Archived: Montrose Hall

Montrose Hall is a modern, purpose built home situated within a local community in Wigan. It provides residential care for up to 41 older people, including people living with dementia. Accommodation is provided over two floors with lift access between the floors. Each floor has a main lounge with dining area and a second smaller lounge. At the time of the inspection 40 people were living at the home.

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

People spoke highly of the care and support provided by staff who were described as being kind, caring and respectful. Staff knew people well and how they wished to be cared for and supported.

The home was extremely responsive to people’s needs and wishes and provided exceptional person-centred care. People were encouraged and supported to set and achieve goals and ambitions.

A great deal of time and effort had been spent by the staff in designing and decorating the home both inside and out, to ensure it provided a stimulating environment, which met specific needs as well as promoting independence and socialisation.

The home had developed excellent links with a number of community groups and organisations. These provided positive benefits to both people living at the home and the wider community. The home had been selected to take part in local authority pilot schemes, which underlined their standing within the community.

The home considered activities and social interaction to be an integral part of people’s lives. People and relatives spoke positively about the opportunities available, which included access to community-based activities and events. Through the support provided by the home, people had reconnected with both friends and activities they had lost touch with.

People were encouraged to provide their views and opinions about the home and care provided through both meetings and questionnaires, to help drive continuous improvements. The home completed a range of audits and quality monitoring processes to help support this process.

People, relatives and staff told us the home was extremely well run, with the registered manager being an active role model, who was open, approachable and focussed on supporting people and staff to achieve their potential.

People’s safety was maintained, through ongoing personalised risk assessments and by ensuring the premises and any equipment was maintained and serviced regularly. People received their medicines on time and had ready access to healthcare professionals as and when required.

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 (report published February 2017).

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.

A comprehensive inspection was last carried out on 19 May 2015, when we rated the service as ‘requires improvement’ overall. We found no breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, however we did make one recommendation in relation to the safe storage of medicines, including controlled drugs at that time.

Montrose Hall is a modern, purpose built home situated within a local community in Wigan. It provides residential care for up to 41 older people, including people living with dementia. Accommodation is provided over two floors with lift access between the floors. Each floor has a main lounge with dining area and a second smaller lounge. On the day of the inspection there were 35 people living at the home, with two more people currently residing in hospital.

At the time of inspection the home had a registered manager. 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.

We found the home was clean throughout and had appropriate infection control processes in place. Hand hygiene guidance and equipment was located in all the bathrooms and there were posters encouraging the use of hand gels and regular washing to prevent the spread of infection on display.

Each of the people we spoke with told us they felt safe. Relatives expressed no concerns about the safety of their family members and were positive about the level of care provided. We saw the home had appropriate safeguarding policies and procedures in place, with instructions on how to report any safeguarding concerns to the local authority. Staff had received training in safeguarding vulnerable adults, which was regularly refreshed and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

Staffing levels were determined by the needs of people living at the home, with a dependency tool being used each month to ensure levels remained safe and effective. We saw the home had sufficient numbers of staff to meet people’s needs and both people and relatives we spoke with confirmed this.

We saw medicines were stored, handled and administered safely and effectively. We noted some inconsistencies with the recording of ‘as required’ medications such as paracetamol, specifically with regards to the recording of occasions when people had not required these. Staff responsible for administering medicines were trained and had their competency assessed up to three times per year.

All staff spoken to demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. We found the provider had followed the requirements in the DoLS and related assessments and decisions had been appropriately taken.

Staff were complimentary about the training available, telling us there was a mix between practical sessions and e-learning. All staff had completed a comprehensive induction programme lasting two full weeks and on-going training was provided to ensure skills and knowledge were up to date. Staff confirmed they received regular supervision and annual appraisals, which along with the completion of regular team meetings, ensured they were supported in their roles.

We observed meal times to be a positive experience, with people being supported to eat where they chose. Staff engaged in conversation with people, explained the choices available and provided support where needed. People we spoke with were complimentary about both the quality and choice of meals available.

Throughout the inspection we observed positive and appropriate interactions between the staff and people who used the service. Staff were seen to be caring and treated people with kindness, dignity and respect. Both people who used the service and their relatives were complimentary about the attitude of the staff and the standard of care received.

We looked at six care files which contained detailed information about the people who used the service and how they wished to be cared for. Each file contained detailed care plans and risk assessments, which helped ensure people’s needs were being met and their safety maintained. We did note some gaps in documentation, particularly relating to bath and shower charts which the registered manager had already identified and scheduled a staff meeting the following day to address.

We have made a recommendation about the recording of information within care records.

The home had a comprehensive activity schedule in place. The home did not employ an activity co-ordinator, believing all staff should be involved in this role. Everyone we spoke with was positive about the variety and frequency of activities available. We saw the activity schedule catered for all interests and abilities and suggestions for either outings or activities made by people were acted upon and implemented.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed on a daily, weekly and monthly basis and covered a wide range of areas including medication, care files, infection control, health needs and the overall provision of care. We saw evidence of action plans being implemented to address any issues found.