The Bellingham Residential Care Home

People’s experience of using this service:

People told us they felt safe at Bellingham Residential Care Home. Relatives stated they believed their family members were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff told us how they managed risk in a way that respected the person and supported their dignity.

People and their relatives felt confident in the management. They told us there was a caring culture within the home and staffing levels were appropriate. One person told us, “I’ve never had to wait for anything.”

It was clear staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and life choices.

People expressed positive views on how staff treated them. Observations during our inspection showed people were respected and care and support was delivered in a dignified manner with consent being sought before any actions were taken.

Care plans had been developed with people and their relatives being involved throughout the process. These were regularly reviewed to reflect people’s current needs and preferences. People were supported in activities of their choice within the home and within the local community.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People received their medicines as prescribed and when needed and appropriate records had been completed.

The registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they were supported to gain vocational qualifications in health and social care.

Staff supported people with their meals sensitively and respected their wishes. Everyone we spoke with told us the food was good and the registered manager ensured people always had access to snacks and drinks as and when they requested them.

There was a complaints procedure which was made available to people and their family. People told us they were happy with the support they received. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well-led.

The service engaged with outside agencies to ensure people received timely healthcare support. The management team engaged with other agencies to gain updates on legislation, best practice and learn from other providers’ experiences.

Rating at last inspection:

At the last inspection the service was rated good (published 24 December 2016).

Why we inspected:

This was a planned inspection based on the rating 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 issues or concerns are identified, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At the last inspection on 07 October 2015 we asked the provider to take action to make improvements because we found breaches of legal requirements. This was in relation to safeguarding people from unsafe care, staffing levels, governance of the home and failure of the service to notify Care Quality Commission (CQC) of instances when people had required hospital treatment. The provider sent us an action plan saying they would meet the legal requirements. During our inspection visit on 01 December 2016 we found these actions had been completed.

The Bellingham provides accommodation and residential care for up to 15 older people. The home is a two storey corner property set in a residential area close to Lytham town centre. There are thirteen single rooms and one double room all with en suite facilities. There are a range of aids and adaptations available suitable to meet the needs of people using the service. There is a garden area around the home. Public transport links are close by. At the time of our inspection visit there were 10 people who lived at the home.

There was a registered manager in place. 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.

People who lived at the home told us they were happy with their care and liked the staff who looked after them. One person said, “This place is fantastic. The staff are excellent, really caring and friendly people.” One person visiting their relative said, “It’s such a relaxed and friendly atmosphere I always feel I am visiting [relatives] home not a care home.”

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them. One person visiting the home said, “I know [relative] is safe and I don’t need to worry about them. I knew when I chose this home it was the right place for [relative]. They are getting the best care possible.”

We looked at the recruitment of two recently appointed staff members. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People who lived at the home told us they felt safe because staff responded when they required their help. One person said, “The staff are always available when I need them. I find they are very attentive.”

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The environment was maintained, clean and hygienic when we visited. No offensive odours were observed by the inspectors. We spoke with four people who lived at the home who all said they were happy with the standard of hygiene. One person visiting the home said, “The first thing I noticed when I came to look around the home was how clean it was. The place is always spotless.”

We found equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People who lived at the home told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments received included, “They come round every morning and tell us the choices for the day. I enjoy all the meals.” And, “Good home cooking, the chef is brilliant.”

People told us they enjoyed the activities organised by the service. These were arranged both individually and in groups.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. We found people were satisfied with the service they received. Comments received from people’s relatives included, ‘We are impressed with the effort all staff take to make it feel so homely.’ And, ‘The continuity of staff is so impressive. They know and understand [relatives] needs so well.’

People told us that they were happy at The Bellingham. They said that they received care and support when they wanted it. One person said, "The staff are fantastic. They are the best'. Another person told us, 'A princess could not have been treated better than me.' A relative told us, 'The staff are very caring. I would recommend here.'

We observed people living in the home being treated with respect and dignity. We saw that staff assisted people with personal care discretely and sensitively, in a timely manner. We saw satisfactory numbers of staff on the inspection to respond to people's needs.

The home was comfortable and pleasantly warm. There was a spacious lounge and a dining room on the ground floor and bedrooms on the ground and first floor. Most people had brought some possessions from home to make to their bedrooms more homely and familiar.

Staff were recruited safely and received training which assisted them to support people effectively. Systems were in place for monitoring the quality of the service people received. People told us that they were well supported by the senior staff team.

We spoke with a range of people about the home. They included the manager, staff members and a number of people who lived at the home. There was one visitor whom we spoke with. We received responses from external agencies including social services in order to gain a balanced overview of what people experienced.

People we spoke with told us they could express their views and were involved in decision making about their care. They told us they felt listened to when discussing their care needs. Staff confirmed with us they also involved relatives in care planning where possible, to ensure people received the right care and support. This was confirmed when we looked at two records, which included evidence of involvement in care planning and review. A visitor we spoke with also told us they were kept informed about their relatives care. A resident we spoke with told us, 'Staff talk to me about what I need. They also remind me of appointments. I would forget otherwise.'

When asked about routines in the home people we spoke with told us it was relaxed and one person told us, "Staff are always around when you need them." We spent time in the main lounge area and spoke with residents coming into the lounge during the morning. Some people sat in groups chatting, others watched television and one person dozed in the chair.