Archived: Belvedere Park Nursing Home

Peoples experience of using the service:

People continued to receive safe care. Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Good staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. 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.

Staff continued to treat people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection were of positive and friendly interactions between staff and people.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their families were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rating at last inspection: Good (report published 22/04/2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

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.

Belvedere Park Nursing home provides nursing care and accommodation for up to 23 people. This includes younger and older people with physical nursing needs as well as people who are nearing the end of their life (palliative care). On the day of our visit there were 21 people living there.

The provider is also the 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.’

Staff had a good understanding of what constituted abuse and knew what actions to take to keep people safe. There were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care, for checking staff were suitable to work with people who used the service, and for managing people’s medicines safely.

Care plans were personalised and contained relevant information for staff to help them provide the care people required. Information about making a complaint was available for people and people knew how to complain if they needed to. Staff said they could raise any concerns or issues they had with the registered manager, knowing they would be listened to and acted on.

Staff had the skills, knowledge and experience to work with people effectively. People received good end of life care from a compassionate and knowledgeable staff team.

The registered manager understood their responsibilities in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff respected people’s decisions and gained people’s consent before they provided personal care.

People felt staff were extremely caring and kind and treated them with respect and dignity. Staff understood the importance of treating people with kindness and compassion. They also provided good humour and many people enjoyed friendly banter between themselves and staff.

People were provided with sufficient to eat and drink and their nutritional needs were well supported. People enjoyed the food provided. Where changes in people’s health were identified, they were referred promptly to other healthcare professionals.

People and staff thought the registered manager and provider were open and approachable. The registered manager supported staff well to provide good quality care to people. There were quality assurance monitoring systems to support the manager in ensuring quality of care was maintained and improved.

Below is a summary of what we found. The summary describes the records we looked at and what people using the service and staff told us.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, the service was aware of its responsibilities under the Mental Capacity Act. The manager understood when an application should be made, and how to submit one.

We looked at the safety and suitability of the premises. We saw the premises were in good order and well maintained.

We looked at records. We saw care records had not been kept up to date for a few months since our last inspection. The manager had put systems in place and had rectified this. Records were up to date for the last three months.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. One person told us, 'The care is excellent.'

We looked at the meals provided to people. We saw people had a good choice of meals. We saw people's food was served to support them eating safely. For example, some people had soft food or pureed diets because they had been identified as being at risk of choking. People told us they enjoyed their food.

It was clear from what we saw and from speaking with staff that staff understood people's care and support needs and they knew people well. One staff member told us, 'I love it here, it is like a family here, people get the care, love and attention they require.'

Is the service caring?

All people with spoke with told us staff were caring. One person told us, 'I get very good care, the staff are very nice, very helpful.' A relative told us, 'She's been here seven years because they've looked after her so well.'

We observed staff being kind and patient with people throughout our visit. We saw people thoroughly enjoyed a music and movement session in the morning. We also saw people enjoyed having a hand and arm massage by a visiting therapist.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records showed us staff responded in a timely way to changing health and social care needs by contacting the appropriate health care professionals.

Is the service well-led?

People we spoke with told us they felt able to contact the manager about their care and the manager would deal with any of their issues quickly and effectively.

Staff we spoke with told us they thought the manager was approachable and provided good support.

We looked at quality assurance systems. We saw the service had recently collated its annual customer service feedback results. These showed people using the service were satisfied with the level of care and support provided.

People living at the home were very complimentary about the care they received. They told us:

"The staff treat me very well, we're friends...If I have problems they look after me."

The staff are, "Very good, very fair and very kind."

"It's a lovely home...the call bell always works and they are here like a shot."

We spoke with visitors. They told us,

"The staff are giving X good care."

"It is very friendly.. everywhere is very clean...mum really enjoys it here and she feels safe and comfortable."

We looked at the care and welfare of people living at Belvedere. We were satisfied people were getting the necessary care and support to meet their needs.

We looked at the cleanliness of the home and the infection prevention measures. We saw good systems were in place to clean the home and the equipment used by people. Staff were aware of their responsibilities in preventing the spread of infection.

We looked at medication management. We were satisfied medication was being administered appropriately to people.

We talked to staff and looked at staff records. We saw staff had been trained to ensure they could meet the needs of people living at Belvedere Park.

We checked the equipment used. We noted people had equipment that met their needs. Equipment was maintained and serviced.

We talked to relatives of people living at Belvedere. They told us they were happy with the care their loved ones had received and had been made to feel welcome when visiting.

We observed staff being kind and considerate to people. We saw people being treated with dignity and respect. People were seen to have developed good relationships with each other, and with staff.

We looked at three care records. These demonstrated the care needs of people were appropriately assessed and updated as soon as care needs changed. The service worked well with other health care professionals.

We looked at menus. We saw that people were provided with a good range of meals which met their dietary needs. During our visit we observed people having their main lunch time meal. Many people required one to one support to eat their food. We observed staff taking their time so that people could enjoy their food and eat safely.

We checked staff recruitment processes and were satisfied that relevant checks were made to keep people safe.

We looked at the formal and informal complaint processes and were satisfied people felt able to tell staff if they had any concerns and these would be acted upon.