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Inspection Summary


Overall summary & rating

Good

Updated 18 August 2017

We undertook an announced inspection on 25 July 2017. At our previous inspection on 30 April 2015 the service was rated ‘good’ overall and in the key questions; ‘Is the service safe?’, ‘Is the service caring?’, ‘Is the service responsive?’ and ‘Is the service well-led?’. They were rated ‘outstanding’ for the key question ‘Is the service effective?’.

Belleview provides a supported living service to up to 26 people across a main house and three bungalows. At the time of our inspection 21 people were using the service. The service supported people with mental health needs, learning disabilities or both.

Since our previous inspection a new registered manager had been appointed. The new manager was registered on 4 January 2016. 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.

We found that whilst people received their medicines as prescribed, safe medicines management practices were not consistently followed. Accurate stocks were not always undertaken and accurate records of medicines administered were not always maintained. We recommend the provider consults national guidance on safe medicines management.

There were sufficient staff to meet people’s needs and safe recruitment practices were maintained. Staff adhered to safeguarding adults procedures and raised any concerns about a person’s safety with the registered manager. Risks to people’s safety were regularly reviewed and risk management plans were in place.

Staff had the knowledge and skills to undertake their role and attended regular refresher training courses. Staff supported and encouraged people to attend healthcare appointments, in relation to their physical and mental health. There continued to be ongoing liaison with the community mental health team in regards to people’s mental health needs. Staff continued to support people in line with the Mental Capacity Act 2005 and provided any support required with people’s nutritional needs.

There continued to be trusting relationships between staff and people. Staff respected people’s decisions and enabled them to make choices regarding their care and how they spent their time. Staff respected people’s privacy and maintained their dignity. Staff encouraged and supported people to maintain friendships and relationships with family members.

Staff sessions had been introduced to review people’s care. This included discussing in detail a person’s diagnosis and medicines, and how this may affect their behaviour. The provider had started to deliver mindfulness sessions to provide people with additional tools and techniques to manage their mental health. The provider supported people to develop their skills, including offering paid employment to some people. Care plans were detailed and regularly updated providing staff with information about people’s support needs. Complaints continued to be taken seriously and managed appropriately.

Systems continued to be in place to review the quality of service delivery and action plans were developed to encourage continuous improvement and ensure accurate records were maintained of all areas of service delivery. Mechanisms were in place to obtain feedback from people, relatives, staff and visiting professionals. The registered manager adhered to the requirements of their registration with the Care Quality Commission.

Inspection areas

Safe

Requires improvement

Updated 18 August 2017

Some areas of the service were not safe. Improvements were required to ensure accurate records were maintained of all medicines administered and in regards to stock checks. We recommend the provider consults national guidance on safe medicines management and administration.

There were sufficient staff to meet people’s needs. Staff safeguarded people from harm and were aware of historic and current risks to people’s safety.

Effective

Good

Updated 18 August 2017

The service was effective. Staff continued to receive training to ensure they had the knowledge and skills to support people. Staff adhered to the Mental Capacity Act 2005. Staff supported people to have their health needs met and liaised with community mental health professionals. Staff provided people with information about healthy eating and provided any support required with meals.

Caring

Good

Updated 18 August 2017

The service was caring. Staff had a trusting and respectful relationship with people. Staff empowered people to make their own decisions. Staff respected people’s privacy and did not enter their rooms without their permission.

Responsive

Good

Updated 18 August 2017

The service was responsive. Staff met to discuss people’s needs and identify how their diagnoses and medicines may affect their behaviour so staff knew how to support them. The provider delivered mindfulness sessions to provide people with tools and techniques to destress and manage any anxieties. Staff linked with other organisations to provide people with additional information about how to self-manage different health diagnoses. Staff supported people to develop their skills to help with education and employment.

Complaints were listened to, investigated and dealt with, as much as possible to the satisfaction of the complainant.

Well-led

Good

Updated 18 August 2017

The service was well-led. The provider had systems in place to review the quality of service provision. There were mechanisms in place to obtain feedback from people, relatives, staff and visiting professionals. Staff felt supported and empowered to make suggestions to improve service delivery and these were listened to by the registered manager and provider.