Mountfitchet House

Mountfitchet House is a residential care home providing personal and nursing care to up to 60 people. The service provides support to older people and people with nursing care needs, some of whom may be living with dementia. At the time of our inspection there were 58 people using the service.

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

Staff were provided with training relevant to their role; however, we found safe moving and positioning practices were not always being followed. People’s care was not always provided in line with their care plan guidance and preferences. The provider’s induction programme did not always evidence how staff who were new to care learnt the required knowledge and skills.

Staff were safely recruited, with relevant checks completed prior to them starting work and there were enough staff available to meet people’s needs.

We received mixed feedback about the quality and variety of food and drink provided. However, people and relatives confirmed this was improving. The service was well equipped and adapted to suit people’s needs. People told us they were supported to take part in different social activities, although some people said they would like more opportunities to go out and a wider range of in-house activities.

The provider had processes in place for monitoring the safety and quality of the service and sought regular feedback from people and those important to them in order to identify and action areas of improvement. Risks to people’s safety were assessed and documented; however information was not always fully updated as people’s needs changed.

People’s medicines were managed safely by staff who were trained to administer them. Staff followed safe infection prevention and control practices and the service was clean and well maintained. Staff were aware of how to recognise and raise safeguarding concerns. People and their relatives felt comfortable making complaints or raising any issues with the registered manager.

People spoke positively about the kind and caring attitude of the staff. 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. People and those important to them were involved in the care planning and review process.

The provider worked in partnership with other healthcare professionals to meet people’s needs and adapt promptly to any changes in their health. People, relatives, and staff spoke positively about the culture and leadership of the service. The provider had built strong links within the local area, enabling people to feel involved in their community.

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 outstanding (published 20 September 2018)

Why we inspected

We received concerns in relation to the management of safeguarding concerns and complaints, the management of medicines and whether care was being provided in line with people’s preferences. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found some evidence that the provider needs to make improvements. Please see the Effective section of this full report.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had assigned one member of staff the role of infection prevention and control champion for the service. The member of staff told us they were responsible for completing infection prevention and control audits, monitoring Personal Protective Equipment (PPE) stock levels and ensuring up to date guidance and information was available to all staff.

There was clear signage at the entrance to the service and throughout the building alerting staff and visitors to the outbreak and providing relevant infection prevention and control information.

The provider had increased the frequency of cleaning throughout the service, with particular emphasis on high touch areas such as door handles and light switches

A free standing visitor’s pod was being built in the grounds of the service to provide a separate space for people to safely meet with their relatives in the future.

Mountfitchet House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Mountfitchet House is registered to provide accommodation and personal care with nursing for up to 60 older people who may also have dementia. At the time of our inspection care was provided to 53 people. Care is provided in four units over two floors, residential, residential dementia, dementia and people who have nursing needs.

At the last inspection in 2015, the service was rated Good. At this inspection, we found the service had continued to develop and was therefore rated outstanding.

The service had 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.

We found the service was very well managed. The registered manager was a strong leader and highly motivated. The service had a full complement of nurses with the necessary skills to meet the needs of the people using the service. This meant people received continuity of care from highly skilled staff. There was an established management team who regularly supported and audited the service to ensure it provided high quality care.

Staff were extremely motivated in their role and felt valued their focus was on the people that used the service. The manager was visible and actively involved in supporting people and staff. Staff morale was high and they felt that their views were valued. The provider worked extremely hard with the management team to ensure all staff felt valued and appreciated.

People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. Medicines were well managed by staff that had been trained and assessed as competent to administer medicines and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

Staff had excellent relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. Staff showed empathy and understanding.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act.

People had sufficient amounts to eat and drink to ensure their dietary nutritional needs were met. The service worked well with other professionals to ensure that people’s health needs were met. People’s care records showed that, where appropriate, support and guidance was sought from healthcare professionals.

People were encouraged to follow their interests and hobbies and to engage in meaningful person-centred activities. They were supported to keep in contact with their family and friends. People’s care plans were individual and contained information about people’s needs, likes and dislikes and their ability to make decisions.

The service was brightly decorated and stimulating for the people living there. The communal areas were decorated to a high standard were clean and furnished giving an overall homely feel. The outside area had accessible gardens with benches and easy access for people with limited mobility.

People received support that was personalised and tailored to their needs. They were aware of how to complain and there were a number of opportunities available for people to give their feedback about the service.

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The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required.