Belmont House Care Home

Updated 15 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Belmont House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Belmont House Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day and announced on the second and third day.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke 9 staff including the regional director, registered manager, deputy manager and 6 care staff. We spoke with 17 people living at the service and three relatives. We reviewed 12 medication administration records (MAR) and seven care plans. We reviewed evidence following the inspection including audits and policies.

Updated 15 October 2022

About the service

Belmont House Care Home is a residential care home providing personal and nursing care to up to 106 people. The service provides support to both older people and younger adults, some of whom are living with dementia. At the time of our inspection there were people 69 people using the service.

Belmont House Care home is a large purpose-built home split across five separate units. One of these units had recently been refurbished but was not in use at the time of the inspection. Two of the units specialise in supporting people living with dementia.

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

Care records did not always provide enough guidance for staff around how to deal with people’s known needs or behaviours. Records to monitor and document care provided, and the related risks, were not always completed.

Feedback about staffing levels in the service was varied and improvements had been made to staffing with a reduction in the use of agency staff over recent months. However, people still felt they needed more staff to assist them and run activities in the service. The registered manager was actively trying to recruit more staff. There is a continued recommendation about the review of staffing levels and deployment within the service.

Audits and checks were in place to ensure the safety and quality of the service. However, these were not effectively embedded and had therefore not highlighted issues we found on inspection.

Staff had a good understanding of safeguarding and action was taken to mitigate risk.

The environment was clean, well maintained and safe for the people living there. Regular checks were completed to ensure the premises were safe and staff carried out regular fire drills and evacuations.

Feedback about the registered manager and leaders in the service was positive and people felt supported. Staff had a positive approach towards their work and the people they supported, they had a strong desire to improve the quality of the service they provided.

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.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 December 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvement had been made but the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of 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 COVID-19 and other infection outbreaks effectively.

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

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to records and governance at this inspection and have made recommendations around staffing levels and deployment.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.