Archived: Belgarth Care Home

Updated 16 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The inspection took place on 26 and 27 April 2017 and the first day was unannounced. The inspection was carried out by one adult social care inspector, an expert by experience and a specialist advisor. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The specialist advisor who supported the inspection had a background in nursing and dementia care.

Prior to the inspection we reviewed information we held about the service including complaints, safeguarding information and statutory notifications received from the service. A statutory notification is information about important events which the provider is required to send to us by law. We also reviewed previous inspection reports.

As part of the inspection we contacted five community healthcare agencies who were involved with the service for their comments, including a district nursing team, speech and language therapy service and a chiropodist. We received responses from two of the agencies who both gave us positive feedback about the home. We also contacted Lancashire County Council contracts team and Healthwatch Lancashire for information.

During the inspection we spoke with five people who lived at the service and four visitors. We spoke with a nurse, three care staff, the manager and the regional manager. We observed staff providing care and support to people over the two days of the inspection and reviewed in detail the care records of five people living at the home. We also looked at service records including staff recruitment, supervision and training records, policies and procedures, complaints and compliments records, records of quality and safety audits completed and fire safety and environmental health records.

Updated 16 June 2017

We carried out a comprehensive inspection of Belgarth Care Home on 26 and 27 April 2017. The first day of the inspection was unannounced.

Belgarth Care Home is registered to provide nursing and personal care for up to 47 people, including people living with dementia or mental ill health. The home is split into two main areas, one area for people with general residential and nursing needs and the other area for people who have higher dependency needs, including people living with more advanced dementia. The service is situated on the outskirts of Barrowford in Nelson, East Lancashire. At the time of our inspection there were 38 people living at the home.

At the time of our inspection the service did not have a registered manager in post. The previous registered manager had left the service in February 2017. A registered manager is a person who has registered with the CQC 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. There was an acting manager in post who had started managing the service on 13 March 2017.

The service was last inspected on 10 and 11 August 2015, when it was found to be compliant with our regulations. As part of that inspection we made a recommendation that the provider should comply with their plans to make improvements to the home environment.

During this inspection we found breaches of our regulations relating to the unsafe management of medicines and a lack of effective staff induction and training.

During our inspection we found that there were appropriate policies in place for the safe management of medicines and staff administering medicines had received appropriate training. However, safe medicines storage and administration processes were not always followed, which meant that it was not possible to know if people received their medicines safely.

People living at the home told us they received safe care. Most people we spoke with were happy with staffing levels at the home.

Records showed that staff had been recruited safely. Not all staff we spoke with understood how to safeguard vulnerable adults from abuse or the action to take if they suspected that abusive practice was taking place. Further training was planned.

We found that people’s risks, such as a risk of falling, were managed appropriately. Accidents and incidents were documented and care plans and risk assessments were updated when people’s needs changed.

We found that staff did not always receive an appropriate induction when they started working at the service. Records showed that much of the service’s mandatory training had either not been completed by staff or was out of date according to the service’s training schedule.

Records showed that staff received regular supervision. The staff we spoke with told us they felt supported by the manager and felt that she was making improvements at the home.

The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe. We found evidence that where people lacked the capacity to make decisions about their care, their relatives had been consulted. However, not all staff had an awareness of the Mental Capacity Act 2005 (MCA).

People living at the home were happy with the quality of the food provided. They told us they had choice at mealtimes and we saw evidence of this during our inspection.

People received support with their healthcare needs and we received positive feedback from community health and social care professionals about the standards of care at the home.

We observed staff communicating with people in a kind and respectful way. People told us staff respected their privacy and dignity and encouraged them to be independent.

The home had been without an activities co-ordinator for some time and there had been a lack of activities available to people at the home. The manager had just appointed a new activities co-ordinator and regular activities were planned.

The manager told us that she planned to introduce regular residents meetings and would be issuing satisfaction questionnaires to people living at the home and their relatives, once she became more familiar with people. She told us that the responses received would be used to improve the service.

People living at the home and staff told us they thought the home was well managed. They felt that the manager was approachable and was making improvements at the home

Regular audits of quality and safety were being completed and had identified the shortfalls we found during our inspection. Appropriate improvement plans were in place.