Mountfield House Care Home

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Improvements had been made to how the provider worked to keep people safe. People were protected from avoidable harm with staff trained to recognise the signs of abuse. Risks to people were assessed and plans put in place to reduce them. Where people needed support from other health professionals these were done. There was enough staff to meet people's needs when they needed it and there had been improvements to the building with regular checks carried out on the maintenance of the building equipment.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff understood how to support people with transitions between services. Staff could describe how they supported people with transitions between services. Staff told us they ensured people going into hospital had up to date information shared with relevant health professionals such as ambulance and ward staff. The registered manager described the support people had on admission with a focus on risk assessment and ensuring people were safe.

The provider worked well with local commissioners. Commissioners did not raise any concerns about how the provider worked in partnership with others or the continuity of care provided to people.

People had a positive experience when transitioning into the service. People told us they felt supported when they came into the service and had a positive experience. One person told us, "I have been here for a while now but it was nice when I came in the staff spent time getting to know me and finding out what I needed." Relatives spoke positively about the support people received when they transitioned into the service and described staff spending time to understand people's needs. People and their relatives told us there were prompt referrals to other agencies when people needed these.

The providers systems ensured people had referrals to other agencies as required. For example we saw people were referred to health professionals to support with meeting their health needs. There were systems in place to ensure people admitted to the service from home or other locations were supported effectively and continuity was considered.

People were comfortable with staff. We saw people interacted with staff well, when people spoke with staff they appeared to be happy and staff responded warmly.

Staff understood how to safeguard people from abuse. Staff could describe how to recognise abuse and how they would take action if needed to keep people safe. Staff told us they had received training in recognising the signs of abuse and the procedures for keeping people safe. The registered manager was aware of their responsibilities for protecting people from abuse and described the process for ensuring any concerns were reported to the appropriate body for investigation and how learning from any incidents was shared with staff.

The providers systems ensured people had referrals to other agencies as required. For example we saw people were referred to health professionals to support with meeting their health needs. There were systems in place to ensure people admitted to the service from home or other locations were supported effectively and continuity was considered.

People were supported to manage risks to their safety. People told us they were supported by staff to manage risks to their safety. One person told us, "Staff make sure I have my frame when I am walking they are very particular about that." Relatives told us staff supported people with their care and helped them to manage risks to their safety. One relative told us, "The staff are very familiar with how to keep [person's name] safe. They manage the catheter really well." Relatives told us they were alerted to any areas of change or if something goes wrong such as an accident straight away.

Staff supported people safely in line with their risk assessment and management plans. Observations showed staff understood how to support people to manage risks to their safety. For example, people were observed having support with their mobility, transfers and meals, checks confirmed this was in line with their individual risk assessments and care plans.

People were supported to manage risks to their safety. People told us they were supported by staff to manage risks to their safety. One person told us, "Staff make sure I have my frame when I am walking they are very particular about that." Relatives told us staff supported people with their care and helped them to manage risks to their safety. One relative told us, "The staff are very familiar with how to keep [person's name] safe. They manage the catheter really well." Relatives told us they were alerted to any areas of change or if something goes wrong such as an accident straight away.

Risk assessment processes in place ensured all risks were identified and assessed with regular monitoring and reviews in place. People were involved in the assessment, monitoring and review of risks to their safety with staff. For example, risks were assessed in relation to skin integrity, falls, weight loss and mobility. Risk assessments completed were personalised to the individual's needs and following incidents or reviews updates were made to the plans.

Staff understood how to support people safely. Staff could describe how risks were assessed and the actions they had to take to reduce the risks to peoples safety. One staff member told us, "[Person's name] is at risk of choking this is managed through a modified diet and the details are in the care plan for us to follow." Staff could give details on how they supported people to prevent risks to their safety for example when preventing peoples skin from breaking down. One staff member told us, " [Person's name] has to be repositioned every 2 hours to relieve pressure." Systems were in place to assess risks and develop plans to reduce them. The registered manager told us they had systems in place to assess risks to peoples safety on admission and put plans in place to minimise the risks. They described how these were updated and reviewed monthly or sooner if things changed.

The registered manager had systems in place to ensure safety checks were completed. For example, there was an up to date fire safety risk assessment in place and regular testing of the fire alarm system and equipment. Where required there were safety certificates in place. For example, the provider had up to date checks on portable electrical equipment. There were systems in place for staff to report any repairs or maintenance required. The system enabled these to be recorded when complete and checks were in place to ensure the registered manager had oversight of these and confirmed they had been completed.

Observations showed the provider had taken action to address the concerns from the last inspection. For example, the banister on the stairs and window restrictors had been updated. We saw there was a fire alarm system and firefighting equipment in place.

The provider ensured people received care in a safe environment. People were happy with the home and said it was safe, warm, comfortable and clean. One person told us, "It is a nice place, my room is lovely." People told us they had been involved in making changes to the environment. One person told us, "We all picked the new wall paper for this room." Relatives also felt the environment was homely.

Staff ensured people were supported safely. Staff told us they had access to equipment needed to support people safely. They confirmed any issues or concerns with the building were reported and these were addressed by the management team and the maintenance staff. Staff told us much had changed with the environment since the last inspection which had improved things. Staff were aware of the evacuation procedures in place in case of emergency and could describe what actions were included in people's individual emergency evacuation plans. The registered manager ensured checks were in place to maintain a safe environment, The registered manager told us about the systems in place to ensure safety checks were done on a regular basis. They described the improvements made to safety since the last inspection including updating the fire safety risk assessment, fitting window restrictors and changes to how building checks were carried out.

People were supported by enough suitably skilled staff to keep them safe. People told us they felt there were enough staff to support them safely. One person told us, "The staff are always on hand. There is always someone around to help you when you need it." Relatives also told us there were enough staff to support people. One relative told us, "There are enough staff there whenever I have visited and I have never known them have to make anyone wait for help when its needed." Relatives told us they had confidence in the support people received from staff. One relative told us, "Sometimes I am unable to visit when I contact them to see how [person's name] is I believe them when they say they are fine they really are fine and this is very important to me."

There were enough staff available to support people when they needed it. We saw people were supported to move around the home, have meals, drinks and their personal care needs met when they needed it. Staff were observed spending time with people, talking to them and supporting them to take part in social activities which people enjoyed. The atmosphere was calm and staff were not rushing people, there was time to speak with people whilst they were supported and people were seen to be relaxed and smiling.

Staff were recruited safely. The registered manager told staff completed application forms, had an interview and where successful they completed checks to ensure people were suitable to work with vulnerable people this included employment references and Disclosure and Barring checks. Systems ensured there were enough suitably skilled staff in place to support people. The registered manger told us they used a recognised staffing calculation tool, however they also used their own judgment and knowledge of people's needs to adjust staffing numbers when needed. Staff received appropriate training and support. The registered manager told us they had an induction in place for new staff and they received regular updates to their training.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.