Mont Calm Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We identified 1 breach of the legal regulation. Care records were not detailed around the physical and emotional care people required and lacked information on how to support people with their communication. Staff demonstrated poor understanding of how to deliver person-centred care and did not know people’s life histories, despite being allocated to them as a key worker. Whilst some people and relatives felt there was good communication, this was not consistent.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us there was a lack of person-centred activities in the home. Comments included, “Nothing to do, occasional entertainer. I get bored out of my skull”, “The only thing (family member) said she would love to go and buy a paper or getting her fish and chips. She hasn’t done that” and “We would like her to be doing more.” One person told us they had a specific interest and passion and would love the opportunity to follow this, but no action had been taken to enable the person to do what they wanted.

Most staff told us people were bored and there were not sufficient person-centred activities for them to participate in. Comments included, “They (people) don’t go out often, I think they could go out more”, “People do get bored” and “I do feel there could be more activities, we could do more.” Whilst staff knew about what family and advocates people had, they lacked knowledge of people’s life histories. They told us knowing this information would help them understand people more. The registered manager told us outings took place once a month. They told us it was often the same people going on this outings. One member of staff told us outings were limited due to the lack of drivers able to drive people.

We observed 4 people went out with staff during our visit, and they told us they had enjoyed this. However, there was a lack of person-centred meaningful activities for the people that remained at home. For large parts of the day the only activity on offer was watching television, but not all people could clearly see the TV due to the layout of the chairs in the lounge. There were no meaningful or sensory destination areas available for people who walked with purpose. Where people spent time in their rooms, there were no one to one activities arranged for them.

People’s care was not always delivered in a way that met their assessed needs. The provider failed to ensure they supported flexibility and a joined up approach during transitions in care, including when people were admitted from hospital.

The registered manager told us admissions from hospital were at times rushed. They said they did not always have the opportunity to undertake a full assessment of a person’s needs before they moved in. This meant they would not fully understand the needs and preferences of people before they took the decision to admit people.

Partners told us full assessments of people’s needs was not always undertaken by the provider before they moved from hospital to the home.

Assessments of people’s needs were undertaken before people moved into the home from their own home. However, when people were being admitted from hospital, the assessment was only undertaken over the phone with a health care professional. There was a lack of evidence the registered manager had sight of people’s health records before they moved in to assist in determining whether they could meet the person’s needs safely and effectively. This meant there was a risk that people were admitted to the service when it may not have been able to meet their needs.

Most people and relatives told us they received information in a format they understood. We saw signage around the home to help to orientate people. However, improvements were needed in how information was shared with people who had difficulty with reading and writing.

The registered manager told us people were shown pictorial food menus. They told us they used communication cards and notebooks for those that were unable to verbally communicate. However, we found staff were not always communicating with people in a way that suited the person’s needs.

Care plans reflected how staff needed to communicate with people that had specific needs. This included guidance for staff to be in front of people when speaking with them, to observe nonverbal and facial gestures and to be mindful of their space, so people could lip read. We did not see other information available in alternative formats for people.

People and relatives said they were asked for feedback and asked to complete surveys. However, relatives said they were not always aware of relatives’ meetings whether at the home or virtually. One relative told us, “If they offered it, I would welcome.” Relatives told us they were provided with a copy of the complaints procedure and policy. They said they would feel confident complaints would be taken seriously. One told us, “Generally speaking, we don’t have any problems.”

The registered manager was unable to tell us how they ensured they gained feedback from people that were not always able to verbally communicate. Although they told us meetings with relatives took place, these were very infrequent so opportunities to gain valuable feedback in order to make improvements were missed. The registered manager told us they investigated all complaints, and we saw evidence of this. For example, they acted when relatives raised that they were not aware of the complaints procedure and addressed this.

We saw a residents meeting had taken place in August 2024. However, prior to this there was no evidence meetings had taken place. According to the minutes, this was well attended by people. People were asked about the food, activity and how they felt about staff. Overall, the comments were positive, but there was mention of people wanting more external activities. This is an area we identified concerns with. Surveys were undertaken with people and relatives and in the main their comments about the service were positive.

People told us they did not always have the opportunity to go out. Relatives fed back their family members were not supported to go out due to their mobility. People’s records confirmed that people whose mobility was restricted or who lived with more advanced dementia, did not have the same opportunities as people who were more independent.

The registered manager stated in their PIR (Provider information Return sent to the CQC) staff members had received face to face training on ‘Equality and Diversity covering topics such as age, disability, gender reassignment, race, religion or belief and sexual orientation.’ However, staff told us they would wake people up in the morning based on those that were less likely communicate they did not want this. Staff told us activities outside of the home were generally limited to the same people meaning not all people had the same opportunities.

Partners fed back that people who were more dependent did not always have the same opportunities to access meaningful activities.

Staff had received ‘Equality and Diversity’ training however this was not effective in ensuring that all people had the same opportunities or that their diverse needs were understood and supported appropriately. People’s daily records confirmed the same people were taken out on activities and others were woken up each day because it was easier for staff. This meant not everyone was given the same opportunities.

We did not receive any direct feedback in relation to this. Whilst people did not raise concerns with us directly, other evidence showed the service had not always ensured people’s wellbeing and care was being reviewed and delivered to ensure that everyone had equal opportunities.

Staff and the registered manager lacked understanding of the needs of people living with dementia, so they could not fully facilitate equal opportunities for all people living in the home. This meant that people living with dementia experienced very limited, restricted opportunities. Staff could not facilitate equal opportunities for all people living in the home.

We found each person who lived at Mont Calm was not treated as an individual. Care plans lacked details of people’s protected characteristics and needs/preferences. The providers systems did not consider this aspect of people’s needs which meant that people’s experience was negatively affected.

Relatives told us they were not asked about the care they wanted for their loved ones when they were nearing the end of their lives. One told us, “They (staff) haven’t asked specifics about end-of-life planning.”

The registered manager told us they asked people about their end-of-life care. However, they also said these conversations were limited to where they wanted to be, who to contact and whether the person wanted to be resuscitated. They did say they had more meaningful conversations with 2 people. However, the records they provided did not show this.

People’s care plans included some information about who to contact when people were nearing end of life, and whether or not people were to be resuscitated. However, there was very little information on any individual preferences and wishes for the care leading up to a person’s end of life. There was little evidence of people’s decisions and what matters to them.