Belong Morris Feinmann

We found the following examples of good practice.

¿ Staff were allocated to a particular household to reduce movement around the home.

¿ The home was very clean, with domestic staff also allocated to individual households. There had been increased cleaning of ‘touch points’, for example door handles.

¿ Clear policies and procedures were in place for all visitors. Visitors had to have a lateral flow COVID-19 test prior to their visit. A visitors pod had been set up in the large ground floor bistro area, with a screen used to reduce the risk of infection.

¿ Activity co-ordinators supported people on one household each day. A large ‘venue’ room was used for activities, providing people with a ‘day out’ by going off their own household.

¿ People were supported to self isolate when they moved to the home or returned from hospital. Where this was not possible, for example if a person walked with purpose, an additional member of staff was allocated to support them and complete additional cleaning of areas they had touched when mobilising.

¿ Staff said they felt well supported by the management team and were given all the information they needed if guidelines changed.

¿ The home said they were well supported by medical professionals, the infection control team and local authority.

Belong Morris Feinmann is jointly registered as a ‘care home’ (known as the care village) and a domiciliary care agency (known as Belong at Home).

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Belong Morris Feinmann is a purpose-built care village. It can accommodate 74 people across six households on three floors, each of which have separate adapted facilities. At the time of our inspection three households were open, with a total of 33 people living at the care village. Each household had a mix of people who needed nursing care and those who needed residential support.

The care village also contains a bistro on the ground floor, a synagogue, ‘The Venue’ which is used for events and a small gym, all of which can be used by the local community. The gym contained ‘Silverfit’ technology which is specifically designed for older people. On the top floor are 13 separate apartments, which are privately owned or rented.

Belong at Home provides personal care to people living in their own houses and flats in the community. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. Three people were being supported by Belong at Home at the time of our inspection.

This report covers both the care village and Belong at Home.

Two registered managers were in place at the service, one for the care village and one for Belong at Home. 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.

At the time of our inspection Belong Morris Feinmann were in the process of separating the care village and Belong at Home so they each had an individual CQC registration in future.

People and their relatives thought they were safe living at Belong Morris Feinmann and being supported by members of Belong at Home care staff. The staff said they enjoyed working for the service and felt very well supported by the registered managers, lead nurse and lead seniors.

People received their medicines as prescribed. The care village used an electronic medicine administration record (eMAR) system which prompted when medication was to be administered. Medication care plans gave guidance for when any medicines that were not routinely administered should be offered to people.

Belong at Home used paper MARs, which had been fully completed.

Person centred care plans and risk assessments were in place. These provided guidance and information about people’s support needs, their likes, dislikes and preferences and how to mitigate the identified risks.

The care village used an electronic care planning system called PCS. Staff were able to access people’s care plans and record the support provided through hand-held devices. The PCS system alerted staff when planned care tasks was required, for example if a person needed re-positioning. Where people might have behaviour that challenges, care plans gave details of potential triggers and behaviours. Two plans we saw gave guidance on how staff should support the person if they became agitated; however, a third plan did not provide full guidance for staff.

Belong at Home used paper care plans, which clearly identified the care and support tasks to be completed when staff visited. Staff wrote daily notes about the care and support provided.

Staff we spoke with knew people and their needs well. Staff said they received information about people’s support needs before they moved to the care village or they made their first home visit.

Care files were reviewed each month in the care village. Belong at Home reviewed care plans after 6 weeks of the service starting and then every six months or after an incident or accident. People and their families were involved in these reviews.

People were supported with their health and nutritional needs in the care village and Belong at Home service.

A GP held a surgery at the care village three weeks out of every four. This meant people had access to a GP on site for minor ailments with a view to prevent any illness becoming more serious. Additional GP appointments were arranged if people needed them. The GP was positive about the support provided at Belong Morris Feinmann.

Staff, people and relatives thought there were sufficient staff on duty to meet people’s assessed needs. At night there was one member of staff for each household and two staff floating between the three households. Staff told us they were always able to ring for assistance if a person needed two staff to support them. The day staff were on duty until 10pm and so could support people to go to bed if they wanted to before the night staff started their shift.

People told us Belong at Home staff were punctual and there were no missed calls.

The Belong Morris Feinmann care village supports people from the Jewish community. Staff received training on the Jewish culture during their induction. All the food prepared by the care village was kosher, with meat and milky meals kept separate. People and their families were advised they should only bring kosher food into the care village. Relatives told us they were able to bring their relatives the food they liked and staff did not ask to check it. The registered manager said that people were encouraged to only bring kosher food to the care village; however, if they were discrete and kept the food in their own rooms then the care village would not remove it.

The care village followed the Jewish calendar and celebrated the Jewish festivals. There was a synagogue on site which held monthly services, which were also open to the local community.

Most people told us the food was not very good and they did not have enough culturally appropriate dishes. A residents committee had been set up to advise on changes to the menu. Following the inspection, the general manager told us an external Jewish catering company had been engaged to improve the quality and range of food provided.

Belong at Home care plans detailed any support a person may need to follow their faith.

People living in the care village had advanced care plans in place detailing their wishes in the event of their death. This included, where people wanted, a named Rabbi who would provide emotional support at the end of a person’s life and ensure the person’s body was treated according to Jewish tradition.

The care village was working within the principles of the Mental Capacity Act (2005). A capacity assessment tool was used and applications made for a Deprivation of Liberty Safeguard (DoLS) if a person lacked capacity to consent to their living arrangements. At the time of our inspection all the people using Belong at Home service had capacity to agree to their care and support. A capacity assessment tool was available to be used when required.

A safe recruitment process was in place. Staff had completed an induction programme when they joined Belong Morris Feinmann and also received refresher training on an annual basis. Clinical training was organised by the lead nurse.

Staff had regular supervisions and staff meetings were held. Both were open discussions with staff saying they were able to raise ideas or concerns during these meetings.

Residents and relatives meeting were held and a survey had been completed with the majority of responses being positive. Where comments had been raised in the survey the registered manager had followed these up directly with the person concerned.

Belong Morris Feinmann had a complaints policy in place. We saw all issues raised had been looked into and responses provided to address the issues raised.

A full activities programme was in place in the care village, which included trips out, a gardening club and arts and crafts. A social committee comprising of local volunteers arranged weekly events such as talks, bridge and a coffee morning, which were also open to people in the local community. Each person had an exercise care plan in place and had access to a trained exercise instructor and the on-site gym.

The service was seen to clean and well maintained throughout.

Both the care village and Belong at Home had a quality assurance system in place. Incidents and accidents were monitored to identify if there were any patterns or trends. The care village had monthly clinical meetings to monitor a range of areas across the service.