Mount Vale Care Home
Healthwatch North Yorkshire has a legal power to visit health and social care services and see them in action. This power is known as 'Enter and View' and offers a way for us to meet some of our statutory functions and to identify what is working well with services and where they could be improved. We also get a response from the care homes to our recommended actions.
Purpose of the visit
- To visit and gather views of the residents and their relatives and the experiences of the services provided.
- To observe the ongoing care being provided for the residents and their interaction with staff and their surroundings.
During the visit
Our authorised representatives visited the home and spoke with residents, residents’ relatives and friends, and care home staff, as well as conducted a planned observation.
We heard from:
• 13 residents,
• 9 residents’ friends or family members,
• 16 members of staff,
whose feedback forms the basis of this report and our rating of the Mill House.
Key findings
We found that at the time of our visit Mount Vale Care Home was operating to a good standard. The care home is well kept, and the environment meets the needs of the residents. Staff are kind and caring and generally seemed to enjoy their work environment. Residents appeared to be well cared for and generally reported being happy with the home.
These findings were based on our observations, and reflect the general happiness of residents, family and friends of residents and staff members as described in their feedback.
However, there were a few issues highlighted and we have made suggestions for review and improvement. The main findings were to address perceived staff shortages, improve communication between staff and management, including adequate and timely access to the resident care plans, and ensure activities are accessible to all residents
Additionally, based on our findings from three Enter & View visits conducted in 2022 and 2023 to care homes managed by Barchester Healthcare, where carpets are predominantly used as an approved flooring style, we recommend that the providers explore alternative cleaning methods, incorporate odour-neutralising products, and consider different or combined flooring options (or implement timely updates) to effectively address persistent concerns about urine odours in the network care homes.
Positive feedback
- The care home is well-maintained, with a comfortable and welcoming environment for residents and visitors.
- Residents have access to a range of amenities including a café area, cinema room, daily activity program and a pleasant garden area.
- Residents on the whole feel safe and well cared for.
- Residents have access to a variety of meal choices and a majority feel the access to food is adequate or better.
- Staff interact in a caring and positive manner and residents are generally happy with the quality of care.
- Majority of staff members report a job satisfaction with a feeling they have access to adequate training.
Recommended areas for improvement
- Activities. Ensure that activities are accessible to all residents with an interest in participation and look for opportunities for one-to-one interaction for those unable or unwilling to participate in group activities.
- Encourage socialisation. Encourage residents to socialise, particularly utilising mealtimes. Consider the use of external resources to facilitate socialising, including visitors and volunteers.
- Resident care plans resource. Ensure there is sufficient IT equipment (computer/laptop etc.) to cover all staff to access and update care plans.
- Staffing levels. Look at opportunities to improve resourcing around stress points like early mornings, mealtimes and overnight.
- Staff support. Staff would benefit from regular contact with management to feedback on changes in residents’ requirements and to review processes in a timely manner.
- Monitoring essential health checks. Proactively facilitate necessary health check-ups, reduce reliance on family involvement, and ensure timely access to the assessments. Recognition of the difficulties involved in accessing services, such as dental care, should be emphasised.
Response from Mount Vale Care Home
Activities
You asked Mount Vale to ensure that all activities were accessible to all of the residents who showed an interest in participating. You also asked us to make sure there was an opportunity for one-to-one interaction for those residents who were unwilling or unable to participate. This month has been a very busy time for our home and for the residents. We have made sure there has been lots of entertainment and activities that everyone can join in with.
We work very closely with the provider of an organisation called Oomph, who offer well-being and activities for every care home resident. They work with experts in dementia, mental health and arthritis. Oomph has continuously expanded its specialist range of content and activities, with the likes Zoo Lab, Instructor Live and Arthritis Action, Archery UK, amongst others. Oomph training and well-being services, help care teams develop professional skills and manage the day-to-day pressure and stress inherent in work and home life. Oomph is passionate about a whole home approach to wellbeing and provides wellness services to care home staff as well as residents helping fulfil our vision of supporting everyone to live a full life.
Mount Vale are passionate about looking after the life enrichment for all our residents, focusing on their well-being. When people are admitted to our service we make sure we have their life history and speak with their next of kin/family and friends to make sure we have a good overall picture of their past lives so we may introduce this into any hobbies and interest so we may can assist them to continue to follow the activities they once enjoyed or introduce them to new ones. Individual’s needs and capabilities are mirrored through their care plans so the activity offered is as personal to their needs as possible.
Encouraging socalisation
Encouraging residents to socialise, especially at meal times, can be a challenge at times, particularly on the ground floor where some of the residents prefer it to be quiet. We have introduced music for a little background noise and the residents choose who they wish to sit with during their meals. The staff will encourage interaction though chats and offerings of different foods and fluids.
A positive dining experience can help enhance social interaction, build a sense of community and increase nutritional intake, all of which contribute to a person’s mental and physical well-being. Our care and hostesses greet residents as they arrive and ask them where they would like to sit helps to set the tone for the rest of the meal. A well-presented table is a central part of the overall ambience. Good quality table linen, a small vase of flowers, fresh water and a menu all contribute to the overall look of the room. Having a menu lets people know what to expect and helps them to be clear about what they’re choosing to eat. Not everyone is familiar with the menu choices, so having a description of the food, or ‘show plates’ are sometimes used. The chef is invited to the monthly residents meeting to discuss meals/food and the dining experience. Conversations and celebrations each mealtime offers a valuable opportunity for social interaction, food can be a great way to get people talking! Tables are arranged with people grouped together and encouraging staff and family members are welcome to join their relatives at mealtimes.
Resident care plan resources
We do not have electronic care planning at this time. However when we do Barchester Healthcare will make sure that there will be sufficient information technology equipment to cover all staffs access to update care files and care files. At this time all our documentation is written and all care staff are able to complete and document their appropriate documentation that mirrors the resident’s needs. On a nursing unit the documentation will have further oversight from the qualified staff.
Staffing levels
Mount vale have made sure that the heads of unit have had the opportunity to speak about the structure of the shifts. Making sure that the busiest times have the appropriate oversight and staff that are skilled enough to be able to follow any tasks required of both the residents and of each other. Team working is encouraged as well as taking responsibility and understand what is required for empowering all the residents to be as independent as possible regardless of their capabilities. Staff can at times misunderstand and misinterpret what is actually needed. They need to prioritised and understand the needs of an individual as well as being prepared to feed back all concerns and information to the person in charge. Communication is paramount.
Staffing levels are determined by a dependency tool and the number of residents. This can change on a daily basis. Management will ensure that any changes to staffing levels are communicated to staff with explanations as to reasons for the changes.
Staff support
Staff have been able to have discussions with both the General Manager and Deputy Manager at any time they require support, having an open door policy. Processes are being reviewed all the time and it does appear to change quickly leaving staff frustrated. The managers have had regular contact with the heads of unit from each floor and have been able to chat opening regarding all concerns the staff and themselves should have. All the staff are important to us and should and are been made to feel that their input is beneficial and crucial to the overall running of the home. Should a staff member need specialised assistance we would work with them to make sure we are able to offer what they need in a timely manner. We would like to think all staff feel valued. Barchester Healthcare, who run the home, have a support service called ‘We Care’ and staff are encouraged to use this free helpline if they feel they need external support. The company are in the process of encouraging staff to complete the annual staff survey.
Monitoring essential health checks
Should our residents need access to outside health care professional, including chiropodists dentists, physios, opticians or occupational therapists, we actively search them out or ask our GP to assist with referrals. Patient access has been limited, for example to audiology, so we need a GP to now refer the resident to them directly. However if someone should need the dental services or opticians we do sometime liaises with the families of our residents as they may have payment plans in place for their individual needs. Unfortunately it can sometimes feel like the individuals we care for are not able to gain access to a dentist as easy as it once was due to NHS waiting lists, however if needed emergency dental care is available if required. This can be discussed on a need to know basis and we could make this clearer when we admit residents to our service in the future
