Background to this inspection
Updated
20 March 2021
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 Care Act 2014.
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
This inspection was carried out by an inspector and a mental health act reviewer.
Service and service type
Belgravia Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was announced shortly before arriving at the home. We inspected because we had received concerns about care and infection control and needed to discuss the safety of people supported, staff and visitors.
We started the inspection activity on 05 February 2021 and ended on 18 February 2021. This included telephone and video calls to people supported and staff. We requested other information to be sent to us by the service.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications we had received from the provider, about incidents that affected the health, safety and welfare of people supported by the service. We sought feedback from professionals who work with the service, including Blackpool local authority and Healthwatch. We used this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with four people who lived at Belgravia Care about their experience of the care provided. We spoke with the registered manager, and one of the directors and four care and ancillary staff.
We reviewed a range of records. This included two people’s care records. We looked at three staff recruitment records. We also looked at a variety of management records. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead in ongoing improvements. We walked around the building to check if the home was clean, hygienic and a safe place for people to live.
After the inspection we spoke with the provider who began making the necessary improvements and sent us information in about this.
Updated
20 March 2021
About the service
Belgravia Care is registered to provide care for up to 25 older people, people living with dementia, mental health or physical disabilities. The home is situated on the promenade at North Shore, Blackpool. There are bedrooms on all floors. There are choices of communal lounges and dining areas. There were 25 people who lived at Belgravia Care when we inspected.
People’s experience of using this service and what we found
People and their relatives told us they felt they were cared for safely by the staff team. However, this did not reflect our findings in relation to infection control and cleanliness of the home.
The management team had assessed risks to minimise the likelihood and spread of infection and in relation to COVID-19. However, the home was not clean or hygienic, which increased the risk of infection and was unpleasant for people. Infection control was not of a safe standard for reducing and managing the risk of infection outbreaks. The registered manager and provider had carried out infection control audits but had not identified the issues we found.
The home was not always well-led, and governance was not always effective. Although the registered manager carried out audits, the system for auditing and monitoring the service did not always identify issues of concern. After the inspection, the provider arranged a deep clean of the home, routine cleaning was increased, additional cleaning staff were employed and audits were improved upon.
People’s care records were personalised and informative. People’s care and support was assessed which helped people to manage or avoid preventable risks. We received positive feedback from people supported about the home. They told us they felt the registered manager and staff team involved and informed them about their care and any changes in the home.
Staff recruitment procedures were robust, and staff received regular training to help them provide the skills needed to give people good care.
Staff spoken with demonstrated an understanding about how to safeguard people from the risk of abuse. Staff supported people with their medicines safely and the registered manager audited medicines regularly.
After the inspection, the provider arranged a deep clean of the home, routine cleaning was increased, and infection control practice improved.
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 last report (8 November 2018).
Why we inspected
We received concerns in relation to care practice, infection control and management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
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.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The provider began to take action shortly after the inspection to mitigate the risks identified. This has made the home safer than it was on inspection. The provider arranged a deep clean of the home which improved infection control. They also increased cleaning staff and improved monitored of the environment.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Belgravia Care on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to keeping the home clean and hygienic and, monitoring that this is carried out, 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.