Belle Vue Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At the last inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider and registered manager monitored and analysed accident, incident and safeguarding records to identify any trends or lessons learned and communicated those with staff.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff supported people to complete and maintain care passports and emergency admission packs to share crucial information with other services in the event of a person being transferred, for example, to hospital. These contained details about people’s care and support needs as well as things that were important to them and their personal preferences, likes and dislikes. They were regularly reviewed to ensure they remained up to date.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had received up to date safeguarding training and knew how to report any incidents. A staff member said, “Safeguarding is a big part of our processes. If a resident needs safeguarding, I will raise this concern to the nurse on duty.”

Deprivation of Liberty Safeguards (DoLS) had been applied for in a timely way, and any conditions were appropriately added to people’s individual care plans. The registered manager recorded and reviewed them regularly.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff assessed and managed risks to people’s health, safety and wellbeing effectively and these were detailed in people’s care records. A relative told us, “The carers are all very lovely. I am happy [Person] is safe; I feel they are doing a better job of looking after him than I ever could and are with him all the time. He is eating and drinking well now. He was on supplements, but he has gained enough weight so is off them for the moment.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

There were environmental risk assessments in place including fire, and regular checks and testing of the premises and equipment. People had personal emergency evacuation plans reflecting their needs and a grab bag was up to date and accessible to staff in the event of an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were visible and call bells were answered quickly. People and relatives felt there were enough staff to meet people’s needs. A person told us, “The care is very good, and I feel safe. The staff are good, and I think there are enough of them; they are always floating around.”

Staff were recruited in a safe way and records confirmed staff had received up to date training, regular supervisions and annual appraisals.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff followed the required infection control guidelines and wore appropriate PPE when supporting people.

The home was clean, tidy and free from odour and domestic staff were visible on each floor. A relative told us, “The home is clean and tidy and there are no odours. [Person] is always clean and neatly dressed.”

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did not always involve people in planning.

Medicines management systems were in place but were not always consistently followed, and oversight was not sufficiently robust. As a result, we could not be assured that improvements would be sustained. Following feedback at the inspection, governance and medicines oversight arrangements have been strengthened. Medicines were stored securely, but access to the medicines room was not restricted to authorised staff only. Access arrangements have since been reviewed to restrict entry to authorised staff only.

At our inspection we found there were significant stock levels for some medicines including insulin, topicals (creams), thickeners and nutritional supplements in the treatment room. We could not be assured the ordering system was effective for these items. The provider addressed these concerns by removing inappropriate medicine stock, updating protocols and strengthening arrangements for residents who require prescribed thickeners.

Oxygen was not stored inline with guidance; however,the provider took steps to address this following our inspection.

Records were not always clear relating to people who received thickened drinks to prevent choking, or the amount of fluids people had consumed in line with any target amounts. Following our inspection the provider confirmed the people who received thickened fluids and that each person had up to date care plans and Speech and Language Therapy (SALT) involvement in their care. IDDSI levels were accurately recorded, and staff have since demonstrated appropriate training and competence in preparing and administering thickened fluids.

Although some inconsistencies were identified in how PEG care was recorded,all required feeds and flushes were administered and documented across relevant systems. Since then, documentation has been reviewed, centralised, and strengthened to improve clarity and consistency.