Montrose Barn

Updated 27 July 2023

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 carried out by 1 inspector.

Service and service type

Montrose Barn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hour notice of the inspection. This was because it is a small service and we needed to be sure that a member of staff would be available to support the inspection. We wanted people to be prepared for our visit so that we could spend time with them to gain their views on the service.

What we did before the inspection

Before visiting the service, we reviewed information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.

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 used all of this information to plan our inspection.

During the inspection

We inspected the service on 24 March 2023.

During the inspection we met and spoke with people who used the service, the registered manager and deputy manager. In addition, we observed staff supporting people within the home and inspected a range of records. These included people’s care records, training records, 5 staff files, staff meeting minutes and the service's policies and procedures. Following the inspection, we received feedback from 2 staff and 2 health and social care professionals about the service.

We had received views from a relative prior to the inspection visit, so were aware of their thoughts about the service. This was taken into account during the inspection process.

Updated 27 July 2023

Montrose Barn is a care home that provides accommodation and personal care support for up to two adults with learning disabilities. The service specialises in the care of people who have a learning disability and autistic people. The service is in a rural location.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting underpinning principles of Right Support, Right Care, Right Culture.

Right Support:

The provider was exceptional in how they ensured that people were always kept safe from potential risks.

Care and support plans were holistic and reflected people’s individualised preferences and support needs. People were involved, with staff support in the development of individualised care and support plans.

Staff were exceptional in the way they supported people to learn new skills and maintain their independence. People had fulfilling days and meaningful goals they chose. Staff supported people exceptionally by focusing on their strengths and encouraging people with what they could do.

People were supported to have maximum choice and control of their life 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. We observed people making real choices in the structure of their day and the activities they took part in. They were consistently in control of how they spent their time; what they wanted to do and when.

People had control of their dignity and how personal care was provided. The service consistently met their needs based on their wishes, enhancing their quality of life and well-being.

Staff were exceptionally responsive and had excellent knowledge of the people they supported. The service had a strong emphasis on ensuring people felt empowered and valued.

Right Care:

Staff were extremely passionate about providing care that was compassionate and provided the best outcomes for people. Staff looked at ways to enrich people’s lives.

People were treated with kindness and were observed to be exceptionally well cared for. Staff were aware of the importance of the presentation for people and excelled in supporting people with this.

Staff understood people’s communication needs as they worked with them consistently and got to know them over time, developing trusting relationships and exploring how to best capture their wishes and views. Staff deeply respected the people they supported, each other and the home environment, providing care that was thoughtful and compassionate.

People were encouraged to take positive risks to enhance their wellbeing and the service communicated well around what risks people faced and how to support them to manage these risks positively. People's care, treatment and support plans reflected their individual needs, and this promoted their wellbeing and enjoyment of life.

The service promoted equality for the people they supported. The registered manager was passionate about supporting people to access services and activities. They supported people to overcome barriers and thought outside the box to achieve this.

Right Culture:

The registered manager and staff team were highly motivated and proud of the service they delivered to the people they supported. There was a visible person-centred culture at the service.

There were consistently high levels of engagement with people using the service and with health and social care professionals to ensure people received safe, effective and responsive care that met their individualised needs.

The service placed people's wishes and aspirations at the center of everything they did, driving a culture that was inclusive and empowering. The registered manager was passionate about supporting people to be able to access, experience and participate in activities inclusively. They promoted positive risk taking and innovative approaches to support them to achieve this and to provide people with meaningful outcomes.

The registered manager was passionate about ensuring staff were suitably skilled and trained to meet people’s complex and diverse needs. The ethos of the provider was that staff were guests in the people's home and this was reflected in how staff supported them.

There was clear leadership and visions and values for the service, that ensured people were at the heart of everything they did.

Last inspection

The service was rated Outstanding at our last inspection. (Published 21 November 2019) This was due to how responsive the provider was in meeting people’s individual needs and the excellent leadership of the service.

At this inspection the service remained Outstanding in Well Led and Responsive as the provider continued to improve and develop its service. We also rated Caring domains as outstanding due to the person centered care that the service was providing. It was evident that people’s quality of life and achievements had excelled since the last inspection.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Why we inspected

We were prompted to carry out this inspection due to concerns we received about recruitment of staff. A decision was made for us to inspect and examine those risks.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.