The focus of our inspection was to answer five key questions. Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records and documents we reviewed.

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

This is a summary of what we found:

Is the service safe?

People who used the service told us that they felt safe and did not have any concerns. The provider had a safeguarding policy and the staff we spoke with understood their responsibility to report any signs of abuse or suspected abuse.

The manager and deputy manager had been trained and understood their obligation to apply the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). This is a legal framework designed to protect the best interests of people who are unable to make their own decisions. No person living in Mountfield had been assessed as needing this safeguard in place.

We saw evidence that staff had been provided with training in relation to mental capacity and safeguarding vulnerable adults. This meant that staff had been provided with the information they needed to help ensure people were safeguarded.

Medicines were stored correctly in locked cupboards and refrigerators as necessary. People’s Medical Administration Records (MARs) contained all of the required information with no gaps in the records. The staff who administered the medicines had received the appropriate training and there was an effective procedure in place in case a medicine error occurred.

Systems were in place to help ensure staff learnt from incidents and accidents. We saw evidence that a full investigation was undertaken on each event along with actions to reduce the risk of a repeat occurrence.

All of the staff were up to date with their mandatory training. The service’s training schedule highlighted when people’s refresher training was due.

There were effective procedures in place to manage and mitigate foreseeable emergencies. During our inspection we observed the management of a person who had become unresponsive. We were assured that the management was appropriate and protected the welfare of the person concerned.

We saw evidence that the provider’s audit schedule was effective. This included regular auditing of the quality of the service, staffing and health and safety.

Is the service effective?

We saw evidence that the care and support people received reflected their needs. Care and support was evidence-based and included nationally recognised screening tools. Plans of care and risk assessments were regularly reviewed and updated in order to reflect any changes in people’s needs.

People who used the service were able to access suitable nutrition and hydration including special diets during meal times. All of the people we spoke with told us that the food was ‘excellent’ and they were supported to eat and drink appropriately. We observed that nutritional and fluid intake was monitored where appropriate.

We saw evidence that the provider had systems in place to help ensure competent staff. These included ensuring that all staff received a meaningful annual appraisal and were able to access training and education appropriate to their roles and responsibilities. We noted that all staff had received training in relation to dementia care. It was evident that this training was effective during our observation of staff caring for and supporting the people who used the service.

Is the service caring?

All of the people we spoke with who used the service and their relatives were satisfied with the care and compassion they received. One person said, “All the staff are lovely and look after me well." One relative said, “There are enough staff on duty to care for people. I feel the staff have the appropriate skills to care for people and I have never had any problems."

We observed staff caring for people in a caring, respectful and dignified manner. It was evident that staff understood the needs of the people who used the service and encouraged them to be involved in making decisions about their care and support.

People’s care plans were person-centred and had been written with the person or their relatives as appropriate.

Is the service responsive?

We saw evidence that the care and support given to people responded to their individual needs. This included evidence that people’s emotional needs were being met. There was detailed documentation in people’s care plans regarding their interests, preferences and situations that could cause distress. We observed staff interacting with people in a positive manner and noted that the support given met their emotional needs. There was a ‘reminiscing’ room that contained activities and items that were suitable and engaging for people with dementia.

The environment of Mountfield was designed to help meet the needs of people living with dementia. This included extensive, secure gardens along with numerous communal areas that allowed people to choose where they wished to sit during the day. One area was considered the ‘quiet lounge’ for people to relax or read. Other communal areas had chairs arranged in groups to encourage socialising.

There was information available to people who used their service and their relatives that explained how to make a complaint. The manager explained the complaints’ procedure to us and we saw evidence that the provider took account of complaints and comments to improve the service.

Is the service well-led?

All of the relatives, staff and visiting general practitioner (GP) spoke positively about the registered manager. The GP said, “I have no concerns about this home. Everyone is safe and you don’t hear people shouting out in distress. The staff and the manager are excellent and people are well cared for."

It was evident during our inspection that both the manager and deputy manager were knowledgeable about each person who used the service. We observed positive interaction between the managers and the staff, and between the mangers and the people living in Mountfield.

We observed a positive culture within the service, and the staff we spoke with told us how much they enjoyed working at Mountfield. One staff member said, “I am very happy working in the home and feel very well supported." It was evident that there was effective team working and that there was a balanced culture of reasonable blame and accountability.

The manager told us that they were supported to try new ways of working to improve the effectiveness and efficiency of the service. This included the design and implementation of the medication rooms. These were air conditioned to maintain the correct temperature at which medicines should be stored, and there were individual cupboards for people’s medicines to ensure the safe administration of medicines at the correct time, as prescribed.

The service had quality assurance systems in place to assess and monitor the quality of the service people received. We noted that there were action plans in place to address any identified shortfalls in the standard and quality of service provision.

Staff regularly sought the consent of people when they were delivering care. They gave people time to think about their decisions and encouraged participation in developing care plans. One person told us, "We're always respected."

Staff gave support to people in ways which encouraged their independence. We saw care plans which were individualised and included people's life histories. We saw people engaging with staff and each other. People told us that they were happy living in Mountfield and family members said that they were pleased with the care. This showed us that care was personalised and that people received care that helped them to be active and to enjoy their time.

The provider had up to date policies in place to minimise the risk of abuse. Staff received regular training on safeguarding and understood what they should do if they witnessed a possible safeguarding incident.

On the day of our inspection the home was staffed with sufficient, appropriately skilled staff. We saw that every new staff member was given an induction programme. We also noted that staff were regularly assessed on their skills, for example in giving medications.

The provider's complaints policy was current and clearly laid out the steps people needed to take should they wish to make a complaint. Family members we spoke with told us that they felt confident that they could raise concerns directly with the manager if necessary. One person told us "We've nothing to complain about."

People spoken with reported that they felt respected and involved by staff. They stated that they were satisfied with the care and kindness provided by staff. They confirmed that they felt able to approach staff if they had any concerns and were confident that these would be addressed appropriately.

We also spoke to relatives of people who were using this service and they confirmed that they were consulted with about the care that their relative were receiving and felt able to talk to senior staff if they had any concerns