CQC report explained · a residential care home
What the CQC found at Montague Road Care Home
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, suitable risk assessments and safer checks of equipment. Medicines were administered and stored safely, and incidents were used to reduce future risks.
- Effective?
- Good
- People had detailed assessments and care plans. Staff had relevant training, people received support with nutrition and healthcare, and the home followed the Mental Capacity Act principles.
- Caring?
- Good
- People had positive relationships with staff and were treated with kindness, dignity and respect. Staff involved people and their representatives in planning and reviewing care.
- Responsive?
- Outstanding
- Care was highly personalised and adapted to people's communication, anxiety, interests and wishes. People were supported with meaningful activities, community trips, relationships and end-of-life decisions.
- Well-led?
- Outstanding
- Inspectors found visible and knowledgeable leadership, strong staff involvement and robust quality checks. The home used feedback, research and learning from incidents to improve care.
What inspectors found, July 2019
Montague Road Care Home was rated Outstanding overall; inspectors found highly personalised care and exceptional responsiveness and leadership.
The inspection was unannounced and took place on 2 July 2019. One inspector spoke with people living in the home, a relative, staff and health and social care professionals. They also observed care and reviewed care plans, medicine records, staff files and management records.
The home provided care for 24 people living with dementia and/or mental health needs. Inspectors rated it Good for safe, effective and caring services. They found enough staff, safe recruitment, suitable training, clean surroundings, good support with food and healthcare, and respectful relationships.
The home was rated Outstanding for responsive care and leadership. Inspectors found care was tailored closely to people's wishes, including activities, community trips, communication and end-of-life choices. They also found strong involvement from people and staff, robust checks on quality and a clear focus on improvement.
The overall rating was Outstanding. This was an improvement from the previous Good rating, published in January 2017. Safe care improved from Requires Improvement to Good, while Effective and Caring remained Good and Responsive and Well-led improved to Outstanding.
Personalised support
Care plans gave staff detailed guidance about each person's needs, including how to recognise and reduce anxiety or distress. Inspectors saw examples of staff helping people achieve personal goals.
“People received high quality care which was extremely responsive, and tailor made to their needs.” from the report
Meaningful activities
People were supported to take part in activities that matched their interests and reduced isolation. This included community trips, animals, sensory activities, music and plans based on personal wishes.
“There were numerous examples of innovative one to one support provided to people which had extremely positive outcomes which met their hopes and aspirations.” from the report
End-of-life care
People were supported to make decisions about the end of their lives, including where they wanted to die and the care they did or did not want.
“The registered manager shared examples of the extremely compassionate ways people had been supported to make end of life decisions and these happened in line with their choices.” from the report
Strong leadership
The home had an open culture where people and staff were consulted. Management systems identified shortfalls, tracked action and supported continuing improvement.
“There were robust quality assurance systems which demonstrated that the provider and registered manager were able to independently identify shortfalls and take swift action to address them.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you adapt care if my relative became anxious or distressed, and how would staff record what works?
- 02How do you make sure there are enough staff if a person's support needs increase or they want to go out?
- 03How would my relative be involved in choosing activities, meals and trips into the community?
- 04How would you discuss and record my relative's wishes about end-of-life care?
- 05What improvements have been made since the previous inspection, particularly around safety and the new flooring?
This was an unannounced comprehensive inspection covering all five key questions; the previous inspection had rated the service Good overall. This explanation was written from the published report of 24 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2017
Montague Road Care Home was rated Good overall, but Safe required improvement because some equipment and pressure mattress checks were not reliable.
Inspectors visited without warning on 14 December 2016. They observed care, spoke with people, relatives, staff and managers, and reviewed care records, medicines records, training records and quality checks.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. People were described as safe, well cared for and treated with kindness, and there were enough trained staff.
Safe was rated Requires Improvement. Inspectors found that some clinical equipment was not checked regularly, some creams were not labelled properly, and pressure-relieving mattresses were not always set to the correct weight. The home did not have a registered manager at the time, although an application had been submitted.
Kind and respectful care
Inspectors saw staff speaking warmly with people, respecting privacy and encouraging independence. Relatives and people were positive about the staff team.
“People were treated with warmth, kindness and respect.” from the report
Safe medicines support
Medicines records and stock checks were correct in the samples reviewed. Staff administering medicines were trained and asked for consent.
“People's medicines were managed safely by staff that had been trained in the safe administration of medicines.” from the report
Enough skilled staff
Inspectors found enough suitably experienced, skilled and qualified staff to meet people's needs. Recruitment checks were also in place.
“There was enough suitably experienced, skilled and qualified staff available at all times to meet people's needs safely and effectively in a calm and patient way.” from the report
Personalised activities
People could take part in group and individual activities, including outings into the community. Activities were linked to people's interests and needs.
“Opportunities were made available for people to take part in meaningful activities and social interests relevant to their individual needs and requirements, both at the home and in the community.” from the report
Clinical equipment checks
seriousSeveral items of clinical equipment were not checked regularly to make sure they were clean, working and ready for use in an emergency.
“clinical equipment such as the suction machine, syringe driver, sphygmomanometer (blood pressure monitor) and glucometers were not regularly checked.” from the report
Pressure mattress settings
seriousSome pressure-relieving mattresses were not set to the person's recorded weight. Inspectors said this could increase the risk of pressure ulcers.
“Pressure relieving mattresses had not always been accurately set for the person's weight.” from the report
Cream labels
needs fixingSome opened creams and pumps did not show the person's name or opening and expiry dates. This increased the risk of cross infection.
“Creams and pumps that had been opened did not all have the opening and expiry dates added or the person's name.” from the report
- 01What system is now used to check the suction machine, syringe driver, blood pressure monitor and glucometers, and how often are these checks recorded?
- 02How do staff confirm that each pressure-relieving mattress is set to the person's current weight?
- 03How are opened creams and pumps labelled with the person's name and opening and expiry dates?
- 04Has the manager's application to register with CQC been completed, and who is legally responsible for managing the home now?
- 05How do you review accidents, falls and pressure care to make sure lessons are acted on?
This was an unannounced inspection of the overall service and all five CQC questions, including observations, discussions and reviews of care, medicines, staff and quality records. This explanation was written from the published report of 24 January 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Montague Road Care Home
2 rated inspections over 2 years: the service has improved, from Good to Outstanding.
- July 2019Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- January 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Registered with the Care Quality Commission on 3 July 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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