Montague Street Care Home

Updated 15 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector.

Service and service type

Montague Street is a care 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was on long term leave and an interim manager was managing the service on a day to day basis. They were already registered with CQC to manage another service and had applied to change their registered location to Montague Street.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. The PIR was completed some time ago but still provided relevant details. This information helps support our inspections. We received feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan our inspection.

During the inspection

We spoke with five people who used the service. We spoke with seven members of staff including the manager, deputy manager, support staff, an agency staff member and the area operations manager.

We reviewed a range of records. This included three people’s care records and their medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service including policies and procedures were reviewed.

After the inspection

We spoke with three relatives via the telephone and sought additional information from the service regarding training and quality assurance records.

Updated 15 October 2019

About the service

Montague Street is two houses adjoining each other, therefore bigger than most domestic style properties, providing support to people living with a learning disability and/or autism. It was registered to support up to 12 people. 12 people were using the service at the time of inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the use of the two separate houses. Staff supporting people did not wear a uniform or any identifying clothing that suggested they were care staff when coming and going with people, and people were supported to have access to local community facilities and services.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Staff knew people well and supported people in line with the person’s preferences and wishes. Staff encouraged people to retain their independence and also embrace new opportunities. One person has recently completed a tandem skydive.

Medicines were managed and stored safely. Staffing levels enabled people’s needs to be met safely, and ensured people received consistent and reliable support. Some agency staff were being used as the service recruited but they were consistent and told us they were well supported. The management team sought to learn from any accidents or incidents involving people.

Staff were recruited safely and received appropriate training and support to enable them to carry out their role effectively. 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.

People were supported to access healthcare services if needed. People were supported to have enough to eat and drink and staff were trained to support people who had different dietary needs.

Interactions we saw between people and the staff team were positive. We saw people given immediate reassurance when they became anxious or distressed.

Support plans were person centred and people were involved in their reviews. We discussed that support plans required further work to ensure they were consistent and this was part of the service's improvement work.

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. People and their relatives told us they knew how to make a complaint.

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.

Systems to monitor the quality of the care provided were effective. The service had been through significant staff and culture change in the last year. Staff told us there was an improved atmosphere. The management team had a clear vision about the quality of care they wanted to provide. The service worked well with other community partners.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner