Belle Vue Country 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 changed to requires improvement. This meant people’s needs were not always met.

This service scored 54 (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. We observed people were mostly supported in a person-centred way. Staff told us what was important to people and how they liked to be supported. Although most staff knew people well, care records did not include person-centred details to ensure all staff were aware of people’s wishes and needs. People’s bedrooms lacked personalisation, some bedrooms only contained furniture and consideration had not been given to their preferences or personalities to provide an inviting space for them. A staff member described person-centred care and said, “Person-centred care means holistic care for a person according to likes and dislikes. We are providing holistic care to them, when we get a new resident to the home, we have the details about their likes and dislikes from the assessment or the person will say what they want.”

There were some shortfalls in how staff understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Staff were supporting people with mental health needs and dementia; we observed occasions where staff were kind but lacked certain skills to understand some people’s actions. For example, some people stood up, staff were concerned for their safety and asked them to sit back down rather than exploring why the person stood and address any unmet needs. However, we also observed staff supporting people well when they were distressed or disorientated.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People did not have access to information in a format to suit them. This included policies and information about how to complain or raise concerns. However, the manager was visible, spent time in the home and people and their relatives were comfortable to speak with them or other staff members for updates.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The complaints policy was situated in the entrance hall, people were unable to access it, however, relatives could review it if needed. The policy was in smaller font and had not been updated since 2017. However, relatives did give examples where they had raised complaints and were listened to. Some comments included, “I’ve spoken to the management about missing clothes; they were very good about it and found the missing things.” And, “On the odd occasion when I’ve mentioned something it’s usually because it’s not been passed on in the handover, but it is always put right.” The manager held a log of comments, suggestions and complaints which evidenced each were taken seriously and actioned in a timely way. We reviewed multiple compliment cards from relatives thanking staff and managers for their care.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. There were areas within the service which required reviewing to suit the needs of the people who lived there. There was limited dementia friendly signage to help people navigate round the home. Toilets and bathrooms were not clearly signposted and people’s bedroom doors did not always have their name or other references to help them find their own space or avoid going into other people’s spaces. We saw a person looking lost in a hallway and asked a member of staff to assist them, the staff member established the person needed to use the toilet which was nearby but not clearly identifiable. A relative commented, “There are lots of wanderers. Some come in and eat all [person’s] biscuits. Men wandering and ladies’ doors being open worry me.”

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. The manager gave examples where they had advocated for people at risk of barriers to care. People were supported by different teams of professionals when needed. Visiting health care professionals provided positive feedback about the support people received. Comments included, “They (staff) are able to recognise and deal with many challenging scenarios which of course come up not infrequently when dealing with an elderly and frail population often with mental health issues.” Another told us in detail how staff had understood their service and instructions they provided, they concluded, “Overall, the nursing home have been responsive to the advice provided by the [health] service. Our input is ongoing currently.”

People were not always 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. End of life care plans were not always in place to capture people’s wishes for the future. Staff responded to people’s changing needs and adapted their support accordingly. However, holistic preferences had not been obtained. Relatives told us they had some involvement but they were for practical arrangements. Some relatives commented, “[Person] has a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) in place, my children and myself agreed that [person] should not go into hospital but live out the rest of their days there.” And, “We have an advanced directive in place, no intervention. Discussed with [family member], staff and the GP.”