Belleview

Belleview is a supported living service providing personal and nursing care to 19 people with learning disabilities or mental health support needs at the time of the inspection. The service consists of a main building with individual bedrooms and communal facilities, in addition to two self-contained bungalows on the same site. Staff facilities including the supported living office are contained within the main building.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The provider had made improvements since the last inspection, where we found medicines were not always managed safely. At this inspection we found people received their medicines as prescribed. Accurate and up to date records were kept to help ensure this. However, one person had some tablets that had passed their expiry date. The registered manager agreed to put checks in place to avoid this happening in future.

Other aspects of the service remained safe. Risks were managed appropriately, including safeguarding people from abuse. Systems were in place to record and learn lessons from accidents and incidents. There were enough suitable staff to care for people safely. Staff followed appropriate guidance to prevent the spread of infection.

People’s needs were assessed in line with current research and guidance. Staff gave people the support they needed to eat and drink enough and to meet their healthcare needs, working with other professionals when required. Staff received appropriate support to do their jobs well. 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; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People received support from staff who were kind, respectful and empathetic. People were involved in decisions about their care and were enabled to express their views about the care they received. Staff promoted people’s privacy and dignity.

People received care that was personalised, met their care needs and took into account their preferences and equality characteristics such as culture and religion. Staff regularly supported people to review their care plans to make sure they remained up to date. People received the information they needed about their care and support. There were opportunities for people to engage in meaningful activities both inside and outside the service. The provider supported people to make plans for end of life care in case they should require this while using the service. The provider responded appropriately to people’s concerns and complaints.

The service had consistent leadership and a person-centred culture. People felt their voices mattered and they were consulted as part of quality assurance. People and staff felt the registered manager was approachable, open and honest. Staff worked well as a team and the provider used a range of checks and audits to monitor service quality and continually improve the service.

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 (published 21 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

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.

Overall, we found people using the service received safe care and support from suitably trained and experienced members of staff. We saw staff respected people’s privacy and dignity. We also saw the provider had taken reasonable steps to ensure people lived in a relatively comfortable and adequately maintained environment.

However, although most people told us they were happy at Belleview; the provider may wish to note that people were not always given enough support to enable them to be as independent as they could, such as self-medicating safely. Furthermore, while we found that people’s needs were assessed; the provider may also wish to note that staff were not always provided with enough detailed guidance about how to support people with managing the risks they might face. This meant people might be placed at unnecessary risk of harm and/or abuse.

We also found that staff treated people who used the service with the utmost respect and dignity and were adequately trained to understand and meet the needs of the people they supported.