This inspection was carried out on the 1 and 2 August 2018 and was unannounced on the first day and announced on the second day.Mount Pleasant nursing home is set in its own grounds and is located in the rural community of Allostock, Knutsford. The home supports 40 older people who require personal and nursing care in the main building. Since our last inspection the registered provider has built a ten-bedded annexe for people living with dementia called Scowcroft. At the time of our inspection there were 10 people living in Scowcroft and 38 people living in the main building.
The home has a registered manager. 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 a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good. The service is rated Good as it met all the requirements of the fundamental standards.
People, relatives, staff and healthcare professionals spoke positively about the staff and management team. They described feeling safe living at the home and being supported by kind and caring staff.
Recruitment systems at the home were safe. All staff had completed an induction as well as mandatory training in accordance with best practice guidelines. Staff were supported by the management team through supervision and appraisal. Staff told us that they felt well supported.
Safeguarding policies and procedures were in place and staff were familiar with these. Staff had received training and were able to describe what abuse may look like and felt confident to raise any concerns and thought these would be listened to.
People had their needs assessed before they moved into the home and this information was used to create individual care plans that included clear guidance for staff to meet people's needs. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process.
Staff had developed good relationships with people who lived at the home. People told us their privacy was respected and their independence was promoted. We observed positive interactions between staff and people living at the home throughout our inspection.
Medicines were ordered, stored, administered and disposed of in accordance with best practice guidelines. The registered provider had medicines policies and procedures in place. Medicines records were accurately completed.
People's food and drinks needs were met and clear guidance was in place for staff to follow to meet people's specific dietary needs.
People living at the home had opportunities to engage in activities of their choice and the management team had developed relationships with organisations within the local community.
The home had dementia-friendly adaptations in place to stimulate the environments of people living with dementia. The home was clean and had all required health and safety checks and documentation in place. Equipment was regularly serviced and individual emergency evacuation plans are in place the people.
Audit systems were in place and were consistently completed. Where areas for development and improvement had been identified, action plans were created and completed. Accidents and incidents were analysed to identify trends and patterns within the home.
The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we found. We saw that the registered provider had guidance available for staff in relation to the MCA. Staff had undertaken training and demonstrated a basic understanding of this. The registered provider had made appropriate applications for the Deprivation of Liberty Safeguards (DoLS). Care records reviewed included mental capacity assessments and best interest meetings.
The registered provider had a clear complaints policy that people and their relatives knew how to access and they felt confident to raise any concerns they had.
Policies and procedures were available for staff to offer them guidance within their role and employment. These were regularly reviewed and updated.