’s care plans contained information about people’s health and wellbeing and were reviewed regularly. However, where people had specific healthcare needs or long-term conditions, there was not always sufficient information for staff on how to support them. For example, care plans did not always include details about the impact of the condition for the individual person, what to look out for if the person became unwell or what a health crisis might look like and guidance on how to respond. When we spoke with staff, they demonstrated a knowledge of people’s health conditions and basic understanding of how to respond to concerns. The registered manager implemented more detailed, person-centred guidance following our inspection visit.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had received training in relation to The Mental Capacity Act 2005 (MCA), which provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The registered manager and staff had a clear understanding of the MCA. We saw examples of where mental capacity assessments had been completed and Deprivation of Liberty safeguarding applications made where people were being restricted to keep them safe. For example, living in the service and consent to care and treatment. The registered manager kept a tracker to ensure applications for authorisations were made in a timely way. We asked the registered manager to ensure, where relatives had legal authority, it was clear in records if this related to health and welfare, finances or both to support safe decision making. During our assessment visit, we observed staff consistently seeking people’s consent before providing support or assisting with activities.