Mountview Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider maintained a record of any falls or adverse incidents reported by staff within the service. Analysis of these incidents was undertaken and patterns and trends identified so action could be taken to prevent recurrence of events such as falls. Further analysis was undertaken by the provider to identify any themes, trends or shared learning needs across their services. Learning around accidents or incidents was shared with the staff team. Staff had a clear understanding of the action to take in the event of an accident or incident.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider had systems and processes in place to support safe admissions and transfers of care. For example, key information was available to support safe transfers to hospital should people require unplanned treatment. Prior to admission people and families were involved in the pre-assessment and information gathering process and were able to personalise their room before people’s arrival to help them settle and feel more at ease. A person told us, “We brought our own bedding when we moved in, our own bed and armchairs to help us settle in.” Staff were informed of people’s needs through care plans and handovers.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People and relatives felt safe in the service. A person told us, “I have never felt under pressure to do something that I didn’t want to do.”

There were systems to ensure people were protected from the risk of harm, abuse or discrimination. The provider worked with safeguarding agencies where required and relevant information was shared.Staff received training in safeguarding and understood their role in keeping people safe. A staff member told us, “I am aware of what constitutes as safeguarding. I have completed online training and participated in group training sessions which were more in-depth and gave me more understanding. I am confident to report any issues of concern and managers are open to sharing information on outcomes.” People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found the provider had systems and processes to monitor approved and pending DoLS applications.

We identified some improvements were required in relation to risk management. However, the provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Where people had specific health needs which placed them at risk of harm, risk assessments had been completed but risks relating to the health condition had not always been considered. For example, we found specific health conditions including Parkinsons and epilepsy were not supported by robust protocols. These are important to provide staff with information about how the health condition affects each individual person and guidance on actions to take in response to changes in people’s needs or a health crisis. The registered manager immediately implemented protocols following our inspection visit. Monitoring records to confirm people had received support to mitigate risks were not always completed accurately or correctly. For example, where people required support to change their position to prevent pressure wounds or to monitor health needs, records did not always evidence support had been provided in line with people’s assessed needs. We raised this with the registered manager who agreed to drive improvements in the records staff completed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There were no visible hazards to people living there. Maintenance records were kept up to date, for example water, gas and electrical appliance testing. All policies had been reviewed and updated for all maintenance areas. Cleaning products were stored securely. People had access to equipment to safely support them to mobilise and transfer between areas, and this was regularly checked and maintained. People had individual Personal Emergency Evacuation Plans (PEEPs) to aid them in being safely evacuated from the service in the event of an emergency.

The provider used dependency tools to ensure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We received mixed feedback from people and relatives. Some told us there was always enough staff, while others felt that at times staffing levels were occasionally low leading to a delay in care. Comments included, “Sometime the staff response to my call bell is very slow and I am not sure why” and “I have been visiting [Name] for some time and never had any concerns about the staff support they receive.” We observed sufficient staff were deployed to support people throughout the morning and during the lunchtime meal. However, we saw demands for staff support increased after lunch and a person was left waiting for over an hour after requesting several times to be taken to their room. We raised this with the registered manager for follow up.

Staff told us they felt there were enough staff deployed to meet people’s needs. Staff comments included, “Most of the time we have enough staff; there are some busy times, but staffing levels are okay” and “There are enough staff now, but up until about a month ago we were struggling with staffing levels. Now things are not a problem.” Staff confirmed they undertook training suitable for their roles and it was sufficient, although some staff felt there was too much emphasis on on-line training and more face-to-face training was needed. A staff member told us, “Training here is okay but not very advanced. There is a lot of e-learning where previously we had more face-to-face training which helped my learning.” Staff received supervision and appraisal to support them and develop them in their role. Staff were recruited safely with pre-employment checks carried out, including Disclosure and Barring Service checks (DBS) to ensure their eligibility to work and suitability to support people in the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

During our assessment visit, we observed that the environment was clean and well maintained. Staff were seen wearing appropriate personal protective equipment when required and used it correctly, demonstrating good awareness of infection prevention and control practices. No concerns were raised by people’s relatives or healthcare professionals in relation to the cleanliness of the environment. The registered manager and provider used auditing systems and processes to monitor the cleanliness of the service.

People’s medicines were managed safely, and they received their medicines as prescribed. Systems were in place to safely administer, and store medicines and people were happy with the support they received to take their medicines. We found some improvements were needed to the recording of people’s medicines. This included the need for more accurate recording of the location of people’s transdermal (applied to skin) patches in line with best practice and clearer guidance and clearer protocols for administration of covert medicines. The registered manager acknowledged the need for more consistent completion of body map for the application of transdermal patches and the pharmacy was contacted to provide clarity around what food and drink covert medicines could be administered in.

Risks associated with people’s medicines had been assessed and mitigated, including time critical medicines and medicines such as anticoagulant blood thinners and flammable topical preparations. Staff had training and competency checks to make sure they gave medicines safely. Medicines policies were in place to guide staff. Regular medicines audits took place which identified any medicine errors and implemented remedial action at an early stage.