Some of the people who lived at Belamacanda had complex needs but most were able to speak with us. We spoke with people who used the service on the day of our inspection. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the home and with staff. We also spoke with staff members. We looked at four people's care records. Other records viewed included staff rotas, training and supervision records, health and safety checks, staff and resident meeting minutes, medication records and records which related to the quality assurance of the service. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Where applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.
People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.
We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.
Is the service effective?
People told us that they felt that they were provided with a service that met their needs. People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.
We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.
Is the service caring?
We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff treated people with respect.
Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.
People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People could therefore be assured that complaints are investigated and action is taken as necessary.
People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.
People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.
The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.