We carried out a review of the data available to us about Mountview 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 Mountview, you can give feedback on this service.
Mountview is a care home providing personal care and accommodation to up to 10 people with mental health needs. The home is a detached, converted residential property with 10 single rooms and shared communal areas. At the time of our inspection there were 10 people using the service.
People’s experience of using this service and what we found
Although the provider had made improvement and supported people to maintain their independence in some areas of their daily lives, there were examples where this did not always happen.
People received personalised care that mostly reflected their needs and preferences. However, some people told us this could be improved. People were supported to maintain good health and had their nutritional needs met.
People were well cared for and the staff respected their privacy and dignity. There was a pleasant atmosphere and people told us they were happy.
People who used the service received their medicines safely and as prescribed. Safety checks were undertaken regularly, including fire safety and environment checks.
There were suitable systems in place to protect people from the risk of infection and cross contamination. The staff were aware of these and the systems had been reviewed and updated appropriately.
The provider had made improvements to ensure safe recruitment processes were implemented. These included recruitment checks, regular training and supervision. New staff were suitable and had the skills and knowledge they needed to support people.
People were protected from the risk of avoidable harm. The risks to people's safety and wellbeing had been identified, assessed or managed. The provider had appropriate systems for investigating allegations of abuse, complaints and concerns.
The provider's systems for monitoring and improving quality were operated effectively and there were systems in place to mitigate identified risks. The provider had processes for learning when things went wrong.
There was a positive culture at the service and people told us the staff treated them respectfully. This had improved since our last inspection.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 May 2021).
Why we inspected
We undertook the inspection to see if the provider had made improvements since the last inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Mountview is a care home providing personal care and accommodation to 10 people at the time of the inspection. The service can support up to 10 people and is registered to provide care to people with mental health needs. The home is a detached, converted residential property with 10 single rooms and shared communal areas.
People’s experience of using this service and what we found
Medicines were not always managed safely. We found instances where staff did not seek advice to ensure that medicines were administered in the safest way. There was an increased risk of harm to people as guidance to help manage people’s medicines was not always made available in a timely manner to staff.
People’s dignity was not always respected. We found that staff had not created a pleasant atmosphere at mealtimes for people to enjoy their meals. The actions and language by staff did not always promote people’s privacy and dignity.
People were not supported to undertake activities that were meaningful to them. Whilst people and their relatives were involved in assessing their needs and identifying their preferences, there was limited therapeutic interventions available to support people’s mental health and well-being.
The provider's infection control procedures contained protocols on how to reduce the risk of infection, but we found that the service did not always ensure that their procedures were consistently adhered to in regard to safety precautions with visitors.
We checked the provider’s systems for recruiting staff and found, whilst there were procedures in place for the recruitment of prospective employees, the provider had not always ensured safe recruitment processes were implemented.
People and their relatives told us staff met their care and support needs. We received mixed feedback from relatives, comments included, “The staff are good and dedicated”, and “The staff don’t know [person’s] name”. However, the responses from people were generally positive towards the care provided.
The provider's systems and processes for identifying and mitigating risk, and for ensuring people received a good quality service, were not always being operated effectively. Risks were regularly reviewed to reflect people’s changing care needs, but staff did not always ensure that identified risks were acted on to help promote safe care to people.
People were supported to access healthcare professionals when needed and staff understood when referrals should be made. Relative’s we spoke with told us they were kept updated with people’s progress. Risks to people were assessed and staff understood what action to take if they had witnessed or suspected abuse by reporting safeguarding concerns immediately.
People had been supported to have enough to eat and drink. People’s dietary needs and preferences were recorded in their care plans and these also contained guidance from healthcare professionals to reflect changes in people’s dietary requirements.
The provider had systems in place to support people at the end of their lives. The manager worked closely with people to ensure they were given the opportunity to express how they wish to be cared for.
The provider understood their responsibility in relation to the duty of candour. Staff found the manager to be supportive and approachable.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 22 November 2018).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified breaches of regulations in relation to person-centred care, dignity and respect, safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Mountview is a ‘care home’ for 10 people with mental health needs. When we carried out this inspection, five women and four men were living in the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The home is a detached, converted residential property with 10 single rooms and shared communal areas, bathrooms, toilets, laundry and kitchen. There was also a large garden that people told us they enjoyed.
The service had a registered manager but they were on maternity leave when we inspected. The provider notified the Care Quality Commission of the registered manager’s absence and arranged for the registered manager of another service to provide support for the home. 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 provider had a policy and procedures to protect people from abuse, staff understood these and had received training.
Staff assessed risks to people using the service and acted to mitigate any risks they identified.
There were enough staff on duty to support people and the provider carried out checks to make sure new staff were suitable to work with people using the service.
People received the medicines they needed safely and as prescribed.
The provider had policies and procedures that covered the day to day running of the service. They reviewed these regularly and made sure they referred to the latest legislation, guidance and standards.
Staff in the service completed training the provider considered mandatory.
We saw the menu reflected people’s preferences and choices were available. Food was stored safely and fresh fruit and hot and cold drinks were available.
The deputy manager and staff had a good knowledge of their responsibilities under the Mental Capacity Act 2005 and worked with people using the service, their families and health and social care professionals to make sure people could make decisions about their care and support, whenever possible.
Where it was necessary to use the Deprivation of Liberty Safeguards to make sure people were cared for safely, the provider worked with the local authority to achieve this. Although some people using the service were subject to restrictions to ensure their safety, nobody was deprived of their liberty unlawfully.
People using the service and their representatives told us the staff were kind and caring and treated them with respect and dignity.
During the inspection we saw examples of positive interactions between staff and people using the service. Staff knew the people they worked with well and could tell us about their care and support needs, life history, significant people and events.
During the inspection we saw that staff respected people’s privacy, dignity and independence.
The provider had also introduced a ‘Resident of the Day’ scheme in the service.
The provider ensured that people's care records were reviewed regularly and kept up to date. Information contained within care plans was personalised to people's individual needs.
Before people came to live at the service, staff completed a full assessment with them, their relatives and professionals involved in their care to determine if the service could meet their support needs.
People told us they enjoyed varied and meaningful activities and said they could access the local community. Staff supported people to access activities they enjoyed and provided support to individuals to develop life skills such as cooking, budgeting and accessing public transport.
People’s care records included information about their health care needs and how these were met in the service.
The provider had a policy and procedures for responding to complaints they received and we saw they had reviewed this in March 2017.
People told us they felt the service was well managed. The provider had appointed a manager who registered with the CQC in July 2017. At the time of this inspection the registered manager was on maternity leave and the deputy manager was covering the post, with support from the manager of another of the provider’s care homes and the provider.
The provider sent satisfaction surveys to people using the service, their relatives and staff in April 2018. The provider’s action plan showed the service scored highly in all the areas they surveyed, with people rating the friendliness of staff and the support they provided at 100%.
The provider had systems in place to monitor quality in the service and make improvements. A representative of the provider carried out monthly monitoring visits.
The last inspection of the service was on 9 September 2013 when we found no breaches of Regulation.
Mountview is a care home for up to ten adults with mental health needs. At the time of our inspection there were ten people living at the service with a range of different needs. The home is owned and managed by MD Homes Limited, a private organisation providing care and nursing homes in Northwest London.
There was a manager in post who has started working at the home one month before the inspection visit. They had not applied to be registered with the Care Quality Commission but told us they were in the process of making the application. 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 and associated Regulations about how the service is run.
People felt safe. Risks to their safety and wellbeing had been assessed and there were action plans in place to minimise the likelihood of harm.
People received their medicines as prescribed and in a safe way.
There were procedures to safeguard people from abuse, which were being followed.
There were enough staff to meet people’s needs and they had been suitably recruited.
People's capacity to consent had been assessed and recorded.
People were cared for by staff who were supported, trained and had the information they needed for their role and responsibilities.
People were given the support they needed with regards to their physical and mental health.
People's nutritional needs were being met.
People were treated with respect, kindness and consideration. They had positive relationships with the staff who were caring for them.
People's privacy and dignity was respected.
People's individual needs and preferences were recorded and met.
People knew how to make a complaint and felt their concerns were responded to.
The manager had been recruited shortly before the inspection. The staff found the manager supportive and approachable. The manager had ideas for improving the service which included updating records and the record keeping system.
The provider, staff and manager carried out audits and checks to make sure people were receiving a quality service.
Overall feedback was positive from the people using the service. One person told us, 'staff offer me choices', another said, 'I am happy with the support I get from staff.' We saw that the staff team supported people to make choices, whilst balancing the presenting risks to the person and/or others. The manager was aware of what to do if people needed to be assessed using the Deprivation of Liberty Safeguards assessments.
We viewed two care records and they contained information on how to support and care for the people using the service. People who use the service were assessed prior to their admission into the home. This was to ensure their needs could be met. Staff followed people's individual care plans and risk assessments which recorded people's particular needs and any potential risks. Where possible, people were involved in the development of their care plan and their views were taken into account.
The medicine systems protected people and ensured they received their prescribed medicines. One person confirmed that they knew what medicines they were taking and why.
Staff received support through one to one supervision, staff meetings and by attending on-going training.
There were various procedures in place to review and monitor the quality of the care provided in the home.
Individuals had care plans that clearly identified their needs and recorded the action staff should take to meet them. Care plans considered people's preferences, likes and dislikes and were reviewed at regular intervals to reflect any changes that took place. We observed positive interactions between staff and the people living at the home. Staff were seen including people in daily activities and engaging in board games and playing cards with people. One person we spoke with said, "we are well looked after here".
The home was clean, warm and well maintained. Health and safety audits were completed and the required health and safety certificates were in place. Fire drills were taking place at regular intervals but did not reflect what would happen in the event of a real fire as people were not evacuating the building immediately.
There were adequate numbers of staff available to meet people's needs. The home had an effective complaints management system in place.
People said they could spend time in their bedrooms or in the communal areas as and when they wanted to.
People told us they had privacy and could lock their bedroom doors and keep their personal items in a safe if they wanted to.
People reported that they 'felt safe from harm living in the home' and would discuss any concerns or complaints with staff.
Some people could go out without staff, whilst others needed support. They told us that they did various activities, such as gardening and reading, although one person said there were not always enough staff working to take them out into the community. We saw from our visit that people were sometimes limited in going out as and when they wanted to. Extra staff worked where needed, but this had to be arranged and therefore trips out were not always spontaneous.