Belvedere House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.
 

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans were not person-centred, lacked sufficient detail, information and guidance for staff. We found gaps within the life history and social activities sections of care plans, with limited information recorded about people's backgrounds, personal histories, and experiences prior to moving into the service. As a result, staff were not always able to describe people's individual histories, preferences, and significant life events.

This meant staff did not always have access to sufficient information about people's backgrounds, interests and personal preferences to support consistently person-centred care. Without detailed information about what was important to people, there was an increased risk that opportunities to promote people's identity, independence and individual interests could be missed. The registered manager acknowledged these gaps and told us care plans were being reviewed and updated to improve the information available to staff.
 

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had a consistent staff team who were rotated between the upstairs and downstairs areas so they became familiar with people across the service rather than working exclusively in one area. This helped promote continuity of care as staff were familiar with people throughout the service.

The service worked collaboratively with external healthcare services to support coordinated care and safe transitions between services. Staff used a dedicated referral process when people attended hospital, ensuring key information about their needs was shared with healthcare professionals. The registered manager told us they participated in an NHS initiative aimed at improving the safety of hospital discharges and would follow up with hospitals where discharge information was incomplete, helping to maintain continuity of care and ensure people's needs were understood and met on their return to the service.
 

The service promoted open communication by providing people and their relatives with accessible information about the service and opportunities to influence how it was run.

People and their relatives had access to relevant information about the service and were given opportunities to provide feedback. Information was shared through newsletters and resident meeting minutes. This provided people with accessible information about developments within the service and matters discussed with residents.

People and relatives were supported to remain informed and engaged with the service. A relative told us, “There is a newsletter and they are always asking for us to let us know our views and opinions.” Another relative told us, “They always ask for feedback at the end of the weekly bulletin.”
 

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives had accessible routes to provide feedback and raise concerns, and staff understood how to escalate complaints. Concerns were recorded and investigated, and actions were identified where required.

During a residents' meeting, where people were encouraged to share their views and experiences, residents told the registered manager they sometimes found it difficult to hear discussions. In response to this feedback, the registered manager introduced the use of a microphone during meetings to improve accessibility and support people's participation. This demonstrated the service listened to people's feedback and took action to enhance their involvement.

Staff understood how to respond when people or relatives were unhappy. One member of staff told us, “I will always report to the nurse first who will then report to the management.” This demonstrated staff understood the importance of escalating concerns through the appropriate channels.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People's mobility needs were assessed and supported through the provision of appropriate equipment and aids, including tripods, wheelchairs, walking sticks and bed rails. Care records identified the specific support each person required, helping to remove barriers associated with reduced mobility. This enabled people to move around the home, access communal areas and participate in daily life on an equitable basis, in line with their individual needs, preferences and abilities.

The service had arrangements in place to support the delivery of care out of hours, including emergency staffing arrangements and night-time management oversight
The registered manager told us agency staff could be used to provide additional cover in an emergency. Staff also provided their availability a month in advance, allowing the service to identify staff who could be contacted if additional cover was requested.

An emergency plan was in place for significant incidents, including fire and other major emergencies. The registered manager and deputy manager carried out unannounced night observations to monitor the quality and safety of night-time care. The registered manager told us night staff were required to check people hourly and that these checks were reviewed during night observations. The registered manager told us these observations included checks that staff received their allocated breaks and followed relevant policies and procedures.
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff demonstrated an understanding of equality and inclusion. One staff member told us, “Every person has a right to be treated the way they want to be treated.” They explained this meant respecting people’s individual preferences and choices rather than expecting everyone to follow the same routine.

The staff member described how they respected people's individual preferences and choices when providing support. The staff member told us, “If a resident wants extra time in bed, I will respect that.”

People’s individual communication needs were identified and recorded in their care plans to support equitable access to care and services. This included information about people who required hearing aids, had sight impairments or required staff to adapt their communication, such as speaking clearly and loudly. Recording this information provided staff with guidance on how to communicate effectively with individuals and helped to ensure that people were able to understand information, express their views and participate in decisions about their care.
 

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s wishes and preferences for end-of-life care were documented within their care plans, supporting a personalised approach to future planning. Respect forms were in place and recorded people’s wishes regarding resuscitation and arrangements following death, including whether they wished to be cremated.

A relative described compassionate support from staff when their family member received end of life care. One relative told us, “They were wonderful when my husband died. They lined the drive when it was his funeral.”

Staff told us they had received end of life training and that this was helpful to them in their role. The registered manager said people’s future wishes were discussed as part of the assessment process when they moved into the service. This included discussing preferences such as funeral arrangements and information was recorded within people’s initial assessments.

The service provided additional support for relatives when people were receiving end of life care. The registered manager told us relatives could use the guest room free of charge during this time, enabling them to remain close to their family member.