Archived: Montrose Care Home

Updated 2 August 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 was planned to check 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 9 July and was unannounced. The inspection continued on the 11 July 2018 and was announced. The inspection was carried out by two inspectors on both days.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.

We had not requested a Provider Information Return (PIR) to the service. 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. We gathered this feedback from the registered manager during the inspection.

We spoke with seven people who used the service and five relatives. We met with three health professionals, seven staff, one domestic staff member and the head chef.

We spoke with the registered manager, deputy manager and care coordinator. We reviewed six people’s care files, four medicine administration records, policies, risk assessments, health and safety records, consent to care, quality audits and the 2017 resident and relative’s survey results. We looked at four staff files, the recruitment process, complaints, training and supervision records.

We walked around the building and observed care practice and interactions between care staff and people who live there. We used the Short Observational Framework for Inspection (SOFI) at meal times. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We asked the registered manager to send us information after the visit. This included policies and the staff training record. They agreed to submit this by Thursday 12 July 2018 and did so via email.

Updated 2 August 2018

Montrose Care home is a residential care home for 22 older people with dementia and sensory impairment. There are two floors with the first floor having access via stairs or a lift. There is a communal living and dining area and a lounge leading out onto the gardens. There are various smaller seating areas throughout the ground floor. There were 17 people living at the home at time of inspection.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected.

There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults.

When people were at risk of falling, malnutrition or skin damage staff understood the actions needed to minimise avoidable harm and plans were in place.

The service was responsive when things went wrong and reviewed practices in a timely manner.

Medicines were administered and managed safely by trained staff. Medication competency checks took place together with daily audits to ensure safety with medicines.

People had been involved in assessments of their care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with professionals such as doctors, nurses and social workers.

Care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. Staff felt confident in their roles. Staff knowledge was routinely checked.

People had their eating and drinking needs understood and met. People were happy with the quality of the food and regular satisfaction surveys were in place. People living in the home had daily contact with the chef to discuss nutrition needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards (DoLS) were understood and were in place as appropriate.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as homely. People were able to express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories and the things and people important to them.

A complaints process was in place and people felt they would be listened to and actions taken if they raised concerns. The service actively encouraged feedback from people, relatives, staff and professionals.

People’s end of life wishes were known including their individual spiritual and cultural wishes.

The home was in the process of reviewing the activities they offered people and were planning on making improvements to their activity programme. A dedicated member of staff had been appointed to co-ordinate this.

The service had an open and positive culture that encouraged the involvement of people, their families, staff and other professional organisations. Relatives and professionals were confident in the service.

Leadership was visible and promoted teamwork. Staff spoke positively about the management team and felt supported.

Audits and quality assurance processes were effective in driving service improvements. Outcomes had clear actions that were followed and reviewed.

The service understood their legal responsibilities for reporting and sharing information with other services.