Background to this inspection
Updated
18 January 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 2 inspectors, a specialist nurse advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Belle Vue Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Belle Vue Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since becoming registered. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 5 people and 10 relatives of people who used the service about their experience of the care provided. We spoke with 6 members of staff including the registered manager, operations manager, care assistants, domestic staff and kitchen staff. We also spoke with 3 professionals who worked with the provider. We reviewed a range of records. This included 5 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and multiple agency staff profiles. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
18 January 2023
About the service
Belle Vue Court is a residential care home providing accommodation and personal care to up to 51 people. The three storey premises are divided into a north and south wing. At the time of our inspection there were 16 people living at the service including people living with dementia.
People’s experience of using this service and what we found
People were not protected from the risk of harm or abuse. Not all staff knew how to report or who to report safeguarding incidents too, lessons were not learnt which resulted in incidents being repeated. Safe recruitment practices were not always followed.
Medicines were not managed safely, and people did not always receive their prescribed medicines on time. Risks associated with people's healthcare needs had not always been assessed and risk reduction measures were either not in place or not followed. People were at risk of infection due to poor infection control practices. Premises and equipment were not clean or hygienic and staff were not clear on their responsibilities.
People did not always receive personalised care and people's care plans did not always contain relevant up to date information. People were referred to external professionals, but recommendations were not recorded or acted upon.
People were not engaged or offered the opportunity to participate in activities. The home was poorly decorated with empty bookshelves and lacked items of stimulation or interactions.
People and their relatives told us they were not included in care planning and that their complaints and concerns had not been acknowledge or responded to. Most relatives we spoke with were not aware of who the registered manager was.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 31 January 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels and medicine management. A decision was made for us to inspect and examine those risks.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to person centred care, staffing, safe care and treatment, safeguarding, consent to care, meeting nutritional and hydration needs, dignity and respect and governance and leadership at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.