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 requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

We observed staff provided person-centred care to people, people’s care records had been improved and included what was important to them and how they wanted their support to be delivered. People’s ‘This is me’ documents had improved which gave unfamiliar staff a better understanding of who they were and their backgrounds.

People’s bedrooms were more homely; staff had gone to efforts to obtain people’s personal items and decorated bedrooms to taste. A relative said, “After the previous inspection a family meeting was held. We completed a form about décor, colours, pictures, food etc. They have honoured that. It (person’s bedroom) is much more personalised than before. [Person] has artefacts and portraits in their room that they would want.” We reviewed a sample of the form and it was a comprehensive list to capture a variety of people’s preferences and wishes. The answers were practically applied and included into care plans.
 

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.

Staff had received further training and mentoring to support them to provide care to people, this included further learning in dementia care. Staff confidently assisted people who displayed emotions and considered why people may not want to remain seated; they checked people for unmet needs and ensured people had opportunities to do as they wished. For example, a person liked to walk around the service at a faster pace, staff supported them to do this safely by making sure the person’s pathway was not obstructed and making sure others were safe whilst the person completed their walk.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

All policies and procedures had been updated to ensure people and their relatives knew their rights including how to make complaints within the service, safeguarding and the MCA. The registered manager showed us examples of how they were working towards creating ‘easy to read’ versions of all relevant policies.

The registered manager walked around the service at least once a day to visit people and ensure they were informed about any happenings for the day or changes within the service.
Signage and notice boards were updated, for example, the ‘champion board’ included photographs of staff and what their lead role was in the service. This meant people would know, for example, which staff was overseeing cleaning and cleanliness.
 

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.

The complaints policy now included details such as timeframes of responding to complaints and where people can escalate unresolved concerns to external bodies. The registered manager kept a log of suggestions, concerns and complaints, the log included investigations and resolutions. Relatives told us their complaints were addressed in a timely way. One said, “I’ve no complaints in the last 6 months. I’m definitely listened to. They started to make sure [person] was taken more to the day room and can see other people.”

The registered manager remained visible within the service, people knew them and told us they were confident to speak with them or other staff if they had any concerns. A person said, “I think [registered manager] would listen, they are approachable. I haven't needed to sit down with them with a problem. I haven't needed to test this with [registered manager].”

Alongside complaints and suggestions, we reviewed multiple compliments to the staff team for their care and support.
 

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

Changes had been made to the environment to support people to move around the service as they wished. Improved signage included people’s names and photographs on their bedroom doors to help them find their rooms and avoid accidently going into other people’s spaces.
Doors to other rooms, such as, the toilets and bathrooms had visual prompts to help people access them.

The garden was accessible with a ramp and seating for people and there was clear signposting for the ‘hydration station’ area and offices. The registered manager shared plans of converting an unused space into a cinema room.
 

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.

People were supported to access health and social care by staff and managers. Staff followed treatment plans and monitored people’s outcomes. Where people did not experience positive outcomes, staff contacted professionals in a timely way to review treatment plans. The registered manager continued to advocate for people who were at risk of barriers to care. For example, a person experienced an improvement in their health and were due to return home, the registered manager was liaising with other professionals to ensure this was done safely for the person. They said they were ensuring the incoming home care provider has a good understanding of the person’s complexities to promote a smooth transition back home.

The registered manager provided examples where they had arranged professional involvement to improve people’s outcomes. They said, “Wheelchairs services have a customised chair for [person] and a sleep system which increases their comfort level. We have seen a difference in [person] sleeping comfortably and sitting out. They are coming to the lounge mid-morning, spends some hours there, has supper then goes back to their room. It’s their choice.”
 

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.

End of life care plans now captured people’s future wishes, they included clinical needs and how the person would be cared for emotionally and spiritually. Further equipment had been provided for nurses enabling them to respond to urgent needs, the registered manager had training in place to support learning and safe use of the equipment and holistic approaches.

Where clinically appropriate, people had Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions documented. Where people were for attempted cardiopulmonary resuscitation, this was clearly recorded and communicated to staff and relevant healthcare professionals.