Belmont Grange Nursing and Residential Home

Updated 21 February 2023

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

The inspection was carried out by an 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 Grange Nursing and Residential 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 Grange Nursing and Residential 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 11 January and ended on 24 January 2023. We visited the home on 11 and 18 January 2023.

What we did before the inspection

Due to technical problems, the provider was not able to complete a Provider Information Return (PIR). A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. 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 all this information to plan our inspection.

During the inspection

We spoke with 5 people, 5 relatives, 3 visiting professionals and 8 staff, including the registered manager, deputy manager, agency nurse, senior care assistants, care assistant, kitchen staff and maintenance person. We also received written feedback from a relative.

We observed interactions between staff and people in communal areas, including at lunchtime. We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 2 staff files. A variety of records relating to the management of the service, including policies and procedures, were reviewed.

Updated 21 February 2023

About the service

Belmont Grange Nursing and Residential Home is a residential care home providing personal and nursing care to up to 30 people. The service provides support to adults and older people in one adapted building. At the time of our inspection there were 29 people using the service.

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

There was a positive culture in the home and people achieved good outcomes. People and relatives told us the service was homely and staff were very caring. Relatives spoke highly of the home, several told us they would recommend it to others. People told us they were happy with the care they received, one told us, “It’s very good care here.”

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, however records were not always fully completed. CQC had not always been notified in a timely way when the home had been granted authorisation to deprive people of their liberty. We have made a recommendation about oversight of these processes.

Safeguarding systems, policies and procedures helped protect people from avoidable harm. Staff were recruited safely. People told us they felt safe at the service. Medicines were safely managed, however there was some recent recording errors staff were working to correct. The home was clean, maintained to a high standard and safety checks were kept up to date. Risks were identified and actions taken to reduce these. People were supported by a well-trained and knowledgeable staff team. People were supported to access external health care professionals, to ensure their needs were met. Health professionals were complimentary about engagement and the responsive way staff acted to address people’s needs.

People’s nutritional needs were met, and people were given enough support with eating and drinking. Management had introduced effective systems to promote hydration. Staff promoted individual's dignity and privacy. Staff supported people in a person-centred way and knew people well, to enable them to provide individualised support. The service provided a range of activities based on people's individual needs and abilities. People were encouraged and supported to maintain relationships and community links. Some people were ‘resident representatives’ and represented other’s rights, taking part in recruitment of new staff or working with local community groups around activities.

Audit systems were in place to maintain standards in the service. People and staff told us the registered manager was helpful, approachable and dealt with concerns if raised. Staff had close links with health professionals, met with them regularly to review people’s needs and had taken part in projects, such as around improved communication. People were actively involved in developing the service and their feedback was listened to. There were various ways the service communicated and encouraged involvement, including newsletters and social media. The registered manager was proactive in seeking out initiatives for the benefit of people using 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

This service was registered with us on 18 October 2021 and this is the first inspection.

The last rating for the service under the previous provider was outstanding, published on 15 November 2019.

Why we inspected

This was a planned comprehensive inspection based on the date the service was registered.

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.

Recommendations

We have made a recommendation about the oversight of mental capacity and deprivation of liberty notifications.

Follow up

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