Montrose House

Updated 31 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced comprehensive inspection on 12 April 2018 and was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also reviewed all other information sent to us from other stakeholders for example the local authority, Healthwatch and members of the public.

We spoke with eight people who used the service and two relatives. We observed the interactions between staff and people. We spoke with the registered manager, two team leaders, three care staff and two student social workers who were on placement at the service. We also received electronic feedback from five health and social care professionals and one professional who visits the service as part of planned activities.

To help us assess how people’s care needs were being met, we reviewed three people’s care records. We also looked at records relating to the management of the service, recruitment, training, and systems for monitoring the quality of the service.

Updated 31 May 2018

Montrose House is a residential care home that provides care for up to 10 people, living with long term mental health conditions such as schizophrenia and bipolar disorder. At the time of this unannounced inspection of 12 April 2018 there were nine people who used the service.

At our last inspection on 12 and 14 August 2015, we rated the service overall Good. At this inspection 12 April 2018 we found that the service had improved to an overall rating of Outstanding and met all the fundamental standards we inspected against.

The service had 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Statutory notifications received showed us that the registered manager understood their registration requirements.

Montrose House was exceptionally well led. There was visible and highly effective leadership in an open and transparent culture that resulted in an organised and well run service. The registered manager was able to demonstrate how their robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example. They were supported by a management team and care workers that were fully committed to delivering the highest standard of care to each person.

Morale was extremely high, at all levels within the service with employees describing how well supported and appreciated they were by the registered manager. All of the staff were proud of where they worked and told us they felt valued and respected. They shared positive experiences about the leadership of the service, and how they were continually motivated and encouraged to professionally develop by the registered manager.

There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result the quality of the service continued to develop. The registered manager demonstrated an open, reflective leadership style working in partnership with other stakeholders to drive continual improvement within the service and to raise awareness of the needs of people living with mental health conditions within the local community.

Feedback from health and social care professionals cited collaborative and extremely effective working relationships. Montrose House was awarded care home of the year in 2017 at the Suffolk care awards and was highly commended in the food and catering category, for providing food in an interesting way that responds to people’s individual needs. In addition the registered manager nominated by the staff at Montrose House, won the award for inspiring leaders and managers.

Care staff were highly skilled and competent to meet people’s needs. They demonstrated an enhanced understanding and knowledge of mental health and how to meet people’s needs. They were available when people needed assistance and had been recruited safely.

Care staff were exceptional at supporting people with their dietary needs. People enjoyed a positive meal time experience and were enabled to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Care staff were confident about using the mental capacity and best interest decisions made were in line with legislation and people’s wishes.

People and their relatives were complimentary about the care and support they received and the approach of the registered manager and care staff. People told us that they felt safe and well cared for. The care staff and registered manager had developed good relationships with people and knew them well. Care staff consistently protected people’s privacy and dignity and promoted their independence.

The service continued to provide a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse, accessing the community and with their medicines. Care staff and the management team fully understood their roles and responsibilities in keeping people safe.

Systems were in place to receive, record, store and administer medicines safely. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People received care that was personalised and responsive to their needs. They participated in meaningful activities and were supported to pursue their interests. The service listened to people’s experiences, concerns and complaints and took action where needed.

The environment met the needs of the people who lived there. All areas of the service were clean and in good state of repair with equipment maintained.