This inspection took place on the 24 and 31 October 2018. Both visits were unannounced.

Montgomery 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.

Montgomery Care Home accommodates 24 older people in one adapted building

At the previous inspection we found a breach of Regulations 10,11,12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people’s rights to respect and dignity were not always respected; systems were not in place to ensure that people’s consent was sought appropriately; people’s care and treatment was not always planned effectively and audit systems were not in place or always effective. During this inspection we found that improvements had been made and their registered provider was no longer in breach of these Regulations.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key questions was the service safe; effective; caring; responsive and well-led to at least good.

We have made a recommendation that the registered provider reviews and monitors the weekly quality assurance checks in place to ensure that they are effective and consistent.

Systems were in place to ensure that people's medicines were safely stored and to help ensure that people received their medicines when they needed them.

People’s living environment was clean and tidy and procedures and equipment were in place to minimise the spread of infection.

Safe recruitment procedures were in place to help ensure that only suitable applicants were employed to support people.

Procedures were in place in relation to the Mental Capacity Act 2005. Records demonstrated that where required, applications had been made on behalf of people in relation to Deprivation of Liberty Safeguards.

People had freedom of movement around the service and told us that they had a choice what time they went to bed and got up.

Sufficient staff were on duty to meet people’s needs and wishes.

People were supported by staff who had received training for their role.

People were encouraged to maintain their independence wherever possible.

People using the service felt safe and told us that they knew who to speak with if they had any concerns.

A complaints procedure was in place and people and their family members knew who they would speak to if they wanted to raise a concern or complaint.

People were supported by staff who knew them well.

People had a choice of menu during mealtimes and regular drinks were available; they were happy with the food they were served.

At the time of this inspection there was a manager in post, however, they had not registered with the Care Quality Commission. 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.

You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 29 November 2017, 1 and 6 December 2017. The visits on 29 November and 6 December were unannounced. This was the first inspection of the service since it was registered with the Care Quality Commission in November 2016.

Montgomery Care Home 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. Montgomery Care Home accommodates 25 people in one adapted building and specialises in providing care to people living with dementia.

The registered manager had recently left their role and therefore there was no 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.

During this inspection we identified areas which required improvement that resulted in a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) 2014. People were seen to have medicine creams and patches applied within communal areas.

We identified areas of improvement that resulted in a breach of Regulation 11 of the Health and Social Care Act (Regulated Activities) 2014. The registered provider did not have effective systems in place to ensure that people’s consent was sought appropriately in relation to the installation of CCTV within the communal areas of the service.

We identified areas of improvement that resulted in a breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) 2014. People’s medicines were not always managed appropriately. People’s care and treatment was not always planned effectively and improvements were needed as to how the service planned and mitigated risk for people.

We identified areas of improvement that resulted in a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) 2014. The registered provider did not have effective quality monitoring systems in place. Records relating to people’s care and the management of accidents and incidents were not always appropriately maintained or accurate.

We have made a recommendation that improvements are made to the environment to promote people’s orientation and stimulation around their living environment.

Sufficient staff were on duty to meet the needs of people throughout the day.

People were protected from the risk of abuse. Staff had a clear understanding of what action they needed to take if they had a safeguarding concern. Procedures were available within the service to support staff in raising any concerns they had.

People and their relatives spoken with felt that the service was safe, clean and tidy and provided a pleasant environment for people to live. Systems and equipment were in place for the prevention of transfer of infection.

People were supported to make everyday choices in relation to what times they got up and went to bed, their meals and where they wanted to be around the service.

Positive relationships had been developed between people using the service and the staff that supported them. People engaged in conversations and laughter and relatives commented on the friendliness of the staff team.

Sufficient staff were on duty to meet the needs of people. Visiting relatives told us that there were always staff available when visiting the service. In addition, relatives felt that staff kept them updated with any changes to their relative’s health and wellbeing.

A formal complaints procedure was available. Both people using the service and their relatives knew who to speak to if they had a concern about the service.