Montrose House

At our last inspection on 12 and 14 August 2015, we rated the service overall Good. At this inspection 12 April 2018 we found that the service had improved to an overall rating of Outstanding and met all the fundamental standards we inspected against.

The service had a registered manager. 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. Statutory notifications received showed us that the registered manager understood their registration requirements.

Montrose House was exceptionally well led. There was visible and highly effective leadership in an open and transparent culture that resulted in an organised and well run service. The registered manager was able to demonstrate how their robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example. They were supported by a management team and care workers that were fully committed to delivering the highest standard of care to each person.

Morale was extremely high, at all levels within the service with employees describing how well supported and appreciated they were by the registered manager. All of the staff were proud of where they worked and told us they felt valued and respected. They shared positive experiences about the leadership of the service, and how they were continually motivated and encouraged to professionally develop by the registered manager.

There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result the quality of the service continued to develop. The registered manager demonstrated an open, reflective leadership style working in partnership with other stakeholders to drive continual improvement within the service and to raise awareness of the needs of people living with mental health conditions within the local community.

Feedback from health and social care professionals cited collaborative and extremely effective working relationships. Montrose House was awarded care home of the year in 2017 at the Suffolk care awards and was highly commended in the food and catering category, for providing food in an interesting way that responds to people's individual needs. In addition the registered manager nominated by the staff at Montrose House, won the award for inspiring leaders and managers.

Care staff were highly skilled and competent to meet people's needs. They demonstrated an enhanced understanding and knowledge of mental health and how to meet people's needs. They were available when people needed assistance and had been recruited safely.

Care staff were exceptional at supporting people with their dietary needs. People enjoyed a positive meal time experience and were enabled to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Care staff were confident about using the mental capacity and best interest decisions made were in line with legislation and people's wishes.

People and their relatives were complimentary about the care and support they received and the approach of the registered manager and care staff. People told us that they felt safe and well cared for. The care staff and registered manager had developed good relationships with people and knew them well. Care staff consistently protected people's privacy and dignity and promoted their independence.

The service continued to provide a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse, accessing the community and with their medicines. Care staff and the management team fully understood their roles and responsibilities in keeping people safe.

Systems were in place to receive, record, store and administer medicines safely. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People received care that was personalised and responsive to their needs. They participated in meaningful activities and were supported to pursue their interests. The service listened to people's experiences, concerns and complaints and took action where needed.

The environment met the needs of the people who lived there. All areas of the service were clean and in good state of repair with equipment maintained.

The five questions we ask about services and what we found