Mont Calm Residential Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified two breaches of the legal regulation Although people told us staff were kind and caring towards them, people received institutionalised care. People received varied outcomes around choice and control of their care. Records were at times written in an undignified way.

This service scored 35 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us staff were kind to them. People’s comments included, “They are like my friends, not my carers. The staff here are doing really well looking after me. You couldn’t get better staff” and “They are caring and respectful.” Despite this, we found people did not always receive respectful and dignified care.

Staff told us they routinely woke some people up early in the morning. One told us, “They (people) don’t know if its morning or night, so we have to communicate that.” During a discussion with the registered manager, they referred to a person, who was unable to verbally communicate due to a stroke, as having a learning disability. This was not an accurate way to describe the person and disregarded their actual needs which showed lack of understanding from staff.

Partners told us they felt staff were caring and respectful when they visited the home. However, they acknowledged that there were some institutionalised practices and routines in the home around people’s care.

We observed some undignified practices during the visit. We overheard a member of staff on the phone discussing one person’s continence needs the presence of other people. When we arrived at the home, we observed 1 person was asleep with a piece of toast resting on their chest which staff had left there. This was not dignified for the person. It was only removed once we raised this. We saw a member of staff place a cup of tea and biscuit in front of a person who was sleeping. They did not gently wake the person to let them know the tea was there. It was left for 30 minutes before the person woke up and started drinking it. Staff did not offer to get the person a fresh hot cup of tea. There were elements of caring interactions with staff and people. When personal care was being delivered, staff ensured the doors were closed. We observed a member of staff chatted with a person whilst walking around the garden with them. Another member of staff had clearly developed a good relationship with a person and they joked and laughed together.

There were people who fed back they did not feel they were treated as an individual. One told us, “I’ve all sorts of skills and interests. That doesn’t seem to be caught into the balance at all.” A relative told us, “They have loads of residents, they are overwhelmed, they can’t give [person] individual care.” Relatives told us their family members would prefer a shower, but that this facility was not available for them. People and relatives were not complimentary about the meal choices and said these did not always meet people’s preferences. There were relatives who felt activities were more geared towards the female residents. One told us, “They do the ladies hair and makeup but not a lot of activities for men, things for them to do.”

Staff did not always consider people’s strengths, abilities and unique backgrounds. Staff were unable to tell us what these were and often just referred to people based on their diagnosis. The registered manager told us all people that lived in the home had the same faith. However, they were unable to provide us any evidence that they were regularly supported to practice this, if they wanted to. Staff and the registered manager told us there were no options to have a cooked breakfast should people want this.

There were no showers in the communal bathrooms for those people that preferred a shower. Staff spent very little time sitting and talking with people, most of the care provided during our visit was task focused.

Staff did not ensure people had access to opportunities to practice their religion. There were inhouse activities that were typically geared toward female residents, including hairdressing and manicures, but there was not much on offer for male residents. Processes were not in place to enable staff to consider the holistic needs of people.

People did not always feel they had control of their lives and support to remain as independent as they could. One person told us, “They have a lot of people here that are very incapacitated, so they have a mindset of looking after people rather than what I can do for myself.” People told us they were woken up early. One said, “I get up at 5:30 now. They come and say do you want to get up. It was a bit of a shock at first. I feel very frustrated by the regime.”

Staff fed back there was a structure to the care being delivered which was not based on the support needs or choices of people. Comments included, “We start at 8.00 and they are all washed and dressed in the lounge”, “Not confident people have had choices. Some of the residents know its regimental” and “We normally follow a set routine.” This meant people were receiving institutionalised care.

When we arrived at the home at 9.30, most people were already up and dressed and the majority were sleeping in their chairs in the lounges. We observed some people’s hair looked unkempt and greasy.

Care and support was delivered to a schedule set by staff, rather than according to individual choices, wishes and needs. People’s care notes stated most people were in the lounge early in the morning before day staff came on duty at 08:00. Staff were not routinely recording what time a person woke up and there were not always preferences recorded in people’s care plans. There was reference to most people only being offered a bath once a week and recorded as ‘[person] is for bath today’ indicating this was part of a schedule as opposed to people being offered choices each day. This meant there was a culture in the home of institutionalised care.

People told us staff were always there to support them with their needs. One relative told us, “The staff are there, anybody moves, they walk with them.” Another told us, “The staff are all very friendly, the staff are caring.” However, we found people’s immediate needs were not always being met.

There was a mixture of responses from staff about whether they had time to spend with people when they were anxious. Staff told us they are able to sit and chat to people whilst others said this did not very often happen. One member of staff told us, “Staff don’t sit and chat.” The registered manager told us people’s needs often had to be anticipated to ensure they did not self-neglect. However, they acknowledged that staff should also be ensuring they were offering people choices each day around people’s preferences. They acknowledged this was not always happening.

People were at risk of social isolation. We observed 1 person was cared for in bed and had no other meaningful interaction with staff aside from staff going into their room every hour to give them a drink. Staff used undignified language when completing people’s care records. For example, people were called ‘extremely mentally disabled due to dementia’ and their end-of-life wishes were recorded in a very insensitive way. We did see a member of staff talking to a person about going out and needing a warm layer to wear. They gently suggested it was taken, but said it was up to the person. The member of staff said, “Do you mind me having a look to see what you’ve got, or would you like to come with me?” You could see the person appreciated this. When staff were assisting a person in bed to sit up, they were reassuring the person.

There were staff that told us they felt supported by the leadership team. One told us, “When we do a good job, they praise us.” However, others told us they did not always feel things changed when they raised issues. One told us, “They could listen a bit more.”

Staff were given regular breaks, but the staff room was not a comfortable space. We saw there were plans in place to refurbish one of the storage rooms into a new staff room, however this had been pushed back to next year The provider thanked staff for their work which was recorded in staff meeting notes.