Belsfield House

Updated 1 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

The first day of the inspection was carried out by two inspectors, a medicines inspector and a specialist advisor with specialist knowledge of mental health services. Two inspectors visited the home on the second day of the inspection and one inspector visited the home on the third day.

Service and service type

Belsfield House 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. [Care home name] is a care home [with/without] 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

The first day of the inspection was unannounced.

What we did before the inspection

We reviewed all the information we had received about the service since our last inspection. We contacted the local authority to gain feedback about the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. 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 used all this information to plan our inspection.

During the inspection

During our visits to the home, we spoke with eight people who used the service and one person’s relative. We also spoke with 20 staff at all levels of the organisation, including the registered manager. Following the inspection visits, we spoke with nine people’s relatives and seven professionals to gain their feedback about the service.

We looked around each area of the home to make sure It was safe, homely and suitable. We spent time observing the care and support people received. This helped us to understand the experience of people who could not or chose not to speak with us.

We reviewed seven people’s care documentation and seven people’s medicines administration records, along with associated medicines documentation. We observed medicines administration and checked how medicines were stored.

We also reviewed a range of records related to the management of the service, including safety certificates, policies, procedures and quality assurance systems.

Updated 1 October 2022

About the service

Belsfield House in Blackpool is a purpose-built nursing home providing residential and nursing care for up to 40 people. At the time of our inspection the home was fully occupied. Accommodation is provided over four floors, each one providing communal lounges and dining areas. Bedrooms are for single occupancy, spacious and include an en-suite facility.

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

Medicines were not always managed safely. The provider had recruited staff safely and had a high number of staff deployed with a good skill mix to ensure people’s safety. Staff had received training to keep people safe and manage risks.

The provider continued to be effective in assessing and delivering care which met people’s needs. The provider continued to deliver care and support to meet people’s nutritional needs. Extensive staff training aimed to ensure staff were skilled to deliver effective care.

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.

There was a real emphasis on equality, inclusion and human rights. Feedback we received was overwhelmingly positive about how caring the staff team was. People were supported to be as independent as possible.

The service provided a range of meaningful activities to help improve people’s health and wellbeing whilst providing opportunity for social interaction. The service was very responsive in meeting people’s needs through a highly person-centred model of care. Health professionals praised how responsive and proactive the service was. The provider had continued to strive for high standards in end of life care.

The provider used a range of systems including audits and checks to assess, monitor and improve the service. However, these had not been effective in ensuring the safe and proper management of medicines, as mentioned in the safe section of this report. The service worked very well with other organisations to ensure people’s needs were met. The registered manager was heavily invested and passionate about delivering a high-quality service.

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 outstanding (published 18 March 2019).

Why we inspected

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.

We carried out a focussed inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part by a specific incident. The information CQC received about the incident indicated concerns about unexplained injury. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern.

We inspected and found there was a concern with medicines management, so we widened the scope of the inspection to become a comprehensive inspection which included all five key questions.

Enforcement

We have identified a breach in relation to the safe and proper management of medicines at this inspection.

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.