Clare Mount

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Relatives told us they were happy with the care their loved one received at Clare Mount. One relative told us staff always had their family member ready when they arrived to take them out. Staff told us they would always treat people with kindness and compassion. However, we found people sometimes were unkempt and had poor oral care, and the care they received was not always delivered with dignity and respect. We were not assured that staff were competent in how to effectively provide care beyond people’s basic needs. We did not see evidence to show staff knew people’s individual preferences about their care or how to deal with someone’s distressed behaviours.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received positive feedback from relatives about the kindness of the care staff at Clare Mount. One relative told us, “They [staff] are doing a brilliant job, my [relative] thinks they are in an hotel or a pub and the staff indulge them.”

Staff explained to us how they would ensure people would be cared for in a dignified way and how they ensure people’s privacy when providing care. They told us they would respect people’s choices and one staff member told us they would ensure they saw the person beyond their condition. However, our observations of people’s presentations and care delivery did not always align with what staff were telling us. The registered manager told us that as part of the staff induction to the home, they were shown a presentation of each person as a meet and greet introduction. However, we reviewed the two presentation examples provided to us and found them to be poorly completed.

The service was under a multi-agency concerns (MAC) process at the time of our inspection and they had alerted us to their concerns. Feedback on these meetings from other health and social care professionals involved in the home was that they were concerned about the care people received at the home. The local authority was closely monitoring the home and conducting a number of ongoing safeguarding investigations at the home and other professionals were working closely with the home's management to ensure the safety of people at the home.

We observed some kind and caring interactions between staff and people. For example, staff were patient and attentive whilst assisting people to eat their meals. The main dining room was pleasant and calm with the tables set appropriately. Food looked appetising and was presented well. Some people appeared appropriately presented; however, not everyone had clean clothes and brushed hair. We were not assured that people were receiving good and consistent oral and personal care. We observed that some people had poor oral care and we found one person’s clothes were unclean and they had very few belongings or clothes. Two people’s bedrooms had a strong malodour. We were not assured that staff were trained and competent in how to effectively provide effective and compassionate care beyond people’s very basic needs.

We did not receive any negative feedback from relatives and we found people experienced kind interactions. However, whilst staff were kind and well-meaning they lacked the training, support and guidance to ensure people experienced good, individualised care and support.

Staff told us that people had “This is me” documents in care files so they could get to know the person. They told us it was sometimes difficult to get information when someone does not have family or friends involved in their care. However, there was little information in care documentation about the person’s personality or their choices and individual preferences for their care. The registered manager did not demonstrate their knowledge about individual people living at the home. They told us people at Clare Mount do not have any particular cultural, social and religious needs. However, we found one person is of faith and their faith leader sometimes visits the home.

Although staff spoke kindly to people, we did not see any evidence of established relationships or that staff knew people well. We did not see where staff knew people’s preferences or how to effectively support someone when they became distressed due to their conditions. We spoke with one lady who was able to speak with us and was not aware of the names of the staff who were supporting her that morning. We observed some staff did not have very good communication with people as their English language was poor.

We found a lack of personal information in people’s care plans. There was very little information about people’s backgrounds or their current strengths and aspirations. People were written about in terms of their conditions, rather than what was important to them as an individual. People with distressed behaviours, due to their conditions, did not have any comprehensive positive behaviour plans in place to ensure staff knew the best and most effective way to support them.

People’s relatives were positive about Clare Mount; however, we did not receive any feedback comments in relation to how people were empowered to have choice and control over their care. Relatives told us they were able to visit unrestricted and one relative commented, “When we visit, we take [relative] out if we can to the park and they are always sorted and waiting for us.”

The registered manager told us there was currently no activity co-ordinator in post. The deputy manager was covering the activity provision and told us they aim to provide a raft of activities; however, we found that these events were only planned and did not always actually take place. They told us they were planning a ‘party in the park’ but this had to be postponed and firm plans were not yet in place. The deputy manager told us they will be providing 1:1 activity when the aromatherapy room was completed; however, this room was still under construction. The registered manager told us there is open visiting hours and family are able to take people out if they so wish.

We observed most people were enjoying a singer who attended both lounges to sing traditional songs to people. We found the same singer was present on both days of the inspection site visits; we were not assured if they were usually there on those days as there was no activity programme or calendar displayed. Other than the visit from the singer, there was very little in the way of stimulation for people sat in the lounges during the day. There was nothing for people to keep themselves occupied, other than the children’s books and toys. People were sat around in the lounges without any effective stimulation and we did not observe people being asked what they would like to watch on the television. People with dementia can become agitated by certain types of music and therefore it is important to consider the genre and the preferences of people. At times on both days of our site visits, the television was on very loud playing loud heavy rock music videos that may not have always been appropriate or therapeutic for the people living at the home.

There was a lack of appropriate activities and there was no specific 1:1 activity for people who were cared for in their room. People had access to books for very young children and children’s plastic activity toys. These books and toys were not appropriate, nor a dignified stimulation activity, for people living with dementia and other cognitive conditions. There was no detailed information in care plans about what an individual person liked to do and there was no evidence that this had been explored and facilitated in a meaningful way that was personal and individual to each person living at the home.

People’s experience of having their immediate needs met required improvement. We found staff did not have effective guidance or a comprehensive understanding of people’s needs and lacked the skills to ensure people who were experiencing distress received appropriate care and support. We also found other people at the home experienced upset when someone became distressed or upset due to their conditions.

The registered manager told us staff were able to recognise if someone was unwell through their training and competency checks. They told us staff had training in modules such as how to recognise if someone was having problems with swallowing and that anyone who needed special attention was discussed in handover. They told us people’s wishes were responded to as it was recorded in the care plan. However, our review of a sample of care plans did not reflect that people’s wishes were fully recorded in care plans.

We found there was a large number of staff present at the home due to the additional funded 1:1 staff. Staff were present; however, we were not assured that people’s individual needs were understood and effectively met by staff. Staff demonstrated a lack of skills and knowledge of people’s conditions and individual needs for care. For example, one person with dementia often wanted to sit forward on their chair and their 1:1 support carer told them to sit back and offered them a drink or a child’s book. There was a lack of attempts to understand the person’s need to sit forward. Mid-morning on the second day of inspection, the staff brought in a trolley of fruit, biscuits and juice but then did not offer any of the items to people; only people who were mobile were able to visit the trolley to help themselves to the snacks and drinks. One lady had food spilled down her clothes and we did not see where staff attempted to help her change.

Staff told us they felt supported in their role by the management team. One staff member told us, “Management have been superb and supported me very well.” The registered manager told us they supported staff through supervisions and taking suggestions on board. They told us they take staff out on special occasions and have ‘employee of the month’. They told us their door was always open and staff can come anytime and that they conduct anonymous staff surveys.

There was limited evidence supplied to us to give assurances that there were effective processes in place relating to staff wellbeing. The registered manager supplied us with 3 staff satisfaction surveys and all the responses were positive.