Background to this inspection
Updated
27 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 5 December 2017 and was an unannounced inspection. This inspection was conducted by three inspectors and an expert by experience (ExE). An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with 13 people, seven relatives, three care staff, two senior care workers, the chef, the registered manager and the nominated individual. We looked at 14 people’s care records, four staff files and medicine administration records. We also looked at a range of records relating to the management of the service.
Updated
27 January 2018
Mon Choisy 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 both were looked at during this inspection. Mon Choisy accommodates 22 people in one adapted building. At the time of the inspection there were 28 people living at the service.
When we last inspected the service on 30 November 2016 and 5 December 2016. We found that the provider was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider did not have effective governance systems and procedures in place and had failed to identify some of the concerns we found during our inspection.
We also found the provider to be in breach of Regulation 18 of the Health and Social Care Act 2008 (Registration) Regulations (2014). This was because the provider had not reported important events that happen in the service to CQC. At this inspection we found that the provider had made significant improvements to address our concerns.
We saw evidence that arrangements were in place to formally assess, review and monitor the quality of care provided at the home. The registered manager was aware of their responsibilities and had reported appropriately to CQC about notifiable events.
There was a registered manager in post. 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 and their relatives told us people were safe living at Mon Choisy. Staff demonstrated they understood how to keep people safe and we noted that risks to people's safety and well-being were managed through a risk management process. We observed people's needs were met in a timely way by sufficient numbers of skilled and experienced staff. People were supported by staff who had been trained in the Mental Capacity Act 2005 and applied it’s principles in their work.
The provider had a robust recruitment process in place which helped to ensure that staff employed were of good character and suited to the roles they were employed for. People's medicines were managed safely and kept under regular review. Infection control measures were in place to help reduce the risks of cross infection.
Staff told us, and records confirmed they had effective support. Staff received regular supervision
(one to one meetings with their manager) and yearly appraisals. People were supported appropriately to eat and drink sufficient amounts to help maintain their health and well-being. People's health care needs were taken care of and they had access to a range of healthcare professionals. Where required, appropriate referrals were made to external health professionals such as G.P’s or therapists.
People and their relatives were very complimentary about the staff and management at the home. They told us staff were kind, caring and compassionate. Staff members, including the management team, were knowledgeable about individuals' care and support needs and preferences. Visitors
were welcomed at all times and people were supported to maintain family relationships.
The provider had systems in place to receive feedback from people who used the service, their relatives, and staff members about the service provided. People were encouraged and supported to raise any concerns with staff or management and were confident they would be listened to and things would be addressed.
There was an open and inclusive culture in the home and people, their relatives and staff felt they could approach the management team and were comfortable to speak with the registered manager if they had a concern.