What life is like for people using this service:

People liked living at The Mount and had positive, trusting relationships with staff and the management team. Staff were kind and caring, treated people with respect and promoted their privacy and dignity at all times. People’s diversity was recognised and promoted by the staff and systems were in place to meet people’s communication needs.

People received highly personalised care from staff who were well trained and supported. The provider ensured there were sufficient, suitably recruited staff to meet people’s needs and promote their wellbeing. Staff knew how to protect people from the risk of abuse. Risks associated with people’s care were identified and managed safely, including receiving their prescribed medicines. People were supported to have a varied and healthy diet and to access other professionals to maintain good health.

People told us they felt involved in their care and the running of the home. Staff empowered people to have maximum choice and control of their lives and supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff worked tirelessly to ensure people had the opportunity to engage in activities that met their individual needs and enabled them to live as full life as possible. There was a strong focus on companionship and making links with others community resources to increase people’s circle of friends.

People benefitted from a service that had an open and inclusive culture. The management team led by example and monitored the quality and safety of the service to ensure it remained safe for people. Staff enjoyed working at the service and felt supported and valued by the management team.

People and their relatives felt confident any concerns and complaints they raised would be acted on. The provider listened and acted on people’s views to drive improvements at the service.

Rating at last inspection: Good (report published 3 March 2016).

About the service:

The Mount is a care home for up to 11 people who have a learning disability or autistic spectrum disorder. The service is provided in a large converted home, with outbuildings adapted to provide additional areas including an internet café, activities room and a quiet room. At the time of this inspection 10 people used the service.

The provider promotes and ensures the service meets the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall and continued to meet the characteristics of Outstanding in the Responsive domain.

Follow up:

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

We inspected this service on 19 November 2015. This was an unannounced inspection. At our previous inspection 14 January 2014 the provider was meeting all the legal requirements we inspected.

The Mount provides care for nine people with a learning disability.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage 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.

There was a strong emphasis on people’s safety when they were in the home and taking part in activities. People’s risks were identified, assessed and managed in a way that supported their independence. People were protected from unnecessary harm by staff who knew them well, understood how to recognise signs of abuse and knew how to report their concerns. Staff understood why people’s anxieties sometimes led to behaviours that challenged their safety and that of others and had plans in place to avoid incidents and manage risks.

People’s medicines were managed safely to ensure they received them as prescribed to keep them well. The provider ensured there were sufficient, suitable recruited staff available to support people with all aspects of their care and well-being.

People were provided with a varied nutritious diet and were offered plentiful fluids to maintain their health and wellbeing. People were involved in planning their meals and enjoyed taking part in creative cookery when they made food for themselves and shared with others living in the home to enjoy.

People were involved in all the decisions about their care and how they wanted to spend their time. People’s consent was gained before care was delivered. Staff understood how to support people individually with their decision making when they were unable to do this for themselves.

People were treated as individuals by kind and compassionate staff who knew them well. Staff had developed positive and respectful relationships with people. People were encouraged to be polite and respect each other. There was an emphasis on supporting people to lead full and interesting lives. Staff encouraged people to socialise together but also respected their right to privacy. People were supported to have fun and enjoy a broad range of social activities. Staff were innovative and adapted social arrangements to meet people’s needs.

People received the care they preferred because staff took the time to speak with them about their likes and dislikes. People were encouraged to discuss and review their care on a regular basis with staff to ensure it continued to meet their needs.

People and their relatives were encouraged to share their views. People knew how to raise complaints and concerns. Complaints were investigated and managed in line with the provider’s complaints procedure. People and their relatives were kept fully informed during the complaint process and when shortfalls were identified actions were taken immediately.

Staff were proud of the service and felt well supported by the registered manager and the provider. The registered manager and provider promoted strong values and demonstrated their commitment to improving people’s lives by ensuring people received individual care which met their needs. People, relatives and staff believed the service was open and transparent. Regular quality checks were completed and people were encouraged to share their views on the service.

During our inspection we spoke with four people who used the service, four members of staff and the registered manager.

People told us they were happy with their care. One person said, “It’s really, really nice here. All the staff look after me”.

We saw that staff were kind and people were supported in a caring and professional manner.

People were provided with appropriate food and drinks to meet their nutritional needs

Regular checks were made on the environment to ensure the safety of people living and working in the home.

Staff were well supported to deliver care and told us they could access appropriate training to keep them up to date with the care of people with a learning disability. A member of staff told us, “This is a nice place to work”.

There was a complaints policy in place and people told us they would tell staff if they were unhappy about their care.

We carried out this visit to check on the care and welfare of people using this service. The visit was unannounced which meant the provider and the staff did not know we were coming. We carried out this visit as part of our schedule of planned inspections.

Six people were living in the home when we visited. We spoke everybody living in the home and three people told us about their experience of living there. Where people were unable to tell us about their experiences due to their learning disability, we spent time observing the support they received from staff. We also spoke with three members of staff and the registered manager.

People's privacy and dignity were respected. We saw staff knocking on people's doors and waiting for an answer before entering. People told us they could spend time alone in their bedroom when they wanted to.

People received care and support that met their individual needs. People had care records which had been written in a style that people understood, and people told us they had decided how they wanted to be supported. The plans included pictures and photographs to support understanding. People told us, “The staff helped me put it together and it tells everyone what I like and what I want.”

Staff supported people to go out and do the things they enjoyed. People told us, “We can go where we want to go. We tell the staff and they help us to arrange it.” And “We choose where we want to go and who with.”

We saw that people using the service were encouraged to be independent and they told us they were responsible for looking after and tidying their rooms. People told us they helped with cooking, and making drinks, and we saw people baking during our visit.

People told us they felt safe living at the home and would talk to staff, family or advocate if they had any concerns. We saw that the people living there and their relatives were asked for their views about the home. People told us that they knew how to complain if they were unhappy but had not needed to do this.

People had a plan of care, which had been completed with each person and people could choose how things were written; the plans included pictures and photographs to support their understanding. The plans were reviewed with people and any changes were recorded. Where people needed health support, this was discussed and people told us they could decide what treatment they wanted to receive.

The routines and daily activities were flexible and staff responded to people’s needs. The staffing was provided to ensure people were able to carry out planned activities and people were able to be involved in all activities during the day and could choose how to spend their time. People told us they enjoyed going out for meals, playing pool, going bowling, learning at college and completing volunteer work.

The home supported people to develop skills needed to live independently and people told us they were happy and they had opportunities to learn new skills and become more independent.

People told us they knew how to keep safe and would talk to the staff, their social worker or an advocate if they had any worries. People were positive that they would be supported to raise any concern and these would be addressed.

People said they were involved in making decisions about their care and their views were taken into account. There were regular meetings about how the home was managed and people could comment on things they liked or things they wanted to change.