CQC report explained · a residential care home
What the CQC found at Montague Street Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found suitable staffing, safe recruitment, safe medicines management, clean surroundings and risk assessments tailored to people.
- Effective?
- Good
- Staff were trained and supported, people received help with healthcare, food and communication, and the service worked with other agencies. Inspectors noted that some legal authorisations and staff supervision needed follow-up.
- Caring?
- Good
- Staff treated people with warmth, kindness, dignity and respect. People were involved in decisions and supported to maintain independence.
- Responsive?
- Good
- Support was based on people's needs and preferences. People were supported with activities, holidays, community access and communication, although some support plans lacked detail or had not transferred consistently.
- Well-led?
- Good
- Inspectors found effective quality checks, an approachable management team and a welcoming atmosphere. The service had made positive changes after earlier management concerns.
What inspectors found, October 2019
Rated Good; inspectors found safe, kind and person-centred care, with some records and legal authorisation checks still needing improvement.
The inspection was unannounced and took place on 17 September 2019. One inspector spoke with five people, seven staff members and three relatives. They also checked care, medicine and staff records, and quality monitoring documents.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, kind interactions, support for health and community activities, and effective management systems.
There were areas being improved. Some Deprivation of Liberty Safeguards applications were not clearly authorised, some support plans had not transferred properly to a new system, and staff supervision was slightly behind. The previous overall rating was also Good, published in March 2017.
Safe medicines
Medicines were received, stored, given and disposed of safely. Staff medicine checks were carried out regularly.
“Medicines were safely received, stored, administered and destroyed.” from the report
Kind and respectful support
Staff knew people well, responded when they were anxious and respected their individuality, privacy and dignity.
“Staff treated people with warmth, compassion and kindness.” from the report
Choice and independence
People were supported to make choices, keep their independence and take part in activities and trips in the community.
“People were supported to engage in activities they enjoyed and we saw the service promoted people accessing local community facilities and supporting them to go on trips and holidays.” from the report
Improved management
Inspectors found that management and staff culture had improved during the previous year, with quality checks in place.
“The management team and staff we spoke with said that significant positive improvements had already been made.” from the report
Unclear legal authorisations
seriousIt was not clear whether some applications to restrict people's liberty had been authorised. The manager had identified this as a priority and had an action plan.
“It was not clear whether some peoples DoLS applications had been authorised.” from the report
Incomplete support plans
needs fixingSome care plans had not transferred consistently to the new electronic system. Some also lacked detail about people's goals and outcomes.
“Plans had not consistently migrated from the old system and some plans lacked detail around goals and outcomes.” from the report
Staff supervision slightly behind
minorThe programme for supervising staff had fallen slightly behind after management changes. A plan and regular meetings were in place to address this.
“The supervision programme was slightly behind after management changes during this year but a plan was in place” from the report
Larger than current guidance
minorThe service supported 12 people across two adjoining houses. Inspectors said its size was larger than current best practice guidance, although the separate houses reduced the impact on people.
“This is larger than current best practice guidance.” from the report
- 01Have all outstanding Deprivation of Liberty Safeguards applications now been authorised, and how are these checked?
- 02Have all support plans been transferred to the electronic system, with clear goals and outcomes?
- 03Is staff supervision now up to date, and how often is it reviewed?
- 04How will the two-house layout support people's independence and avoid the risks linked to the service being larger than current best practice guidance?
- 05How much agency staff is currently being used, and will the same staff continue to support people?
This was an unannounced planned inspection covering all five CQC questions, the care provided and the premises; the previous overall rating was Good. This explanation was written from the published report of 15 October 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, March 2017
Rated Good; inspectors found safe, kind and personalised care, but protective equipment and night staffing needed attention.
This was an unannounced inspection on 19 and 20 January 2017. One inspector spoke with people living at the home, care staff and a visiting health professional. They also observed care and checked care records, medicines records, audits and recruitment files.
The inspectors found that people were safe and received their medicines as prescribed. Staff understood people's needs, supported their choices and treated them with dignity. People had suitable food and drink, access to health professionals, activities and family relationships.
The home had a registered manager and inspectors found an open culture, regular checks and systems for acting on concerns. They also identified that protective equipment was not always easy for staff to reach, night staffing was a concern for staff, and the latest satisfaction survey had not yet been sent.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. This means the inspectors found the service met the required standards in the areas they examined at that inspection.
Safe care and medicines
Risks were assessed and reviewed, staff understood safeguarding, and medicines were checked through audits and competency assessments.
“People received their prescribed medicines when required and these were stored and administered safely.” from the report
Skilled and supported staff
Staff received training, induction and regular supervision. Inspectors found training helped staff meet people's particular needs.
“People were cared for by staff who received support and training to help them meet their needs.” from the report
Respectful, individual care
Staff knew people's likes, dislikes and histories. People were supported to make choices and remain as independent as possible.
“People were treated with dignity and respect and their privacy was protected.” from the report
Activities and community life
People took part in crafts, movie nights, trips, holidays, shopping and community activities. Their own activity wishes were considered.
“All staff encouraged people to take part in activities as well as supporting them to access the local community, have trips out and take holidays” from the report
Open management
People, relatives and staff were encouraged to give feedback. The management team used audits and meetings to identify and act on issues.
“There was an open and transparent culture at Montague Street Care Home and people felt able to have their say on the running and development of the service.” from the report
Protective equipment was not always accessible
seriousGloves and arm protectors needed for one person's support were not kept where staff could always reach them. The manager said this would be corrected.
“However we saw that the gloves and arm protectors were not stored in a location that was accessible to staff at all times, which could expose them to risk of harm.” from the report
Night staffing
needs fixingStaff said night staffing was not always enough because there was one waking member of staff and one sleeping member who was only called in an emergency. The provider planned to change this to two waking staff.
“Staff told us they felt staffing levels were not always adequate on night shifts.” from the report
Feedback was not fully up to date
minorThe annual satisfaction survey had not been sent when inspectors visited, so the available feedback was more than a year old. A new survey was provided after the inspection.
“At the time of our inspection the satisfaction survey for this year had not been sent out so analysis of feedback was over 12 months old.” from the report
- 01Has the planned change to two waking staff on night duty been made, and what staffing is provided overnight now?
- 02Where are gloves and arm protectors stored, and how do you make sure staff can reach them at all times?
- 03How are people's current views and relatives' views collected since the satisfaction survey was updated?
- 04How are care plans and risk assessments reviewed when someone's needs or behaviour changes?
- 05What activities and community trips are available for the person we are considering placing here?
This was an unannounced comprehensive inspection covering all five questions, based on observations, discussions and checks of care, medicines, staffing and management records. This explanation was written from the published report of 23 March 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 Street Care Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 2 March 2011.
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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