We carried out a review of the data available to us about Belmont Lodge Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Belmont Lodge Care Centre, you can give feedback on this service.
Belmont Lodge Care Centre is a care home providing personal care and accommodation for up to 46 older people and people living with dementia. At the time of the inspection, there were 18 people using the service.
People’s experience of using this service and what we found
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. Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of people.
People had developed positive relationships with the staff, who treated them with respect and kindness. Staff supported people to make choices about their care and their views were respected. People and their relatives were involved in making decisions about their care and support.
Care plans were person centred and reflected people’s likes, dislikes and preferences. People were involved in meaningful activities. A complaints system was in place and was used effectively.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 13 January 2021) and there were two breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We carried out an unannounced comprehensive inspection of this service on 8 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
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 effective, caring and responsive which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Belmont Lodge Care Centre on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Belmont Lodge is a care home which provides personal care and support for up to 46 older people some of whom may be living with dementia. At the time of our inspection, 24 people were being supported at the service.
People’s experience of using this service and what we found
People and relatives were positive about their experience at the service. One person told us, “I feel safe here, I have been here a few years and if I didn’t feel safe, I would walk out the door.” A relative told us, “The staff are very good they are absolutely brilliant. They [staff] know [person name] really well."
Care and treatment were planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff had received appropriate training. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medication was dispensed by staff who had received training to do so.
The acting manager had good oversight of the service, they had encouraged a culture of learning and development. There were systems in place to monitor and review care and people’s experience at 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 and update: The last rating for this service was Inadequate (3 January 2020) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations in Safe or Well Led. However, Effective and Responsive were not reviewed at this inspection breaches of regulation 11(Consent) and 9 (Person centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 remain in place.
This service has been in Special Measures since 3 January 2020 during this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
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 coronavirus and other infection outbreaks effectively.
Belmont Lodge is a care home which provides personal care and support for up to 46 older people some of whom may be living with dementia. At the time of our inspection, 33 people were being supported at the service.
Risks to people's safety were not always identified and mitigated and risk assessments did not always contain accurate information to help staff manage risk. Incidents and accidents were not managed safely to prevent a reoccurrence.
Suitable systems and processes were not in place to ensure people consistently received the care they needed and had the right to expect. Robust arrangements had not been made to safeguard people from situations in which they may be at risk of experiencing abuse.
There were insufficient numbers of skilled and competent staff to keep people safe and meet their needs. The registered manager had not based staffing levels on people's needs and the type and level of support each person required throughout the day in relation to risk. The service has several lounges, sitting areas and corridors to cover throughout the service and staff were not always deployed effectively.
People's care was not always robustly assessed and reviewed to ensure it was up to date and in line with best practice. Staff were caring but did not always have the skills and knowledge to undertake their role. The provider had not always assured themselves staff were appropriately trained, experienced or competent.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Quality assurance processes were not always effective. They had not identified concerns we found during the inspection, relating to the management of behaviours
The provider had not notified CQC of all safeguarding incidents in line with legal requirements. These omissions meant CQC did not have oversight of all safeguarding allegations to make sure appropriate action had been taken.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (report published 29 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding people from abuse, staffing, consent to care, notifying of incidents and good governance.
Follow up
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service.
This will usually lead to cancellation of their registration or to varying the conditions the registration. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection was undertaken on 1 and 2 March 2017.
Belmont Lodge provides accommodation and personal care to up to 46 people. People living in the service may have care needs associated with dementia. There were 36 people living at the service on the day of our inspection.
A registered manager was in post. 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.
At this inspection we found significant improvements had been achieved across most areas of the service. However, additional work was needed to some records and evaluation arrangements to ensure ongoing progress.
There were processes in place to manage risks in the service. Staff practice and use of equipment for people was notably safer. Medicines were safely managed to ensure people received their prescribed medicines. People were supported by staff who knew them well and were available in sufficient numbers to meet people's needs effectively. Recruitment procedures were more comprehensive. Staff knew about identifying abuse and how to report it to promote people’s safety and well-being. Action had been taken as needed to ensure people were safeguarded.
Staff were more confident and had received additional training and support needed to enable them to improve their practice. One exception to this had already been identified and action was being implemented to address this. People’s dining experience was notably enhanced. People had choices of food and drinks that supported their nutritional or health care needs and their personal preferences. Arrangements were in place to support people to gain access to health professionals and services.
People overall were cared for by kind and caring staff. People’s dignity and privacy were respected and this was another area of staff practice much improved since our last inspection. Visitors were welcomed and relationships were supported.
People had opportunity to participate in their care planning and to have input into the way their care was provided. People were supported to participate in social activities of their choice. People felt able to raise any complaints and felt that the provider would listen to them. Information to help them to make a complaint was readily available.
Staff morale was higher and staff worked as a team to provide care in a friendly and calm environment. The provider had used their staff performance systems to effect positive changes in staff culture and responsibility.
Systems were in place to offer people ways of expressing their views and influencing their everyday experience of the service. The provider had listened to people’s views and ensured that actions were taken in response to people’s comments.
There was clearer leadership and accountability in the service. The registered manager, with the support of the provider, had worked to stabilise the service and implement positive changes.
Belmont Lodge is registered to provide accommodation with personal care to up to 46 older people. People may also have needs associated with dementia. There were 40 people receiving a service at the time of our inspection.
A registered manager was in post. 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.
At our inspection of August and September 2015 we found that the provider was not meeting the requirements of the law in relation to the training, support and deployment of staff, people’s nutrition and hydration, care planning and good governance.
At our inspection of July and August 2016 we established that sufficient improvements had been made in some areas and further progression was still needed in others. The need for further improvements and the identified areas of risk were of concern because the management of the service had not used the quality assurance systems effectively to continually improve the service for people. Further failings had been identified in areas that were not failing at our 2015 inspection.
The provider’s quality assurance system, although improved needed further development to ensure that all aspects of shortfalls in the service were captured and addressed on an on-going and sustained basis. The provider responded promptly where we identified concerns in the service. However, our concern remains that the improvements were not identified and actioned by the provider’s own systems. As part of this inspection process, we met with the provider to discuss their retrospective action and to get their assurances on continued compliance. We were assured that action was being taken swiftly to address shortfalls in the service to ensure people’s safety and wellbeing.
Systems to manage medicines and risk for people living and working in the service needed improvement. While staff support systems had improved, areas of staff practice were not always safe, respectful and person centered. Records, both in relation to the quality of the information they contained and to their secure storage, needed further attention. Improvements were needed to ensure that all aspects of people’s care needs were documented to provide guidance for staff on meeting people’s needs.
Improvements were noted to the management of risks to the environment and the running of the business so as to ensure people’s safety since the last inspection. People were supported by increased numbers of staff who were more effectively deployed to meet people's needs. People were supported to participate in a wider range of social activities that interested them and met their needs. Improved information on available activities and meal choices in an accessible format was arranged for people during the inspection.
People’s care was planned and reviewed with them or the person acting on their behalf. Arrangements were in place to support people to gain access to health professionals and services. Visitors were welcomed and relationships were supported.
People felt able to raise any complaints and felt that the provider would listen to them. Information to help them to make a complaint was readily available.
People knew the registered manager and found them to be approachable and available in the home. People living and working in the service had the opportunity to say how they felt about the home and the service it provided and be listened to.
This inspection took place on 27 August and 1 September 2015.
Belmont Lodge Care Centre provides accommodation for up to 46 older people who require personal care. People may also have needs associated with dementia. There were 38 people living at the service on the day of our inspection, including two people who were in hospital.
A registered manager was in post but was on leave at the time of our inspection. 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.
Staff were not available in sufficient numbers to meet people's needs safely and staff were rushed at times. Improvements were needed to staff deployment.
People’s nutrition and hydration needs were not always properly assessed and met.
Staff did not receive suitable training and support to enable them to meet people’s needs effectively. Staff performance was not suitably monitored and appraised to ensure good practice was in place.
Records were not always available to guide staff on how to meet people's assessed care needs. People did not always receive the support required to meet their identified individual needs. People had varied levels of opportunity to participate in social activities and engage in positive interactions.
The provider’s systems to check on the quality and safety of the service provided were not effective in identifying and acting on areas that required improvement. People did not always feel their views were listened to positively.
Medicines were not consistently stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines safely. Risks to people’s health and well-being were not always assessed or were not sufficiently detailed to ensure people’s safety. People received varied support in the way their healthcare needs were met.
The provider had a clear complaints procedure in place. Improvements were needed to ensure everybody felt their concerns were listened to.
Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected.
Staff had attended training on safeguarding people and were knowledgeable about identifying abuse and how to report it. Recruitment procedures were thorough.
People were supported by staff who knew them well. People’s dignity and privacy was respected and staff were kind and caring. Visitors were welcomed and people were supported to maintain positive relationships with others.
You can see what action we told the provider to take at the back of the full version of the report.
We observed that all staff spoke kindly and respectfully to people who lived in the home.
Belmont Lodge Care Centre was clean, although in need of refurbishment, which the manager told us was due to commence shortly. All the staff we spoke with were aware of their role in preventing cross infection.
We observed staff managing medication and saw that medicines were stored, handled and administered appropriately. There was a system in place which was followed to ensure that if people declined their medication, they were referred to the prescriber for advice on further management.
Staff received training and support to ensure they were fully competent and confident in their jobs.
One person, who had been living at Belmont Lodge Care Centre for some time said to us, "It's really very nice here. The staff are very kind. They all know me and my family really well" Another told us, "I really like my room and I can go there if I want to be quiet. Otherwise I can choose to sit in one of the lounges and chat."
We spent time listening to interactions between staff and people living at the home. We took time to observe the daily routines to help us determine what it was like for people living there. We saw that people looked happy and relaxed in their surroundings and that they responded positively to staff during our visit. We saw that people were given a choice in the time they got up and how they spent their day. One person told us, 'I'm quite happy. Staff are all very, very good. They look after me like a daughter.'