Archived: Montclair Residential Home

We found the following examples of good practice:

The provider had developed new ways of recording observations about people's health which were shared with healthcare professionals in advance of appointments. This had reduced the need for external visitors to the home and had facilitated good virtual consultations with healthcare professionals.

The provider was following best practice guidance to prevent visitors to the home spreading COVID-19 infection. The provider had individual visitor plans and they kept in touch with family members and people's friends through regular phone calls, emails and video conferencing.

The provider had arrangements for visitors to meet with people in the porch near the entrance which had a Personal Protective Equipment (PPE) station and a toilet. All visitors were asked COVID-19 screening questions on arrival, and had their temperature checked. A COVID-19 lateral flow test was carried out on all visitors and visiting professionals. Following the government’s announcement allowing families to visit their relatives from 8 March 2021, the provider discussed visiting with people and their families so they were informed of the new arrangements and how to ensure each other’s safety during visits. This included the completion of lateral flow tests, wearing of PPE and adhering to social distancing. Following the inspection the provider confirmed visiting had commenced in line with government guidelines.

To ensure people's well-being the provider had arranged for weekly musician sessions and the musician was part of the weekly COVID-19 testing programme for staff. Due to COVID-19 they had suspended group activities and activities were performed on a one to one basis.

The provider had an admissions process in place. People had a COVID-19 test within 24 to 48 hours prior to being admitted into the service and were isolated for 14 days following admission to reduce the risk of transmission of COVID-19.

The home had two areas for staff to don and doff (put on and take off) PPE.

Our observations during the inspection confirmed staff were adhering to PPE and social distancing guidance. The provider informed us that when a person tested positive for COVID-19, the care home managers (registered nurses) cleaned their room instead of the cleaners. This was to ensure the safety of staff and people.

The provider had ensured staff who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing.

Further information is in the detailed findings below.

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

Staff were knowledgeable in safeguarding adults’ procedures and reported concerns appropriately to the local authority and, if required, the police. Risks to people’s safety had been identified and managed. We identified some environmental risks on the day of our inspection and staff took immediate action to address those concerns. There were sufficient staff to meet people’s needs and safe recruitment practices were followed. Staff adhered to infection control procedures and safe medicines management was in place.

Staff received regular training and supervision to ensure they had the knowledge and skills to support people. Staff were aware of people’s dietary requirements and people had access to food and drink throughout the day. Staff supported people to access healthcare professionals and followed advice provided. 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. An accessible, clean and homely environment was provided.

Staff had built good working relationships with people. People and the relative we spoke with were complimentary about the staff and felt they were well cared for. Staff were respectful in their interactions with people and spoke to them politely. Staff respected people’s privacy and dignity, and supported them to be as independent as possible. People were involved in decisions about their care and staff asked people’s permission before providing support.

People received personalised care that met their needs. Staff were aware of people’s communication methods and spoke clearly to aid understanding. Staff were aware of who was important to people and supported them to maintain those relationships. They provided a range of activities to protect people from the risk of social isolation. The service had reviewed their practices to ensure they were aware of people’s end of life choices and end of life care plans had been developed. A complaints process was in place. People and the relative we spoke with had not needed to make a complaint.

The management team had been reviewed and strengthened since our previous inspection to provide greater oversight and clarity over lead roles. People, their relatives and staff were regularly asked for their feedback about the service and improvements were made in response to the feedback received. The manager had processes in place to review and improve the quality of service delivery. The manager was aware of their CQC registration requirements and submitted notifications about key events as required. They had also ensured that the service’s CQC rating was clearly displayed at the service and on their website.

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 18 September 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection on 17 March 2015 the service was rated 'good' overall and for each key question. At this inspection the service remained rated ‘good’ overall.

Systems and processes remained in place to keep people safe. There were sufficient staff to meet people’s needs and safe recruitment practices were followed. Staff identified and mitigated risks to people’s safety and escalated any concerns as required, including reporting to the local authority safeguarding team when necessary. People continued to receive their medicines as prescribed and accurate records were kept in regards medicines management.

Staff had the knowledge and skills to undertake their duties and were supported to participate in regular training courses, including obtaining additional relevant qualifications. Staff adhered to the Mental Capacity Act 2005 and followed lawful practices for those that did not have the capacity to consent to aspects of their care. Staff continued to support people with their nutritional and health needs.

Caring relationships were established between people and staff. Staff respected people’s individual differences, supporting them to practice their faith and maintain relationships with relatives. Staff offered people choices and respected their decisions. People’s privacy and dignity was maintained.

People continued to have their needs met. Staff were knowledgeable about the people using the service and the level of support they required. Clear care plans were maintained and on the whole updated in line with changes in people’s needs. There continued to be a complaints process in place which ensured people’s concerns were listened to.

The provider continued to have systems in place to monitor the quality of service delivery and obtain feedback from people, relatives and staff. The provider was due to undertake their annual review of service delivery and informed us they would use learning from participation in local research projects to further enhance the quality of care. The provider was not aware of their responsibility to clearly display their CQC rating on their website, as well as at the service. At the time of our inspection the information on the service’s website did not sufficiently display their CQC performance rating. The provider informed us they would ensure this was corrected.

We found that care plans accurately reflected the support that people needed. People's relatives had been involved in compiling them, and they were reviewed regularly.

Appropriate procedures were in place to ensure that people's medication was safely administered to them.

Robust recruitment procedures were in place in order to help prevent those people who had been judged as being unsuitable to be caring for vulnerable people from doing so.

Premises were safe and well maintained and records showed that equipment and services were checked and serviced according to current guidelines

We observed detailed care plans, training records and policies and procedures. We spoke to two members of staff who said thy liked working at the home and that the manager was 'passionate about quality'. We also spoke to an NVQ assessor who was visiting the home and they also said that the staff were very competent and knowledgeable. All staff had either achieved or were working towards NVQs. The provider had put processes in place for keeping people safe and had appropriate policies for safeguarding, whistleblowing and complaints. Staff were aware of these policies and said they knew how to use them.