This unannounced inspection took place on 13 and 14 September 2016. Mount Pleasant is a care home, registered to provide accommodation for up to 14 people needing personal care. People living at the home are older people, most of whom are living with dementia.
The home was spread across two floors. Some bedrooms were located on the ground floor but the majority were situated on the upper floor and accessed via stairs with a stair lift. The home had two double bedrooms. There were communal areas including a dining room and two lounge areas where people could sit. People had access to two pleasant outside decked areas with comfortable furniture in which to relax.
The home had a registered manager that was also the registered provider. 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 and associated Regulations about how the service is run.
We last inspected Mount Pleasant in August 2015. At that inspection we found the home was in breach of its legal requirements with regard to following recruitment processes and ensuring that people received the foods and fluid they needed. During this inspection in September 2016, we found the necessary improvements had been made.
Due to their health conditions and complex needs not all people were able to share their views about the service they received. Those that could speak with us told us care was provided with kindness and we observed that people's privacy and dignity was respected. People enjoyed living at Mount Pleasant and they considered it their home. People received care that enabled them to live their lives as they wished and people were supported to remain as independent as possible. Staff knew the people they were supporting well. Relatives we spoke with described the staff as very good and caring.
The home had a robust recruitment process in place. Appropriate checks were carried out before staff began working at the home to ensure they were fit to work with vulnerable adults. Staff had received appropriate induction, supervision, appraisal and training, which allowed them to fulfil their roles effectively and develop trusting relationships. Staff understood their roles and responsibilities and would seek people's consent before they provided any care or support. There were sufficient numbers of staff to support people safely and staffing levels were adjusted to meet people's changing needs and wishes.
People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were systems in place to protect people from abuse. There was an up to date safeguarding policy in place for staff to access with contact details for the local safeguarding adults team.
Staff respected people's rights to make their own decisions and choices about their care and treatment. People's permission was sought by staff before they helped them with anything. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well. Where people may need restrictions on their liberty and freedom in order to keep them safe applications had been made to the local authority to make sure people were not unlawfully restricted.
Staff were knowledgeable about people's needs and how to meet those needs and care records were detailed and accurately reflected the care people received. The care records showed the personalised care people required to help staff consistently meet people's needs and we saw staff followed these.
We saw care plan documentation contained risks assessments which covered areas such as pressure area care, moving and handling, nutrition and falls/mobility. Each risk assessment had a corresponding 'risk plan' which detailed control measures that were in place to minimise the risk.
Medicines were managed safely and in line with current regulations and guidance. Staff had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered and audited appropriately.
Staff were caring and respectful towards people with consideration for people's interests and life histories when chatting with people. People's right to private space and time to be alone with their relatives and friends was accepted and respected.
People were supported to have interesting and fun things to do. The home ensured staff practices promoted quality of life for all people by offering social opportunities on a daily basis.
People had access to healthcare services and received on-going healthcare support, for example, through their GP, hospital doctors and specialists. Referrals were made to other professionals such as community nurses and dieticians if the need arose.
People's nutritional needs had been assessed and people were supported to eat and drink as and when required. The menus provided a choice of meals and people were able to choose a meal that was different to the menu choices.
Quality assurance systems were in place to assess and monitor the service people received. Families were consulted so that their views could be gained. A survey of people's views was carried out in March 2016 and showed people were very happy with the care delivery at the home. People told us they could raise concerns or complaints if they needed to because the registered manager and staff were always available and approachable and people were confident they would be listened to.