Archived: Belle House

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, our observations made during the inspection and the records we looked at.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There was sufficient equipment at the service, which was well maintained and serviced regularly. People were cared for in an environment that was safe, clean and hygienic, although we told the provider we found that some of their cleaning records had lapsed.

Systems were in place to make sure that all staff learnt from events such as accidents and incidents, complaints, concerns and adverse inspection findings. Feedback was sought from people and their relatives and acted upon. This helped reduce risks to people and enabled the service to improve.

CQC monitors the operation of the Deprivation of Liberty safeguards (DoLS) which apply to care homes. This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted at Belle House, we found that suitable policies and procedures were in place. Documents in people's care plans showed that their mental capacity had been assessed in areas such as day to day decision making. This provided a basis for monitoring people's mental health and meant that they had been safeguarded as required. One person we spoke with told us 'I feel safe and settled here'.

Is the service effective?

People told us they were happy with the care delivered and their needs had been met. Our observations and speaking with staff showed that they had a good understanding of people's care and support needs and that they knew them well. A visitor we spoke with told us they were 'Happy with the care' their relative received.

Where people needed equipment, such as walking aids and hoists, to support their mobility or to assist in transferring them form one position to another, we saw that it was available, serviceable and in use.

Is the service caring?

People and visitors told us that the staff were kind and attentive. Care records contained personalised information which helped staff to know the people they supported and how to meet their needs. We saw that care workers showed patience, compassion and understood how to support people as individuals. One person told us 'I'm happy that I live here'. Our observation found that staff knew how to communicate effectively with people and we saw how this helped to reduce one person's anxiety and meet their needs.

Is the service responsive?

People's needs had been assessed before they moved to Belle House. This meant that the service had the skills and facilities to meet their identified needs. Regular monitoring of people's health, associated risks and their social needs identified when particular measures were required to help keep people safe. We saw that, when identified, such measures were put in place. This meant that the service was responsive to people's individual needs. Records confirmed people's preferences and care and support had been provided in accordance with their wishes. However, we told the provider that some information in people's care plans was contradictory and could potentially lead to a serious mistake being made about if a person wished resuscitation attempts to be made.

Is the service well-led?

The service had recently introduced an improved quality assurance system that is now embedded into practice. Records showed that identified shortfalls were usually addressed promptly and the quality of the service had improved. However, we told the provider that management checks had not identified that some cleaning records were incomplete. Discussion with staff found that they had a good understanding of their responsibilities and of the values of the service.

We looked at records held in relation to how the home assessed and monitored the quality of care provided and at issues identified in the warning notice. We spoke with staff. Most people using the service had complex needs which meant they were not able to tell us their experiences. We found that the concerns identified in the warning notice had been addressed.

We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant they were not able to tell us their experiences.

We observed staff interacting positively with people and providing person centred care. However, some care practices indicated that people's dignity was not always respected.

We looked at measures in place to ensure the risk of infection was minimised and found that systems were not always effective.

We found that the systems to monitor the quality of the care provided remained ineffective.

We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant they were not able to tell us their experiences.

We observed staff interacting positively with people and providing person centred care. However, some care practices indicated that people's dignity was not always respected.

We looked at the systems and processes in place for the safe management of medicines.

We found that arrangements had been established that ensured the safe management of medicines. The home was generally well maintained.

We found that recruitment practices were thorough and appropriate checks were carried out on new staff. Regular training was provided for staff that ensured they were able to meet people's needs.

Improved systems to monitor the quality of the care provided had been introduced but were still not fully embedded into everyday practice.

We found that care plans clearly documented the needs of people and how they should be met. However, there were significant shortfalls in record keeping demonstrating that care was not provided in line with assessed needs.

We observed staff interacting positively with people and providing person centred care. However, some care practices indicated that people's dignity was not always respected.