Mountside Residential Care Home is registered to provide support to a maximum of 52 people and 31 people were living at the service at the time of our inspection. The service is registered for older and younger people, who may be living with a physical disability, and dementia. People’s experience of using this service and what we found
The provider, manager and staff team had worked hard to address the areas for improvement following the last inspection. Although improvements had been made, further time was needed to fully embed these changes into day to day practice and to meet the regulations.
Improvements had been made to the provider’s governance systems and these had identified some of the shortfalls found at this inspection. However, the systems were not fully embedded and some audits had not been completed since July 2021. There was a lack of clear and accurate records regarding changes to peoples’ health and well-being. For example, oral care, specific health needs including weight loss, and daily records. Changes to peoples’ health and well-being were not always planned for and monitored effectively, such as falls and skin injuries. The provider's systems failed to identify that care and treatment was not always provided in a safe way.
People were not always protected from the risks of abuse and harm because staff had not followed the organisational policy and procedure, following a recent alleged abuse incident. This has now been progressed and risk to people mitigated.
Improvements had been made to aspects of risk management, but we found that care and treatment was not consistently provided in a safe way. Incidents and accidents were not all recorded and reflected in peoples care plans. Some people have had multiple falls and there was no evidence of preventative measures taken. Therefore, opportunities of learning from accidents and incidents to aid prevention of a re-occurrence had been missed. There were some injuries that had not been communicated to senior staff and this meant that there was a lack of risk monitoring. Weight loss was not pro-actively managed and there was a lack of guidance for staff to follow for those at risk of choking. Environmental risks had been identified but there were some trip hazards that had not been actioned. This was dealt with when identified during the inspection by the maintenance person and the risk of trips mitigated. Personal emergency evacuation plans were not all accurate and updated to reflect changes to the environment, (stair gates), mobility and health. This was attended to by the second day of the inspection.
Improvements had been made to the provision of person-centred care. However, this was a work in progress and not everyone’s specific health needs were identified and planned for to promote responsive care to ensure their safety and well-being. For example, oral care, and deterioration of mobility. There was also a lack of guidance of how to manage people who lived with dementia.
Improvements had been made to the management and prevention of infection control. Government COVID-19 guidance was followed to ensure peoples’ health was protected.
Some people confirmed they were involved in their care planning and felt listened to. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives. Further training in end of life care was being sought from the local hospice.
Complaints made by people were taken seriously and investigated. There was a need for clearer recording which the manager was aware of and taking steps to address.
People told us that they were looked after well and enjoyed living at Mountside Residential Care Home. One person said, “This is my home, I feel I am safe and they are good to me,” and “I wouldn’t want to live anywhere else.”
Staff were open and transparent during the inspection. Staff were respectful to people and wanted to deliver good care. One staff member said, “Changes are happening, but we are a good team, we need to communicate better though, still got improvements to make.”
Rating at last inspection:
The last rating for this service was Inadequate (published 15 May 2021)
Why we inspected:
We carried out an announced inspection of this service on 6 and 9 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Personalised care, Safe care and treatment and Good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contained requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mountside Residential Care Home on our website at www.cqc.org.uk.
Enforcement:
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified continued breaches in relation to safe care and treatment, person centred care and good governance at this inspection.
This service has been in Special Measures since May 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Please see the action we have told the provider to take at the end of this report.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.