Belle Green Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received support from care workers with kindness, empathy and compassion and care workers respected people’s privacy and dignity. People were treated as individuals and their care, support and treatment met their needs and preferences. The provider promoted people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing. The provider listened to and understood people’s needs, views and wishes. The provider cared about and promoted the wellbeing of their staff, and they supported and enabled them to always deliver person centred care.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they could tell staff about things that concerned them. They were confident that changes would happen if they did. Comments included “I’ve never complained; I’m quite happy “and “I’m not sure who the manager is, but if I had a problem, I would tell them, and I am sure they would help. I can’t think of anything I’d change.”

Staff knew how to report accidents or incidents which were recorded on the digital system. The registered manager reviewed incidents and shared feedback with the team for further action and learning.

There were processes in place to monitor accidents and incidents affecting people’s safety. When an incident occurred, action was taken across the service to ensure that lessons were learnt, and staff improved practices to keep people safe.

People and relatives told us they were involved in discussions about their care needs.

Staff worked closely with external professionals to ensure people’s needs were suitably met. Staff had made appropriate referrals to other health and social care services were needed to enable people safe continuity of their care.

We saw the provider had successfully worked with partners and had been involved in discussions with them about people care needs. One visiting health professionals said,” Staff are proactive at coming to me for advice and passing info on. They implement what we suggest.”

The provider had processes in place to ensure safe system, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided.

People and their relatives told us they were happy with the service and felt safe around the staff. One person commented, “Oh yes, I feel safe; it’s having someone nearby to say good morning to.”

Staff were able to recognise possible signs of abuse and knew how to report such concerns promptly. There was a commitment to taking immediate action to keep people safe from abuse and neglect. This included working with partners in a collaborative way.

People were comfortable in the presence of staff and we observed warm interactions between them. When people became distressed, we saw staff respond quickly and gently to the person using distraction and de-escalation techniques to minimise the risk of adverse incidents occurring.

Systems and processes were in place to identify, review and investigate safeguarding matters. Appropriate action had been taken when any concerns were raised. Documents showed how the registered manager maintained oversight of any safeguarding matters and ensured learning from these. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.

People and their relatives told us they felt safe and were supported to understand and manage risks. People were involved in the assessment of their needs and the management of their risks where able. People believed staff would respond to their needs quickly and efficiently, especially if they were in pain, discomfort, or distress.

Staff promoted people's safety and independence. People’s care plans were regularly reviewed and in response to any change in needs.

During our visit, we saw how staff supported people to do the things they wanted to do safely. For example, we saw staff supporting people with eating, they made sure the person was sitting up straight, so they were not at risk of choking. We observed staff walking alongside people and helping people to sit down in a caring way which protected people from falls.

People’s care and clinical records included information around individual risks and support staff needed to provide. For example, risks around mobility, falls and equipment use, skin integrity, health conditions, eating and drinking were assessed.

People said they felt safe in the environment and had all the equipment they needed.

Staff reported there were systems to check the environment and equipment in the service. No concerns had been raised about the safety of the environment by staff.

We observed equipment in the home was in a good state of repair and had been regularly serviced. Staff locked equipment and chemicals away when not in use. The building was well maintained.

Safe monitoring systems were implemented which the provider used to monitor safe environments. For example, the provider ensured people and staff were trained in the use of equipment. The provider had a robust routine of environment checks in place. Appropriate maintenance audits were effective and completed within the allocated and suitable times to promote a safe environment. Checks such as fire alarm and water safety were completed regularly. People had personal emergency evacuation plans in place which were up to date and personalised to their needs.

People and relatives gave us mixed feedback about staffing levels. Comments included, “There’s not enough staff; they say, ‘I’ll just be two minutes,’ and it was 55 minutes this morning.” One relative said, “They could do with more staff for cleaning and caring.” While other people said, “I am happy with the number of staff," "I get enough attention" and "I find them good; they [staff] always acknowledge you.”

Staff told us there were enough of them to support people safely, because the management team supported them at busy times. However, staff said there were times when they could be rushed, for example at busy times like lunch time or due to staff absence. Staff said they had regular support meetings with their supervisor and an annual appraisal. Staff confirmed they had completed employment checks before they started work and told us they had completed training necessary for their role.

Throughout the inspection staff were busy with care tasks. They had little opportunity to spend any meaningful time with people or ensure their safety. During our visit to the service, the registered manager and deputy manager provided support to people at peak times such as mealtimes which ensured people did not have to wait for assistance when required. However, we also noted that the support being provided was task driven. This meant that there was little time for staff having a chat with people. Staff were busy and at times were in a hurry to move onto the next task. This was noted by everyone on the inspection team. Staff said they had regular support meetings with their supervisor and an annual appraisal. Staff confirmed they had completed employment checks before they started work and told us they had completed training necessary for their role.

The registered manager used a dependency tool to assess the number of staff required. A dependency tool collates information about each person in receipt of care and support and calculates how many hours of staff support they need. However, the dependency tool does not account for the layout of the building or busy times of the day. There were safe recruitment processes in place. Required pre-employment checks had been completed for staff before starting work. This included a check with the Disclosure and Barring Service (DBS). New staff received an induction which included training and shadowing experienced staff. Records demonstrated staff had regular supervisions and an annual appraisal.

People and relatives gave us mixed feedback about infection control. One person said, “It's clean here." However, one relative commented, “They could do with more staff for cleaning and caring. There are stains on the walls in the dining room."

Staff said they had received appropriate training in infection prevention and control and were aware of safe hygiene practices. While the staff we spoke to had no concerns about the infection and prevention control systems, we found elements of care did not meet the expected standard. We found aspects of the environment did not support safe infection control measures. Some flooring and dining room fittings needed replacing, which could pose a risk to people as cleaning of these could be more difficult for staff to effectively clean.

Infection control systems were in place. However, parts of the service needed repair and re-decoration; sluice rooms and dining areas needed replacing and updating, which could pose a risk to people as cleaning of these areas would be more difficult. The provider agreed areas of the services needed repair and told us they would take immediate action to address these concerns.

The service had an infection prevention and control (IPC) policy in place and guidance for staff. IPC audits were completed regularly and reviewed by the management team.

People told us they received good support to take their medicines. People were supported to take their medicines at the right time and said staff helped them to apply medicated creams when needed. People said they were able to see their GP when they needed to review their medicines.

Staff told us they received training and competency assessments to ensure they were safely administering medicines.

The registered manager and management team carried out various checks to ensure medicines were being safely administered, for example, regular medicines audits were taking place to monitor and address any administration errors. Medicines administration records had been fully completed. These gave details of the medicines people had been supported to take and an accurate record of medicines held in the service. Where people were prescribed ‘as required’ medicines, there were clear protocols in place, however these would benefit from having a little more information. We discussed this with the registered manager who took immediate action to address the concern.