Archived: Belmont

Belmont is a care home providing accommodation and personal care for up to 49 people aged 65 and over. At the time of the inspection there were 39 people using the service.

People’s experience of using this service and what we found

People did not always receive their medicines as prescribed and in line with best practice guidance to improve their conditions or symptoms. Not all staff had received training in the handling of medicines. People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise, respond and report concerns. Allegations of abuse had been dealt with in a robust manner to assure people about their safety. People and their relatives told us they were safe. People and their relatives gave us mixed feedback regarding staffing levels at the home. The registered manager had robust and safe recruitment procedures and monitored the safety of the premises.

Staff supported people with meaningful day time activities inside the home and in the local community. People's individual communication needs had been assessed and staff had tools to assist their interactions with people. The registered manager dealt with people's concerns and complaints appropriately.

People told us their care and support had not always been planned in partnership with them and their relatives. Staff had received regular training. Improvements were required to ensure all staff were trained in the safe handling of medicines and received supervision in line with best practice guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

People were positive about the service and said staff were kind and caring. People were treated with dignity and respect and their right to privacy was upheld. People were comfortable in the company of staff.

The governance and quality checks in the home did not consistently promote safe management of medicines. People, their relatives and staff spoke positively about the registered manager. The registered manager and the provider needed to improve the quality monitoring systems to ensure they were robust.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (16 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement:

We have identified breaches in relation to the management of medicines and lack of effective quality monitoring systems at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Belmont is situated in a rural location on the outskirts of Longridge. The service is registered to provide personal care and accommodation for a maximum of 49 people. Accommodation is provided in 46 bedrooms with en suite facilities. The home is a single storey building divided into four units, each with its own lounge, dining room and kitchen. There are two other large communal rooms mainly used for activities and social functions, and outdoor areas people can use. At the time of the inspection 41 people lived at the service.

At the last inspection on 17 April 2015, the service was rated ‘Good’. At this inspection we found the service remained Good.

People had received their medicines as prescribed and staff had been trained in the safe management of medicines. We found areas that required improvement in the medication storage. The registered manager took immediate action to make the required improvements during the inspection. Medicines were stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans had been put in place to ensure people’s health and well-being were maintained.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People’s consent to various aspects of their care was considered and where required DoLS authorisations had been sought from the local authority. However, improvements were required in relation to staff knowledge and understanding of mental capacity.

Staff had received regular training and supervision to ensure they were supported in their role.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty. Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. However people who received support, or where appropriate their relatives, were not adequately involved in reviewing their care records. The registered manager had identified this before our inspection through their audits. People’s independence was promoted.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “The food is very good, I get a choice and I get enough.” We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to participate in activities of their choice and a range of activities that had been organised. We observed the activities coordinator engaging people and offering a range of activities. People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of care at Belmont. These included, regular internal audits of the service, surveys for residents, staff and resident meetings to seek the views of people about the quality of care being provided. We found improvements were required to ensure that issues and concerns identified in audits were overseen by the registered manager and action plans were signed to demonstrate that the remedial work had been undertaken and completed by those responsible.

People were provided with a good diet that catered for their needs. 'I like my food, its good and I can have what I want'. Meals served were homemade and the menus showed meals were varied and nutritionally balanced.

We observed people living in the home were comfortable around staff and showed no signs of fearful or concerning behaviour. Staff communicated well and appropriately with the most vulnerable people, such as people with dementia. Staff were trained to safeguard people and they understood their duty of care to protect people using the service from harm.

People were cared for by staff who had been recruited properly and were of proven good character.

People were given good opportunities to give their views as to whether the service and accommodation provided met with their needs and expectations. High standards of quality monitoring were carried out to ensure people's health welfare and safety.

We found family members were happy with the care of their relation. One person wrote 'I can't describe to you what it is like to be separated from the person you have loved and cherished for over 60 years. However I am greatly comforted by the knowing that . Is in safe hands and that you do all in your power to make her happy and comfortable. Thank you and God bless'.

There were no rules imposed on people or any institutional practices observed. Staff were trained to protect people and recruitment practices were safe in ensuring people employed were of proven good character. People knew the complaints procedure.