The Mount Residential Home

Updated 22 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors and an Expert 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.

Service and service type

The Mount is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Mount is a residential care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been appointed and has submitted an application to register with CQC.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 2 February 2023 and ended on 9 February 2023 when formal feedback was provided. We requested and reviewed records remotely during this period. We visited the home on 2 and 7 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We also used information gathered as part of the monitoring activity that took place on 23 November 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people and 3 relatives about their experience of the care provided. We also spoke with 7 staff which included care and senior staff, domestic, and catering staff. We also spoke with the manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of documents and records including the care records for 6 people, 5 medicine records and 2 staff recruitment files. We also looked at records that related to the management and quality assurance of the service.

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.

Updated 22 April 2023

About the service

The Mount is a residential care home providing personal care and accommodation for up to 18 people some of whom may have Dementia. The service was supporting 15 people at the time of the inspection.

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

Systems to monitor the quality and safety of the home were either not in place or were not effective in identifying shortfalls. The providers governance systems had failed to identity the shortfalls we found during this inspection in relation to management of medicines, risks, and records to ensure staff had clear information on how to meet people’s need and preferences.

Risks to people were not consistently well managed and left people at potential risk of harm. Staff did not have clear information about known risks and how to manage and reduce these. Medicines were not always administered safely, and storage of cold medicines was not always monitored.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Some staff training was not up to date and not all staff followed safe practices when supporting people. People were not always consulted about the home to ensure their preferences were considered. Improvements were required within the environment as certain areas had an odour and needed redecoration.

People were supported by staff that understood how to protect people from abuse. People had access to routine healthcare checks to monitor their healthcare needs. Staff felt supported in their role. Systems were in place to support people to maintain contact with their loved ones. The manager was described as approachable, open and transparent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 29 March 2019).

Why we inspected

The inspection was prompted in part by a notification of an incident following which a person using the service sustained an injury and died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk and falls management. This inspection examined those risks. We undertook a focused inspection to review the key questions of safe, effective and well led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Mount residential care home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the management of risk and medicines, consent and to the overall governance of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.