We carried out a review of the data available to us about The Mount & Severn View on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Mount & Severn View, you can give feedback on this service.
The Mount & Severn View is a care home providing personal and nursing care to up to 58 people. Accommodation is provided in one adapted building consisting of two units. The service provides support to older people and younger adults some of whom are living with dementia or have a physical disability. At the time of our inspection there were 43 people using the service.
People’s experience of using this service and what we found
Risks to people were assessed and there were plans in place to mitigate risks. The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19. People received their medicines when they needed them from staff who were trained and competent to carry out the role. People felt safe living at the home and with the staff who supported them. There were enough staff to meet people’s needs. The provider’s staff recruitment procedures helped to protect people from harm. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider's policies and procedures supported this practice.
There were effective systems to monitor and improve the quality of the service provided. The registered manager promoted an open and honest culture and was very visible in the home. They were aware of their legal responsibilities and of their responsibility to be open an honest when things go wrong. The views of people, their relatives and staff were sought and valued. Staff received the supervision and support needed to carry out their role effectively. The registered manager worked in partnership with other professionals to ensure good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 September 2019).
Why we inspected
We received concerns in relation to pressure care, use of equipment and completion of clinical tasks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern.
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 remained good based on the findings of this inspection.
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 & Severn View on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The Mount & Severn View provides accommodation and nursing or personal care for up to 58 people. On the day of our inspection, 43 people were receiving services, some of whom were living with dementia.
People’s experience of using this service and what we found
Staff members followed effective infection prevention and control procedures when supporting people. Staff members had access to, and used, appropriate personal protection equipment.
People received safe care and support as the staff team had been trained to recognise potential signs of abuse and understood what to do to safely support people.
The provider had assessed the risks to people associated with their care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm to people.
People received safe support with their medicines by trained and competent staff members.
Staff members were aware of the necessary actions they should take in the event of an emergency.
The provider supported staff in providing effective care for people through person-centred care planning, training and one-to-one supervision.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems at The Mount & Severn View supported this practice.
People had access to additional healthcare services when required.
People were supported to maintain a healthy diet by a staff team which knew their individual preferences.
People received help and support from a kind and compassionate staff team with whom they had developed positive relationships.
People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability.
People were provided with information in a way they could understand. The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.
The provider, and management team, had good links with the local communities within which people lived.
The management team and provider had systems in place to identify improvements and drive good care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was ‘Requires Improvement’ (published 25 September 2018) and there was a breach of regulation in how the service was managed. The provider completed an action plan after the last inspection to show what they would do, and by when, to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Mount & Severn View is registered to provide accommodation with nursing and personal care to a maximum of 58 people, some of whom are living with dementia. There were 49 people living at the home on the day of our inspection. People’s bedrooms are over two floors and the first floor is accessed by stairs or a passenger lift. People have access to communal areas within the home and access to the home’s gardens.
A registered manager was not in post at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our last inspection on 24 August 2017 we rated the service as requires improvement and we found one breach of regulation of the Health and Social Care Act 2008. We asked the provider to take action to make improvements to ensure there were sufficient numbers of staff, people received the care and support they needed and were treated with respect and consideration at all times. We also asked the provider to make improvements to their arrangements to ensure people were protected from abuse and not restrained unlawfully. We asked the provider to send us an action plan. At this inspection we found that some improvements had been made, however further improvements were required.
The systems the provider had in place to identify areas that required improvement and to drive those improvements were ineffective in ensuring the experiences of people had improved since the last inspection.
Staffing numbers had been increased, however people still did not receive care in a timely manner.
Risks to people were assessed and minimised however environmental risks had not been considered.
People were not always treated with dignity and respect and their needs were not always responded to in a timey manner.
Complaints were investigated however there was no system in place to address informal grumbles.
Infection control measures were in place however they had not prevented malodours in some areas.
People were safeguarded from the risk of abuse and their medicines were stored and administered safely.
The principles of the Mental Capacity Act 2005 were followed to ensure people who lacked capacity consented to their care and support at the service.
People were cared for by staff who were trained and supported to fulfil their roles.
People’s needs were assessed and they had access to health care agencies when they became unwell or their needs changed.
The Mount & Severn View is a nursing home. It provides accommodation with nursing and personal care for a maximum of 58 people. On the day of our inspection 55 people were living at the home. People’s bedrooms are over two floors and these are accessed by stairs or a passenger lift. There is a six bedded wing dedicated to the care of people living with dementia within the home called the Memory Lane unit. People have access to communal areas within the home and access to the home’s gardens.
The registered manager had retired the day before our inspection. The provider had already moved a registered manager from another one of their homes and they had applied to become registered manager at The Mount & Severn View. They are referred to as the new manager in this report. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People, relatives and staff all expressed concern to us about there not being enough staff at the home. People’s call bells were not always answered in a timely manner because staff were helping other people. This had impacted on people’s dignity, safety and the way in which staff were able to meet their needs when they needed help. Improvement was needed to make sure staff were always available to support people when they needed it.
Managers were not aware of staffing concerns or the effect this had had on people and their dignity. People's needs were assessed to establish how many staff were needed, but this had not been effective in ensuring people received support when they needed it.
People could be at risk of not having their right to make their own decisions upheld. Staffs' knowledge about how to support people who did not have capacity to make their own decisions was good. But the records of the processes they had to follow did not reflect this level of knowledge.
People and relatives had opportunities to give feedback about the service provided. Relatives who raised concerns informally did not always feel these had been resolved. The provider had a complaints policy in place, which people and relatives were aware of. Complaints were investigated and responded to, in a formal manner, as per this policy.
People and relatives thought staff were well trained and understood how to support them. Staff had received training to give them the skills and knowledge needed to support people's individual needs. Some staff felt they needed more specialised training to help them understand people’s health conditions better. Training had already been identified for this to happen.
Staffs’ experience of the support they received in their roles was varied. Some staff felt involved in what happened at the home whilst others did not.
Staff had received training in and understood how to protect people from any avoidable harm and abuse. Staff knew how to and were confident in reporting any concerns they may have about a person’s safety. However, managers told us they had not been made aware of staff concerns about staffing levels.
People continued to have their health needs met. People had access to a range of healthcare services, when required.
Risk to people had been identified and assessments reflected how care should be provided to the person to minimise any risks to them. Staff knew what they needed to do to help reduce risk to people and keep them safe.
People were supported to take their medicines when they needed them. Medicines were stored safely and the processes in place helped to make sure they were managed safely.
People felt they had good relationships with staff and that staff respected their privacy. They were happy with the care and support they received and gave praise and positive comments about the staff at the home.
Systems were in place to assess and monitor the standards of care delivered at the home. The standards of care were assessed against our key questions. Action plans identified areas for improvement but had not identified the concerns we found at our inspection and what people, relatives and staff told us about the staffing levels.
The management team were receptive to our feedback and kept us updated on the improvements they planned to make after our inspection.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which relates to the staffing at the home. You can see what action we told the provider to take at the back of the full version of the report.
This inspection took place on 23 and 25 February 2015 and was unannounced.
The Mount & Severn View provides accommodation, personal and nursing care for older people and people living with dementia for a maximum of 58. There were 56 people living at the home when we inspected.
The home had a registered manager in post who was present for our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us that they felt safe living in the home. Staff told us that they had received safeguarding training and knew how to protect people from potential abuse. They were also aware of their responsibility of reporting concerns of abuse to the manager and other agencies. There were sufficient staff on duty to keep people safe. We saw that staff were nearby to support people when needed. Staff had access to risk assessments that told them how to support people in a safe way. Accidents were monitored and action taken to reduce further risks.
People told us that they were involved in their assessment and care planning and this ensured they receive care and treatment the way they liked. Staff told us that they were supported by the manager and had regular supervision and training. People’s consent for care and treatment was obtained and where people lacked capacity a best interest decision had been made to ensure they received the appropriate support.
People told us that they were happy with the meals provided to them and we saw that where necessary people were supported to eat their meals. People told us that they had access to other healthcare services when needed and a record was maintained of when healthcare professionals had visited.
People told us that staff were caring and treated them with respect. We saw that people were supported in a kind and caring manner and this was done in a way to promote their privacy and dignity.
Staff were aware of people’s past history and their interests and this information was included in their care records. People told us that they had access to various social activities in and outside the home and staff supported them to pursue their interests. People were aware of how to share their complaints and concerns. Complaints were recorded and showed what action had been taken to address them.
People told us that they were happy with the service and were involved in regular meetings that enabled them to have a say in the way the home was run. Staff said that the management team were supportive and listened to their views. The service provided was regularly monitored and quality audits were carried out to ensure people received a safe and effective care and treatment.
We carried out this visit as a result of concerns we received with regard to staffing levels on Salway unit. Salway unit is a unit for six people living with dementia.
We reviewed people's care needs on the unit, talked with staff and made observations during our visit. We did not identify any concerns and found people experienced care, treatment or support that met their needs and protected their rights. People were cared for by enough qualified, skilled and experienced staff.
We found that people who used the service were protected from the risk of abuse. This was because the provider had taken reasonable steps to identify potential abuse and acted appropriately.
There were systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The registered manager undertook audits including care plan audits. We saw that the manager used a needs analysis tool to calculate staffing levels. They told us that if a person's dependency level increased staffing levels were adjusted to reflect this. We saw evidence of these audits/tools in records we sampled.
Staff told us that they enjoyed working at the home and that they were well supported by the manager. We saw that staff had received appropriate training for their roles and that they were properly supervised and appraised.
We found that care plans were comprehensive and person centred. We saw care being delivered with kindness and sensitivity. People told us that they felt safe in the home. We found that there was a comprehensive safeguarding policy in place and that staff were familiar with it.
We found that that staff understood the need to obtain people's consent for their care and treatment. However, people's consent was not consistently recorded.
There was a suitable complaints procedure in place and we saw evidence that complaints were responded to in an appropriate way.
Feedback from relatives was mixed. Two people were very complimentary about the care that their relative received. They told us that they were fully involved in the assessment and care planning and review process. They were happy with the staffing levels and considered that staff were quick to respond to any health care needs. Comments received included, 'We were fortunate to get mum in here, she is cared for very well. The meals are really good ' like a hotel, the staff are very very good and the manager is nice and approachable'. 'The care my wife receives is marvellous. I couldn't wish for anything better. The staff are very helpful and I'm kept well informed, I wouldn't find another place like this'. Another person considered that their relative was isolated and that 'the home had failed in their duty of care' following a recent accident at the home.
Most of the staff we spoke with told us that they enjoyed working at the home and that they are provided with many training opportunities to develop their skills and knowledge. They considered that the care plans are reflective of people's individual needs and provided good examples of how they promote privacy and dignity. They told us that they received formal supervision to discuss their work practice, performance and identify any training needs. They told us that regular team meetings are held in addition to handovers so that they are kept informed about any changing needs. Comments included, 'I really like working here. We work well as a team and the manager is supportive and approachable. I'd recommend the home to anyone'. 'The residents and staff make it a lovely place to work, although it can be disorganised and communication between the team could be improved'.
'I enjoy the challenge'.
Five people expressed concern about staffing levels given the dependency levels of the people accommodated and the layout of the home. One person said, 'Sometimes there are not enough staff on duty at night. Staffing levels are reduced but they still have the same number of us to look after. I'm sometimes kept waiting when I call the bell'. Another person said, 'People's needs are not always met as we are so busy'.