Mountdale Nursing Home provides accommodation, personal care and nursing for up to 22 people some of whom may be living with dementia. At the time of our inspection 21 people were living at the service.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, district nurse, tissue viability nurse and palliative care nurse. The environment was appropriately designed and adapted to meet people’s needs.

Staff were well trained and attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them at the service. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to. People were provided with the appropriate care and support at the end of their life.

The registered manager had a number of ways of gathering people’s views, they held regular meetings with people and their relatives and used questionnaires to gain feedback. The registered manager carried out quality monitoring to help ensure the service was running effectively and to make continual improvements.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Many of the people we met during our inspection could not, because of their complex needs, tell us verbally about their experiences and so we used observation to help us understand their experience of the service. We also looked at care records and gained feedback from staff about people's care and support needs. We talked with some people who used service and with visiting family members. Below is a summary of what we found.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had detailed policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This was to ensure that people who could not make decisions themselves were protected. Relevant staff had been trained to understand when a DoLS application should be made, and how to submit one. This meant that people were safeguarded as required.

Staff we spoke with said they had been properly recruited and trained. Staff told us that they received good support in their roles.

Is the service effective?

There was an advocacy service available if people needed it. This meant that, when required, people had access to additional support to help them make decisions.

People’s health and care needs were assessed and they were involved in their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A relative said, “We are very pleased that our relative is living in this home, the staff are kind and good at keeping us informed about our relative”. Other comments we received from relatives were, “The staff are approachable and listen to our views, they are also caring and thoughtful”.

The responses and views of people who used the service, their relatives and professionals involved with the service provision, were recorded at the annual quality monitoring review. Any shortfalls or concerns raised were addressed.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided by staff in accordance with people’s wishes.

Is the service responsive?

People had the opportunity to enjoy a range of activities and, with staff support, were able to get out and about in the local community.

A person who used the service we spoke with told us, “There are things for us to do each day, staff talk to me about what I want to do and if I decide not to get involved in the activities, that’s fine”. “The staff are good to me, I tell them if I’m not happy about something and they try to sort it out for me”.

Is the service well-led?

The service worked well with other agencies and services to ensure all aspects of people's needs were being met.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the aims of the home and of the standards of care and support that was expected of them.

Regular service monitoring processes were in place. This helped to ensure that people received a good quality service at all times.

A relative we spoke with told us, “I am glad that my relative is in this home, the staff are attentive to my relative’s needs and the managers and staff are good at keeping me updated about my relatives wellbeing”.

The inspection took place on the 14 and 15 December 2015 and was unannounced.

Mountdale Nursing Home provides care and accommodation for 22 adults who may have complex nursing needs. It also provides a service for people who may need care due to living with some form of dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

People’s medication was well managed and people receive their medication as prescribed.

Meetings had been held for the people living at the service and for the staff. People felt listened to and that their views and opinions had been sought and the service had made appropriate improvements.

Staff had been offered training to help ensure they had the skills and knowledge required for their role as a care worker.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people. People were kept safe and risk assessments had been completed to show how people were supported with every day risks. Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. There were sufficient numbers of staff on duty.

People were supported to be able to eat and drink sufficient amounts to meet their needs. They told us that the food was good and said that they were able to choose alternatives if they were not happy with the choices offered on the menus. People were supported to maintain good healthcare. People had access to a range of healthcare providers such as their GP, dentists, chiropodists and opticians. The service kept clear records about all healthcare visits.

People had agreed to their care and had been asked how they would like this to be provided. They were treated with dignity and respect and staff provided care in a kind, caring and sensitive manner. Detailed assessments had been carried out and care plans were developed around the individual’s needs and preferences.

The service had a clear complaints procedure in place which was clearly displayed. This provided information on the process and the timespan for response.