Archived: Belmont House Care Home Ltd

Belmont House Care Home Limited is registered to provide residential care for up to nine people with mental health needs. At the time of the inspection there were nine people living at the service. The service had a registered manager. 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.

People told us they were happy with the service and we saw staff were kind and caring.

We could see from records that staff recruitment was safe. References were in place and Disclosure and Barring Service checks had taken place prior to people being employed. This meant staff were considered safe to work with vulnerable adults.

There were improvements in the way that medicines were managed since the last inspection, but the systems in use were not effective in reconciling all stocks with records.

Staff were able to tell us what they would do if they had any concerns about safeguarding adults from abuse, and there were policies and procedures in place.

Staff told us they were supported well and we saw evidence of staff supervision. Staff were undertaking refresher training at the time of the inspection.

Care plans were comprehensive and covered a broad range of needs and the majority of risk assessments provided advice to staff on how to manage risks identified.

At this inspection the service was clean throughout and food was sealed and labelled appropriately. There was a programme of decorating underway and a health and social care professional told us the lighting at the service had been improved recently.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. We found the service was working within the principles of the MCA. At the last inspection we had noted the registered manager had not obtained consent to lock the front door from people at liberty to leave the service. The registered manager had undertaken to obtain consent. This had not been obtained at the time of this inspection but had been obtained at the time of writing this report.

Since the last inspection improvements have been made in relation to the management of the service, and so is no longer in breach of the regulation in relation to the governance of the service. For example, there were audits taking place to check the environment for both damage and cleanliness, and medicines management had improved. However, there were areas in which the management of the service required improvement. The registered manager was aware of this and had recruited additional management support to assist her.

We have made recommendations in relation to staff training, leisure activities and consideration of a safe smoking environment.

Belmont House Care Home Limited is registered to provide residential care for up to nine people with mental health needs. At the time of the inspection there were eight people living at the service. The service had a registered manager. 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 the service was in need of a deep clean and the systems for infection control were not effective. The provider did undertake some quality audits but these did not cover all the relevant areas to ensure the service was consistently good.

Employment references were not verified for one person prior to them starting work. Other checks were completed to ensure staff were considered safe to work with vulnerable adults.

We saw staff were kind to people living at the service and the majority of people living there confirmed this.

Staff were able to tell us what they would do if they had any concerns about safeguarding adults from abuse, and there were policies and procedures in place.

We found there was a discrepancy between records and actual medicines so not all medicines could be accounted for, and records of temperatures had not been kept so the service could not confirm medicines were stored at a safe temperature for use.

Care plans were personalised and detailed and individual needs and preferences were recorded. Risk assessments were in place and up to date for all but one person who had recently moved into the service.

Staff told us they were supported well and we saw evidence of regular staff supervision. Relevant training had been undertaken.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. We found the service was working within the principles of the MCA but needed to obtain consent for a locked front door at the scheme from those not subject to restriction under the legislation.

We found three breaches, in relation to the safe care of people including the management of medicines and infection control, with ensuring the people living at the service are treated with dignity and respect and in relation to the governance of the service

We have made a recommendation in relation to verification of staff recruitment references.

You can see what action we told the provider to take at the back of the full version of the report.

We set compliance actions requiring the provider to take steps to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

We made a further visit on 4 November 2013 to check on the action the provider had taken to meet the requirements of the regulation. We found that the provider had ensured people's records were accurate and fit for purpose. The provider kept records of staff training and the staff rota had been accurately maintained. This meant that the provider had taken sufficient action to meet the requirements of the regulation.

We also spoke with three staff members and the registered manager for the home, and looked at four people's care records. People told us that staff listened to them, provided them with the support that they needed, and encouraged them to maintain their independence skills. However there was room for improvement in the variety of activities available to people both within and outside of the home.

The home environment was clean and well maintained. Quality assurance systems were in place for the home, although these needed further development. Staff told us that they received appropriate support, training and supervision to ensure that they delivered care and treatment safely and to an appropriate standard.

There were insufficiently current and accurate records in place to protect people from the risk of unsafe or inappropriate care.

At the previous inspection, whilst staff said there was a system for supervising and appraising staff very limited records were available to confirm this was taking place.

At our request the provider sent us a range of records to confirm that individual supervision sessions and performance appraisal sessions were taking place. People living at the home were better protected against the risks of unsafe or inappropriate care arising from the lack of proper records in relation to people employed at the home and their management.