Archived: Belmont House

Belmont House is a care home that provides accommodation and personal or nursing care for up to 52 people. At the time of this inspection there were 42 people using the service.

People’s experience of using this service:

• Belmont House had sustained compliance with the regulations since the last inspection but aspects of the service had deteriorated. A new manager had recently started working at the service. They were responsive to inspection feedback and understood further improvements to the service were required;

• People told us staff were kind and caring. They were positive about how they were treated by staff. People told us they were in control of their day to day routines and staff supported them to remain independent. Staff asked people for consent before providing care, however improvements were required in how the service recorded assessments of people’s capacity to make decisions and best interest decisions made on their behalf;

• People felt safe whilst residing at Belmont House. They had access to other community health professionals as required. Staff supported them safely with their medicines;

• Most staff could tell us about people’s likes and dislikes and knew information about people’s backgrounds. They used this knowledge to care for people in the way they wanted. However, information about people’s preferred priorities for care at the end stages of their lifer was not recorded in detail in people’s care records, which meant their wishes or preferences were at risk of not being followed or respected;

• Refurbishment and redecoration was ongoing at the service. Clear signage was available to orientate people to key places in the service. However, further improvements were required to make the service dementia friendly;

• Staff received a range of training and people thought staff had the right skills and experience to care for them effectively.;

• People were positive about the quality of the food. People were provided with a range of food options that met their nutritional requirements;

• Risks to people receiving care at Belmont House were assessed and kept under review. People’s needs were assessed and support plans were developed to guide staff in how to care for each person.

• People and their relatives gave mixed feedback about the range of activities which took place both in the home and in the community. We have made a recommendation about the provision of activities at the service;

• People who used the service and their relatives told us they had confidence in the management team and they could raise any concerns, which would be responded to. They also had the opportunity to attend regular meetings about the service to provide feedback and ideas for improvement. Relevant stakeholders were not always asked for feedback about the service in order to drive improvements;

• The service met the characteristics of good in all key questions, with the exception of responsive. The manager had plans in place to improve other areas of the service.

More information is in the full report.

Rating at last inspection:

At the last inspection the service was rated good (published 23 June 2016).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

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.

Belmont House is a care home which is registered to provide accommodation and personal care for up to 52 people, who may have nursing needs or be living with dementia. On the day of our inspection there were 46 people living in the home.

There was a manager at the service who was registered with CQC. 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.

Following our last inspection the service was found to not be meeting the legal requirements for three regulations. These regulations related to staffing levels, obtaining consent for decisions and nutrition and hydration. We asked the provider to send us a report that said what actions they were going to take. At this inspection we found the provider had made the necessary improvements to these areas to meet the relevant regulations.

People we spoke with told us they felt “safe” living in the home and the staff were “kind” and “caring.”

On the day of the inspection the home was vibrant and active. We found staff were very busy attending to people’s needs though people did receive care and support when this was requested or required.

Information from staff files evidenced that appropriate checks were completed for all staff before they were allowed to work in the home, which helped to make sure staff were of good character.

We found where decisions had to be made for people on their behalf these were in their best interests under the Mental Capacity Act 2005 and had involved a multidisciplinary group of professionals.

People told us they enjoyed the meals provided and there was plenty of choice available. We saw staff taking time to ensure people were provided with a healthy and nutritious diet. Where concerns about people’s nutrition and hydration were identified accurate and up to date records were completed.

Each person had a care plan which gave details about what their day to day care and support needs were. Staff were familiar with people’s specific preferences in how they received care and support.

Staff we spoke with were confident the training they were provided with gave them the skills necessary to carry out their role well. They told us they had benefitted from the courses they attended.

The provider had carried out work to improve the aesthetics of the home and people we spoke with were pleased with this. There remained areas of the home that needed refurbishment work, particularly on the garden areas and on the nursing unit. The registered manager showed us the plan in place to make the outside areas more pleasant to sit in and told us about proposed work to make the nursing unit more dementia friendly.

The service had a full and varied activities programme available for everyone. A local community group were very active participants in organising and providing social activities both inside and outside the home. People who used the service were also offered one to one time with the activity worker where they could be read to or simply enjoy a private conversation.

There was an open and transparent relationship between people who used the service, their relatives and the registered manager. People said they were able to raise any issues or concerns they had and knew these would be dealt with in a responsible way by the registered manager.

People who we could communicate with,told us that they were treated with dignity and respect. One person said, "they (staff) always knock on the door and tell me who it is. They are respectful, excellent and top class.'

People told us that the staff looked after them well and they were happy with the care they received. One person said, "I think its marvellous, ten out of ten.

People using the service said they felt 'safe' living in the home.

We found that staff were provided with appropriate training and supervision so that people's health and welfare needs were met by competent staff.

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provided. People who used the service and their representatives were asked for their views about their care and treatment.