Mount Vernon Terrace

Updated 19 August 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.

Inspection team

This inspection was carried out by 2 inspectors.

Service and service type

Mount Vernon Terrace 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. Mount Vernon Terrace is a 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

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 used all this information to plan our inspection.

During the inspection

We spoke with the registered manager, nominated individual, 2 domestic and 3 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 1 person who was receiving the regulated activity and other people who used the service. We looked at 2 recruitment files, 2 care plans, 2 medication administration records and multiple documents about the oversight of the service.

Updated 19 August 2023

About the service

Mount Vernon Terrace is a residential care home registered to provide the regulated activity ‘Accommodation for persons who require nursing or personal care’ to up to 16 people. However due to 2 of these rooms being double rooms, the registered manager reported they would support a maximum of 14 people at any one time. The service provides support to younger and older adults who require support with their mental health. At the time of our inspection there were 12 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection there were 2 people being supported with personal care.

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

Medication was not always managed safely. Care plans lacked some guidance for staff, but these were updated immediately after the inspection. Personal emergency evacuation plans (PEEPS) contained some incorrect information, but these were updated during the inspection.

People were not supported with regular person-centred activities.

The environment needed some work to make sure people were safe and free from harm such as infections and injury, but there were planned works evidenced by the provider.

There were appropriate levels of staffing and safe recruitment processes in place. Staff had received adequate training, including agency staff.

People were supported to eat and drink enough to maintain a balanced diet.

People’s privacy, dignity and independence was promoted. Resident and staff meetings had been held. Staff and people told us about improvements at the home since the new provider and registered manager took over.

Care plans did not always contain all the information required to care for people in a person-centred way. People were supported with regular activities, where they chose to be engaged in this activity.

Business records did not always contain up to date information. Systems and processes needed to be improved to identify gaps in care plans. People and staff were positive about the management of Mount Vernon Terrace. The registered manager was quick to put things in place where areas of concern were highlighted to them.

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 in the service supported this practice.

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 the service under the previous provider was good (published on 29 November 2019).

Why we inspected

The inspection was prompted in part due to concerns received from the new registered manager and provider about the conditions within the home and neglect of people when they took over the service. 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.

The overall rating for the service has changed from good with the last provider, 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 and well led sections of this full report.

The registered manager acted immediately after the inspection to address the concerns identified.

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

Enforcement

We have identified breaches in relation to safe care and treatment and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.