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Archived: Bellus Lodge Inadequate

Reports


Inspection carried out on 28 February 2017

During a routine inspection

The inspection took place on 29 February 2017 and was announced. The inspection continued on 2 March 2017.

We carried out an announced comprehensive inspection of this service on 5 April and 6 April 2016. After that inspection we received concerns in relation to the care and support of people and management of the home. As a result we undertook another comprehensive inspection.

Bellus Lodge provides accommodation and personal care to people with learning disabilities and behaviour support needs. It is registered for up to six people. At the time of our inspection there were six people living there. There were two bedrooms on the ground floor and four bedrooms on the first floor. There was a main kitchen and open plan living and dining area. This led into an enclosed garden and patio area.

As a condition of registration the service must have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There had been changes in the management of the home immediately prior to this inspection. The manager registered with us no longer managed the carrying on the regulated activity.

Bellus Lodge was not always a safe place for people to live. Safeguarding systems and processes in place were not established and did not operate effectively to prevent potential abuse of people.

Risks were not always managed safely. Risk assessments were not always followed appropriately and several staff told us they had not read these. We found that injuries and marks were not always recorded or reported.

People were not always receiving care from staff that were competent, skilled and experienced. There was a risk that people were receiving care from staff who had not had training to meet the needs of people with learning disabilities and complex behaviour. People were being physically restrained and administered medicines by untrained staff. People received bruising following restraint by untrained staff. This left people at risk of unsafe care and treatment because staff did not have the appropriate training and knowledge to provide effective care.

Information regarding pre-employment checks was not available to us during the inspection.

People's rights were not always protected under the Mental Capacity Act 2005 (MCA), and the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty they have been authorised by the local authority as being required to protect them from harm. Assessments had not been completed specific to the decision that needed to be made around people's capacity. DoLS applications had been submitted to the local authority.

People were not always supported effectively in relation to their nutritional needs or continued health care. Plans and guidelines were not being followed by staff. Staff confirmed that menus did not always reflect people’s food likes and dislikes. People were not always supported to access health care services appropriately.

Positive caring relationships were not always established between people who lived at Bellus Lodge and staff members working with them. We found that staff had not read people’s files and did not know everyone they supported.

Staff at the Bellus Lodge did not always treat people with dignity and respect. Care and support was not always delivered privately. There were times where people were watched and observed for periods of time throughout the day. There was evidence of lack of interaction and choices for people at the service around how their care was to be delivered.

The service was not always responsive to people’s health, social and recreational needs. Care plans and as

Inspection carried out on 5 April 2016

During a routine inspection

The inspection took place on the 5 and 6 April 2016 and was announced. Bellus Lodge provides accommodation and care for people with complex support needs. It is registered for up to six people. At the time of our inspection there were five people living there.

People have their own bedrooms and shared access to two bathrooms one of which had a sensory spa. Shared areas also included a lounge and dining room, kitchen and laundry and an enclosed garden.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had received fire training and taken part in fire drills. The house had a completed fire risk assessment and people had individual personal evacuation plans. Not all senior staff were aware of the plans. We discussed this with the manager who told us they would review this and ensure that senior staff are aware of them and where to locate them in the event of an emergency.

Risks relating to the building had been assessed. We observed people accessing all areas of the house and garden safely. Risk assessments had been completed for when people went into the community and included the level of staff support people needed. This demonstrated that people’s risks were being managed with the least restriction on their freedoms and choices.

Risks to people had been identified and assessed. Some risk assessments were in relation to behaviours people had that may place themselves or others at risk of harm. We spoke with staff who demonstrated a good understanding of the risks people lived with and any identified interventions that reduced the risk. We saw that people’s records included a safeguarding plan. This provided information about how people were protected from abuse.

Families and visiting professionals told us they felt people were safe living at Bellus Lodge. Staff had completed safeguarding training and understood how to recognise potential abuse and the actions they would need to take. A safeguarding poster was in an easy read picture format. This meant that people using the service had information about safeguarding that they could understand.

The service had enough staff to support people safely. Staff had been recruited safely. Policies and procedures were in place for managing unsafe practice.

People had their medicines stored and administered safely. Staff had received training and had their competencies checked. Some medicines were prescribed for only when people required them. Procedures were in place to ensure that people only received these medicines when all other interventions had not been successful.

Staff received induction and on-going training that provided them with the specialist skills needed to carry out their roles effectively. Staff received supervision every six to eight weeks and told us they felt supported in their roles. Appraisals had been completed and staff had opportunities for career development and further training.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the servi

Inspection carried out on 9 June 2015

During a routine inspection

Bellus Lodge opened on 18 March 2015 and this was our first inspection of the home. We carried out an unannounced inspection that included an unannounced visit to the home on 9 June 2015 and telephone interviews which concluded on 22 June 2015.

Bellus Lodge provides accommodation and care for people with complex support needs. It is registered for up to 6 people. At the time of our inspection there were three people living there.

It is a condition of the registration that Bellus Lodge has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a registered manager and we met them during our inspection.

We were unable to rate the service as it is too new for evidence in some areas to be gathered.

People were relaxed and happy when we visited and one person told us they were happy in the home and felt supported to do what they wanted.

People were supported in a person centred way by staff who were enthusiastic and committed to providing quality care. They understood their roles in relation to encouraging people’s independence and safeguarding them in respect of their vulnerabilities.

There were enough staff, however some of the staff were inexperienced in care and had not yet completed all the training the service had identified as necessary. This put people at a risk of receiving inappropriate or unsafe care. The managers had a plan in place to address the training shortfall.

Families felt that they had been involved in assessments but felt less involved now their relative was living in the home. We have made a recommendation about involving families and friends in decisions about people’s care.

Difficulties regarding communication agreements between the home and professionals were identified. These were being addressed by both parties.

The provider and staff team were developing the service and a commitment to learning and responding was clear in changes we saw made. Further developments were needed and the managers were implementing systems and structures to ensure these happened.