High Mount

Updated 4 July 2023

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

High Mount 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. High Mount is a care home without 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 was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 reviewed information received by CQC about the service since the last inspection. We requested and reviewed information from the Local Authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people living at High Mount, observed care and support being given in the communal areas of the home and spoke with 2 relatives.

We spoke with 5 members of staff, which included the Registered Manager and Deputy Manager.

We reviewed a wide range of records, such as care plans, medication administration records, staff records, quality assurance documents and policies and procedures.

After the inspection we received further information from the provider regarding the governance of the service and continued to liaise with the Local Authority.

Updated 4 July 2023

High Mount is a residential care home that provides accommodation and personal care to a maximum of 8 people. The service provides support to people living with a learning disability. At the time of our inspection there were 8 people living at High Mount.

High Mount comprises of 2 single storey buildings that are situated in a cul-de-sac close to community amenities. Each building has 4 bedrooms, shared accessible bathrooms, communal living spaces and a shared garden.

We expect health and social care providers to guarantee people with a learning disability and autistic people, respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right Support, Right Care, Right Culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: People were not always safe at High Mount. This was because the provider did not always ensure that risks were assessed, monitored, and managed to minimise the likelihood of harm.

People’s hydration and nutritional needs were not always met which put people at increased risk of poor health outcomes. People’s care plans were not always updated to reflect changes in need which meant care given did not always meet current needs.

Right Care: Health professionals’ directions were not always followed which resulted in people not accessing health care services and not always receiving the care they needed to promote well-being. This meant people were exposed to continued risk of harm.

People were not always supported by enough staff, this meant care was not always person centred to maximise people’s choice and control.

Environmental and equipment risks were not always identified and where they were, the provider failed to always act effectively to safeguard.

Right Culture: The provider failed to ensure the governance systems in place were always effective in delivering high quality care and support. Systems did not always identify or monitor effectively, to ensure risks were mitigated against, and, where increased concerns were identified through audit processes, no effective actions were taken to make the changes needed.

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 requires improvement (published March 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when, to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

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

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating has changed to Inadequate based on the findings of this inspection.

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 effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this report.

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

Enforcement

We have identified breaches in relation to safe care and treatment and governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

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 of 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.