Mountdale Nursing Home

Updated 24 January 2024

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

The inspection team consisted of 1 inspector, 1 regulatory coordinator and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Mountdale Nursing Home 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.

Mountdale Nursing Home is a care home with 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 were two registered managers in post. One of the registered manager’s was also the nominated individual.

Notice of inspection

The 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who use the service and 7 relatives about their experience of Mountdale Nursing Home. We spoke with both registered managers, 1 qualified nurse and 7 members of staff. We also spoke with the staff member responsible for facilitating activities and the service’s chef. We reviewed a range of records. This included 6 people’s care records and 8 people’s medication administration records. We looked at 6 staff files in relation to recruitment, training, induction and supervision. A variety of records relating to the management of the service, quality assurance information and policies and procedures were viewed.

Updated 24 January 2024

About the service

Mountdale Nursing Home is a residential care home providing the regulated activities of personal and nursing care to up to 24 people. The service provides support to older people, older people who require nursing care and people who are living with dementia. At the time of our inspection there were 23 people using the service.

People’s experience of the service and what we found:

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

Staff did not routinely support people to take part in social activities. People did not benefit from an environment that met their needs. Not all staff could communicate effectively with people using the service and this impacted on the quality of care some people received. Staff supported people with their medicines in a way that promoted their health outcomes.

Right Care

Staff did not understand how to protect people from abuse and harm. The provider and staff had training on how to recognise and report abuse but did not know how to apply it to keep people safe. The service did not have enough appropriately skilled and competent staff to meet people’s needs. Information about risks were not comprehensive or up to date. People were not protected by the service’s infection, prevention, and control of infection arrangements.

Right Culture

There was a lack of clear leadership and oversight. Responsibilities and accountability arrangements were not clear. The arrangements for identifying, capturing, and managing risk were not effective. Although staff reported incidents, managers failed to act on known issues. Feedback and complaints were not dealt with in an open, transparent and timely way. Staff were not aware of the service’s vision and values.

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 [Published November 2017].

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of Safe and Well-Led. During the inspection we found concerns with protecting people from harm, staffing, including the provider’s recruitment practices and procedures. Therefore, we widened the scope of inspection to include the additional key question of Effective. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Mountdale Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safeguarding people from abuse, risk management, staff recruitment practices, including staff training, induction and supervision and governance arrangements. We have also made a recommendation about the premises.

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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.