CQC report explained · a residential care home
What the CQC found at Bellamy's Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks such as falls, choking, nutrition and distressed behaviour were assessed and reviewed. Medicines, safeguarding, staffing, equipment and building safety were managed appropriately.
- Effective?
- Good
- Staff had relevant training and support. People received help with their health, nutrition and communication, and mental capacity and best interest decisions were recorded more appropriately.
- Caring?
- Good
- Staff were kind, patient and caring. Inspectors saw that privacy, dignity, confidentiality, communication and independence were respected.
- Responsive?
- Good
- Care plans were detailed, person-centred and kept up to date. People had choices about activities and support, and there was an accessible complaints process.
- Well-led?
- Good
- Management support, teamwork and quality monitoring had improved. People, relatives and staff had opportunities to give their views, although the care-record audit tool was limited.
What inspectors found, July 2018
Bellamy's Cottage was rated Good; inspectors found safe, kind and personalised care, with major improvements since the last inspection.
This was an unannounced inspection on 30 May 2018. Inspectors observed staff and people living at the home, spoke with people, relatives, staff and professionals, and checked care records, medicines, training, complaints, audits and the building.
The home supported eight men with learning disabilities or autism. Inspectors found that risks were better assessed, medicines were managed safely, staffing was sufficient and the environment was clean and safe. Staff supported people with health, nutrition, communication, independence and activities.
People and relatives gave positive feedback. Staff were described as kind, patient and caring. Care plans and mental capacity records had improved, and people were involved in choices about their care and daily lives.
The overall rating and all five question ratings were Good. The previous inspection in March 2017 rated the home Requires Improvement and found breaches about consent, care records, governance and required notifications. Inspectors said the required improvements had been made and the regulations were being met.
Improved care records
Care plans had been rewritten and included people's needs, preferences, risks and goals. They were reviewed when people's needs changed.
“Care plans were detailed, person centred and updated when people's needs changed.” from the report
Kind and respectful care
Inspectors saw positive relationships between staff and people. Staff respected privacy, dignity and people's preferred ways of communicating.
“Staff were kind, patient and caring and had developed positive relationships with the people they supported and were seen to respect their privacy and dignity.” from the report
Safe support
Risks were assessed and updated, medicines were managed safely, and staff understood safeguarding and less restrictive ways of supporting people.
“Risks to people's health, safety and welfare were better assessed and mitigated.” from the report
Activities and independence
People were supported to take part in activities at home and in the community, including day services, outings and holidays. Staff encouraged people to do more for themselves.
“There was a range of meaningful occupations and activities for people to participate within the service, at the organisation's skill centre and some people attended community day services.” from the report
Limited audit records
minorThe audit tool used for care records mainly recorded a date and signature. Inspectors said it would be better to include more detail about findings and improvements.
“The audit tool for the checks on care records was limited to a date and signature” from the report
- 01How do you now record the findings and actions from care-record audits?
- 02How are mental capacity assessments, best interest decisions and liberty safeguards kept up to date?
- 03How will you make sure risk assessments remain current when someone's health or behaviour changes?
- 04What activities and community opportunities would be available for my relative, based on their interests?
- 05How are relatives involved in care-plan reviews and in giving feedback or making complaints?
This was an unannounced inspection covering the overall service and all five CQC key questions; it also checked improvements required after the March 2017 inspection. This explanation was written from the published report of 7 July 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2017
Bellamy's Cottage was rated Requires Improvement overall; inspectors found kind care but gaps in risk assessments, consent records and quality checks.
Inspectors visited on 29 and 30 March 2017. They observed care, spoke with people, relatives and staff, and reviewed care files, medicines records, staff records, incidents, audits and maintenance records.
People were treated kindly and with respect. Staff supported health needs, medicines, meals, activities and independence. There were enough staff on duty, and recruitment and training were suitable.
However, some risk assessments and care plans were missing, unclear or out of date. Mental Capacity Act decisions were not always assessed or recorded properly. The checks used to find and fix these problems were not effective enough. The home also missed some required notifications to the CQC.
The overall rating was Requires Improvement. Caring was rated Good, while Safe, Effective, Responsive and Well-led were rated Requires Improvement. This was a change from the previous Good rating in December 2014.
Kind and respectful care
Inspectors saw staff treating people with dignity and responding to their communication needs. Relatives and people spoke positively about the staff.
“We saw people were treated with dignity and respect throughout our inspection.” from the report
Enough suitable staff
There were enough staff on duty, and the home covered sickness and holidays. Recruitment checks, induction and ongoing training were in place.
“There were sufficient staff on duty to meet people's individual needs.” from the report
Health and medicines
People received medicines as prescribed and were supported to access health professionals. Staff understood how to seek help when health needs changed.
“People's health needs were met. Medicines were ordered, stored and administered safely and people received their medicines as prescribed.” from the report
Food and activities
People had varied meals they enjoyed and were supported with activities, outings and day services. They were encouraged to take part in daily living tasks.
“We observed the lunch and tea-time meal services and we saw people enjoyed their meals.” from the report
Open involvement
People, relatives and staff could share their views through meetings and surveys. People were reminded about how to raise concerns.
“People who used the service, relatives and staff were able to express their views on how the service was run through surveys and a range of meetings.” from the report
Missing risk assessments
seriousSome risks, including falls, nutrition and skin damage, did not have clear written assessments or instructions for staff. This meant staff might not have had the guidance needed to reduce those risks.
“Therefore staff did not have clear written guidance about this subject.” from the report
Incomplete care records
seriousSome care plans were missing, duplicated or out of date. They did not always explain how to support changing needs, behaviour, mobility, skin care or weight.
“This meant there was a risk their care needs could be overlooked.” from the report
Consent decisions not recorded
seriousCapacity assessments and best-interest decisions were not always recorded. This included decisions about moving accommodation and equipment that restricted movement.
“Not working within the principles of MCA in assessing capacity prior to making best interest decisions, was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak quality monitoring
needs fixingAudits did not reliably identify problems in care records, weight monitoring, environmental checks and some safety checks. The change to a new care-record format also caused confusion.
“Although there was a quality monitoring system, this had not been wholly effective in highlighting shortfalls and taking action to address them.” from the report
Missed notifications
seriousThe CQC was not told about some safeguarding concerns and DoLS outcomes as required. The provider said this was an error and promised to notify the CQC in future.
“This was a breach of regulation 18 of the Care Quality Commission (Registration) Regulations and on this occasion we have written to the registered provider reminding them of their responsibility regarding notifications to CQC.” from the report
- 01Have all care plans and risk assessments been reviewed and updated, particularly for falls, nutrition, skin damage, mobility and behaviour?
- 02How are Mental Capacity Act assessments and best-interest decisions recorded now, including decisions about restrictive equipment?
- 03What checks now confirm that care records are accurate, complete and consistent after the change to the new records format?
- 04How are weight records, hot water temperatures, shower-head cleaning, window restrictors and other environmental safety checks monitored?
- 05What system is now used to ensure all safeguarding incidents and DoLS outcomes are notified to the CQC on time?
This was a comprehensive inspection covering all five key questions, with ratings given for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 10 May 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Bellamy's Cottage
3 rated inspections over 3 years: the service has held its Good rating throughout.
- July 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- January 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 10 May 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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12 live-in carers within about an hour of North East Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,350 a week. 10 can care for a couple. 7 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.