Archived: Bellever Residential Home

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

This inspection was undertaken to follow up that required improvements have been made in relation to consent, medicines management and recruitment following our previous inspection in January 2014.

Five people lived at Bellever when we visited, we spent a day at the service, and met with all the people who lived there. Some of the people who lived at Bellever were unable to talk to us to tell us about their experiences of living at the home so we talked to staff about their care needs and spent time observing the care and support provided and staff interactions with people. We spoke with six staff about people's care needs and looked at two people's care records. We also spoke with a relative and two advocates, the local learning disability team, a physiotherapist and a person who does music therapy at the home. During the inspection we looked around the building, reviewed a variety of records including care records and looked at four staff files.

Bellever is one of seven homes run by Guinness Care and Support Limited within Devon area that are in the process of deregistering as care homes and preparing to become supported living services. A supported living service is one where people live in their own home and receive care and support in order to promote their independence. A supported living service aims to enable each person to be as autonomous and independent as possible, and usually involves social support rather than medical care.

Is the service safe?

We found that each person's needs and risks were assessed and comprehensive care plans were in place about how to meet those needs. People were not put at unnecessary risk, but where possible they had choices and remained in control of their own decisions.

We found health and safety checks were undertaken as well as regular repairs and maintenance. All accidents and incidents were reported and monitored to make sure staff learnt from them and took actions to reduce the risk of recurrence. Environmental risk assessments showed action was taken to reduce environmental risks to a minimum. We found the provider had effective recruitment and selection processes in place with appropriate checks being undertaken before staff began work. This ensured people were protected from unsuitable staff.

Is the service effective?

People's care records included detailed information about each person's preferences, their likes and dislikes and the care and support had been provided in accordance

with people's wishes. We found the home used evidence based tools for assessing risks and followed national guidance about supporting people with nutrition and hydration and in the prevention of pressure ulcers. This meant care provided helped to keep people as healthy as possible.

Is the service caring?

One advocate said, 'X has been extremely happy here'. We found people seemed happy and well cared for and were well supported by staff who knew about their care needs. There was lots of chat and laughter throughout the day between staff and people. We observed staff were caring towards people and treated each person as an individual and with dignity and respect. We found care was person centred and each person was supported to be as independent as possible, according to their ability. Throughout the day we heard staff prompting people and offering them praise and encouragement for their achievements.

Is the service responsive to people's needs?

The environment of the home was adapted to meet the physical and mobility needs of people who lived there, such as ramps for wheelchair users and wide doors for easy access. Referring to the d'cor and disabled access facilities at Bellever, one relative we spoke with said, 'We are well blessed'.

We saw that people were supported by staff in a relaxed and unhurried manner with personal care and with everyday living tasks, at a time convenient for them. We found that staff sought advice appropriately and in a timely way to support some people's complex health care needs and care professionals we spoke with confirmed staff followed professional advice.

Is the service well led?

The relative and advocates we spoke with reported they were satisfied with the care provided by staff at the home. They confirmed staff regularly contacted them and consulted and involved the person and their supporters in decision making about their care. However, they reported some concerns about the provider's communication and consultation about the proposed changes to supported living, which they felt needed to be improved. This view was also expressed by several staff we spoke with.

The home did not have a registered manager, the post holder had left and had not been replaced as part of the planned move to supported living arrangements. Instead, the provider had appointed a team leader to oversee three learning disability settings in Crediton. We spoke with the team leader, who told us they visited each service several times a week and was available by telephone for advice. All staff we spoke with confirmed they felt well supported by these arrangements.

A senior care worker, based at the home, provided day to day leadership and co-ordination of people's care. We saw the home had good systems in place to support effective communication within the staff team, and to ensure all aspects of the day to day running of the home were completed. We saw a range of quality monitoring checks were in place, for example, related to cleanliness and food preparation, equipment, fire safety, medicines management and care records. This showed the service had well established and effective quality assurance audits in place to promote the continual improvement of the service.

We found the home was compliant with the five standards we looked at.

On arrival at the home we asked for the manager or senior person on duty and were told there wasn't one. We phoned head office and spoke with the head of care homes and supported living to let them know we were inspecting the premises. We then spoke with the supported living manager and let them know which outcomes we were inspecting, and that the inspection was being carried out as registered care home as they had not yet been re-registered as a supported living service. They then arranged for the senior care assistant to come in on their day off to assist with the inspection.

We asked people who lived at the home if they were happy with the care and support they received and one was able to reply 'yes'. One relative we spoke to told us 'The care providers are brilliant, x's language seems to have increased, and they seem very settled.' They also said 'The amount of communication we get as a family is to be commended.' Another we spoke to told us 'The care is good. Any problems we all work together. They (the support staff) do an extremely good job, with not a lot of support from senior managers.'

We found that people had comprehensive and extensive care plan files, which contained lots of information on how people needed to be supported. This meant support staff could be clear about what type of support a person needed, their choices and preferences, and which parts of tasks they were able to do for themselves.

We saw comprehensive care plans and risk assessments that were person centred and included details of the things that people liked and did not like. These had been regularly reviewed.

Staff were aware of the importance of safeguarding adults from abuse and told us what signs they would look for and the action they would take if they suspected abuse.

We were told by staff that they felt well supported, through supervision and annual appraisals, and had opportunity to undertake training.

We saw evidence of regular quality checks and were informed of the organisations plans to improve their quality monitoring processes.