Archived: Belgravia Care

Belgravia Care is registered to provide care for up to 25 older people, people living with dementia, mental health or physical disabilities. The home is situated on the promenade at North Shore, Blackpool. There are bedrooms on all floors. There are choices of communal lounges and dining areas. There were 25 people who lived at Belgravia Care when we inspected.

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

People and their relatives told us they felt they were cared for safely by the staff team. However, this did not reflect our findings in relation to infection control and cleanliness of the home.

The management team had assessed risks to minimise the likelihood and spread of infection and in relation to COVID-19. However, the home was not clean or hygienic, which increased the risk of infection and was unpleasant for people. Infection control was not of a safe standard for reducing and managing the risk of infection outbreaks. The registered manager and provider had carried out infection control audits but had not identified the issues we found.

The home was not always well-led, and governance was not always effective. Although the registered manager carried out audits, the system for auditing and monitoring the service did not always identify issues of concern. After the inspection, the provider arranged a deep clean of the home, routine cleaning was increased, additional cleaning staff were employed and audits were improved upon.

People’s care records were personalised and informative. People’s care and support was assessed which helped people to manage or avoid preventable risks. We received positive feedback from people supported about the home. They told us they felt the registered manager and staff team involved and informed them about their care and any changes in the home.

Staff recruitment procedures were robust, and staff received regular training to help them provide the skills needed to give people good care.

Staff spoken with demonstrated an understanding about how to safeguard people from the risk of abuse. Staff supported people with their medicines safely and the registered manager audited medicines regularly.

After the inspection, the provider arranged a deep clean of the home, routine cleaning was increased, and infection control practice improved.

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 last report (8 November 2018).

Why we inspected

We received concerns in relation to care practice, infection control and management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The provider began to take action shortly after the inspection to mitigate the risks identified. This has made the home safer than it was on inspection. The provider arranged a deep clean of the home which improved infection control. They also increased cleaning staff and improved monitored of the environment.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Belgravia Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to keeping the home clean and hygienic and, monitoring that this is carried out, at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the time of the inspection 23 people lived at the home.

The inspection visit took place on 11 October 2018 and was unannounced.

There had been a change of registered manager since the last inspection. The new manager had started the process of applying to CQC to become registered. 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.

Until shortly before the inspection the service had provided care for several service user bands including people with learning disabilities. However, in reflecting on Registering the Right Support and other best practice guidance, the providers had felt the service they provided did not fit with this philosophy. They stated they would no longer admit people with learning disabilities to the home and modified their statement of purpose to reflect this change.

There were sufficient staffing levels in place for the people supported when we inspected. However, the service had applied to CQC to increase the numbers of people supported from 23 to 25 and accommodation would be provided over five floors. To make sure staffing was sufficient to meet people’s dependency needs and support people throughout the building, we made a recommendation that staffing be kept under review so people remained safe.

People told us they felt safe and looked after by staff. We observed interactions between staff and people. These were positive friendly and supportive. There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments had been developed to minimise the potential risk of harm to people. These had been kept under review and were personalised to meet people’s needs.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed.

Care plans were in place detailing how people wished to be supported. The staff team used electronic care records these were in the main informative and personalised. However, a small amount of information generated by the system was either generalised or conflicted with the personalised information staff had recorded. There was a mix of views from people about their level of involvement in care plans. Although they said they had been involved in making decisions about their care. The new manager said she would encourage people to be more involved with reviewing their care planning.

Staff had been recruited safely and received training to develop their skills and knowledge. They also received regular one to one supervision to discuss, current care provided, future plans and any support or training need. These measures assisted them to provide safe and effective support.

We saw people had access to healthcare professionals. People told us staff cared for them in the way they wanted and met their care needs promptly. They referred them to healthcare professionals in a timely way. We saw and people told us staff provided care in a way that respected peoples’ dignity, privacy and independence.

We saw staff were attentive to people’s needs and wellbeing and responded promptly to requests for assistance. They provided care in a personalised way, taking people’s preferences into account. One person told us, “The staff are all very friendly here. They are very helpful.” Staff were aware the importance of upholding people’s rights and diverse needs and treated people with respect and care.

People told us they enjoyed a variety of social and leisure activities and staff were welcoming to their families and friends.

People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The home had started using a specialist food provider shortly before the inspection. People told us they enjoyed the food provided and had choice and variety. We observed the lunchtime meal. People received sufficient food and drink and the assistance they needed. The kitchen was clean, organised and staff were trained in food safety.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. The design of the building and facilities in the home were appropriate for the care and support provided. We found equipment had been serviced and maintained as required.

There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when providing personal care to people so they did not risk causing cross infection.

The management team sought people's views in a variety of ways. They assessed and monitored the quality of the service through audits, resident and staff meetings. People told us the management team were approachable and willing to listen. They knew who to complain to if they were not satisfied with their care and felt appropriate action would be taken. People also had information about support from an external advocate should this be required.

Further information is in the detailed findings below.