The Mount Care Home is a residential care home providing care and accommodation with nursing for up to 37 people. At the time of the inspection there were 34 people living at the service.

There was a registered manager in the home. 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.

At the last inspection the service was rated Good in all five domains. At this inspection we found the service had strengthened their practice in Responsive and is therefore now rated outstanding in this areas. Safe, Effective, Caring and Well-led domains remain rated as Good. The service is rated Good overall.

This was a comprehensive inspection carried out on 6 and 7 September 2017. It was unannounced on the first day and announced on the second.

People were safe at The Mount Care Home. They were protected from harm and abuse by staff who had been trained and had knowledge of how to safeguard people. Staff understood their responsibilities to report and act on issues if they arose. Individual risks and those related to the environment were assessed, managed and reviewed to keep people safe. There were sufficient staff who had been recruited using effective procedures to ensure their suitability. Medicines were managed and administered safely. Routine health and safety checks were completed in accordance with legislation and guidance.

People received effective support. Staff were trained in areas relevant to their job role and their skills were assessed and monitored. They were supported by the management to develop and gain appropriate qualifications with an emphasis on improving the service for people. Staff told us the opportunities to enhance their skills had created a sense of commitment and they felt valued.

Staff were supported and received regular supervision and appraisal of their work. The service met the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. Consent to care and support was sought in line with legislation and guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A flexible approach to meals ensured people maintained a healthy weight. Where concerns had arisen relating to people’s nutrition, professional advice had been sought and acted on.

People’s psychological wellbeing was monitored carefully and specific care plans were developed when required to facilitate improvements and improve their quality of life. Attention had been paid to following national guidance in making the service as suitable as possible for people living with dementia. Staff paid attention to detail and understood the effect the environment had on people.

Staff were caring and knew people’s individual needs very well. People were comfortable and relaxed with staff, demonstrating that trusting relationships had been established. Relatives praised the care provided. People were respected and shown compassion by the staff supporting them. Privacy and dignity were maintained and people were encouraged to be as independent as they could or wished to be. People were enabled to have dignified and pain free end of life care and relatives were supported at this difficult time.

The service was extremely responsive. People’s care plans were comprehensive and provided detailed guidance to staff on how to meet their personal preferences and routines. The provider and registered manager had introduced a number of innovative ideas to provide responsive care. These included ‘Our Organisation Makes People Happy’ which promoted the enhancement of the mental, physical and emotional

The inspection took place on 9 and 10 July 2015 and was unannounced. This was the first inspection of the service under the registration of a new provider.

The Mount Care Home is a care home with nursing. It is registered to provide a service for up to 37 people. Some of the people living at the service may require either nursing or specialist care associated with dementia.

The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the registered manager had applied to de-register as the manager for this service with the Care Quality Commission. However, the provider had taken steps to ensure the service had managerial cover and a new manager had been appointed. They had submitted the relevant forms to become registered with the Care Quality Commission as is required by law and assisted with the inspection.

On the first day of the inspection we found the laundry building could not be locked. This was a potential risk to people’s safety as chemicals were used in this area. We raised this with the manager who took immediate action. By the end of the first day of inspection the laundry had a new lock and was secure.

There was a relaxed and positive atmosphere in the service. People who use the service told us they were happy. Care plans focussed on the individual and recorded their personal preferences and where possible people had been involved in making decisions about their care. Care plans reflected people’s needs and staff were aware of how people liked to receive care.

People were treated with kindness, compassion and respect. Privacy and dignity was maintained and staff promoted independence whenever possible. People told us they felt safe living at the service. Staff were knowledgeable about their responsibilities to keep people safe and understood how to report safeguarding concerns.

There was a medicine management system in place and people received their medicines from suitably trained, qualified and experienced staff. Medicines were stored, administered and disposed of safely. People’s health needs were monitored and staff worked with health professionals to ensure these needs were met.

There was a robust process in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of staff to ensure people’s needs were met. Staff received regular training and had the skills, knowledge and experience to support people with their care.

People who could not make specific decisions for themselves had their legal rights protected. People’s support plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests.

The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty.

There was a complaints procedure in place. Complaints were investigated and responded to appropriately. The quality of the service was monitored by the provider and audits were conducted regularly by the manager and nominated individual. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service.