We carried out a review of the data available to us about Mountearl on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Mountearl, you can give feedback on this service.
Mountearl is a residential care home providing personal care to up to 9 people. The service provides support to people, with mental health conditions and a learning disability across two separate units, each of which has separate adapted facilities. The home was at full capacity at the time of our inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Right Support: The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care: The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Culture: People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to worked with staff to develop the service. Staff valued and acted upon people’s views.
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 good (published 28 February 2018.)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
Comprehensive procedures were in place upon entry to the home. Temperature checks, confirmation of vaccination status, screening forms and PPE checks were undertaken for all visitors.
People who were identified as clinically extremely vulnerable were supported to minimise close physical contact by means of social distancing or isolate when needed.
Sufficient PPE stocks were in place with regular monitoring and access to additional supplies as and when needed.
PPE control stations were available in high traffic areas.
There was signage throughout the service for people to follow in relation to PPE and social distancing.
Systems in place ensured people and staff vaccination status were regularly monitored. Regular testing was undertaken in line with government guidance.
Mountearl accommodates eight people, with mental health conditions and a learning disability, cross two separate units, each of which has separate adapted facilities. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At the last Care Quality Commission (CQC) inspection in November 2015, the overall rating for this service was Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.
The service had a registered manager in place. 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 2008 and associated Regulations about how the service is run.
The service had developed systems to protect people from identified risks. Risk management plans incorporated behavioural support plans that were regular reviewed to reflect people’s changing needs and guidance from healthcare professionals.
People continued to be protected against the risk of abuse. Staff were aware of the correct procedure in identifying, responding to; and escalating suspected abuse. Staff received training in safeguarding vulnerable adults and the provider regularly supported people to express their concerns.
People continued to receive care and support from familiar staff that had undergone pre-employment checks to assess their suitability to work. The provider ensured sufficient numbers of staff were on duty to keep people safe. Where people’s presentation and needs changed, this was reflected in the increased staffing levels.
People received their medicines as prescribed. Robust systems in place ensured medicines were managed safely. Audits of medicine were carried out four times a day, which ensured errors were identified swiftly and action taken to minimise the impact on people.
The provider ensured staff had the skills and knowledge to carry out their roles effectively. Staff were supported to access regular training to meet people’s needs. Regular supervisions and annual appraisals were carried out and enabled staff to reflect on their working practices.
The service had an embedded culture of ensuring people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service do support this practice. Staff had sufficient knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
People were treated as equals and had their differences embraced and encouraged. The service actively supported people to recognise their religious and cultural preferences as and when they wished.
The service had liaised with dieticians to ensure people were supported to access nutritious foods that met their dietary needs and requirements. People were encouraged to make healthy choices and supported to devise the weekly menus. People with specific dietary requirements were catered for.
People continued to be supported to develop their care plans, which were person centred and gave staff clear guidance on how to meet their social, health, medical and mental health needs in a responsive manner.
The service had an embedded culture that encouraged people to access activities that met their social needs. People were supported to access the community and participate in activities of their choice.
The service undertook regular audits to monitor the service performance. Audits enabled the provider to identify issues and act swiftly to minimise the impact on people. The provider consistently sought feedback on the service delivery to drive improvements.
Further information is in the detailed findings below.
This inspection took place on 20 and 27 November 2015 and was unannounced.
Mountearl is a residential home that provides accommodation and support for up to ten people with mental health conditions and learning disabilities. At the time of the inspection there were seven people using the service.
There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.
People received their medicines as prescribed and in a safe manner. Staff demonstrated good practice with medicine management. Staff received on-going training and support in medicine administration, recording, and storage.
Staff treated people with kindness and respect by sufficient numbers of staff who met their needs.
People were protected against the risk of abuse. Staff and the registered manager were able to demonstrate their knowledge of identifying abuse and the appropriate steps they would take to raise their concerns. The service had comprehensive policies and procedures relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These aim to make sure that people in care homes, hospitals, and supported living are looked after in a way that does not deprive them of their liberty and ensures that people are supported to make decisions relating to the care they receive. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and lawful manner.
People were protected against identified risks. Risk assessments were comprehensive and gave staff information and guidance on how to minimise risks and what to do when faced with behaviours that others find challenging.
The registered manager undertook necessary checks before staff worked and supported people. The service had in place comprehensive induction programme to ensure skilled and knowledgeable staff supported people. Inductions were tailored to people’s specific needs and gave staff the skills and knowledge on how to meet people’s needs. The registered manager held regular supervision, and appraisal with staff to identify their training and development needs.
The service had care plans that were person centred and reflected people’s wishes, likes and dislikes, history and aims/goals. Care plans were regularly reviewed and updated to reflect people’s changing needs and where possible people were involved in the development of their care plans.
People were given information and explanations about their care in a manner they understood and were supported to make decisions about the care and support they received.
People’s health and wellbeing was regularly assessed and people were supported to access health care facilities within the local community.
People received personalised care that met their needs.
The registered manager operated an open door policy whereby people, staff, and visitors could approach her for support and guidance. Both people who used the service and staff told us they could approach the manager at any time.
People, their relatives, staff and other health care professionals were given the opportunity to feedback on the delivery of care. This happened through meetings and quality assurance questionnaires.
Below is a summary of what we found. The summary is based on our observations during the inspection, we spoke with three out of seven people who used the service, their relatives, three staff supporting them and from looking at records.
Is the service safe?
People told us they felt safe living at the service. Staffing levels were adequate and staff were trained and competent in their roles. Appropriate checks including Disclosure Barring Service (DBS) checks and references were undertaken before people commenced employment. Staff were aware of how to respond to emergencies and there was support available 24 hours a day.
Assessments were undertaken to identify any risks to people that used the service and actions were taken to address the identified risk. Health and safety systems were checked regularly to ensure they worked properly. Medicines were administered and handled safely.
Is the service effective?
People were involved in the assessment of their care needs and in developing their support plans. Their support plans were tailored to reflect their individual needs and the outcomes they wanted to achieve. Detailed information about the person were included in their support plans to ensure staff understood the needs of the people they supported.
Is the service caring?
People were supported by attentive staff. Staff were patient, encouraging and caring. They spoke to people with respect. We saw positive interactions taking place. People commented that staff were 'kind' and 'caring'. We saw that staff were not rushed and spent time with people and engaged them in activities.
Is the service responsive?
People were offered a range of activities within and outside the service regularly. Staff understood the individual needs of the people who used the service and supported them accordingly. Care plans and risk assessments were reviewed every six months or as required to reflect changes in people's needs. Other health and social care professionals were involved where required.
Is the service well-led?
There was a range of quality assurance systems in place to check the quality of service provided. The manager consulted with people who used the service, their relatives and staff using various methods such as surveys to get their views on the service. The provider visited the home regularly to conduct audits.
Staff told us that they were clear about their roles and responsibilities. Staff had regular supervision sessions and appraisals to ensure they were adequately supported to do their jobs effectively.