CQC report explained · a residential care home
What the CQC found at Belle Green Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2022
Rated Good and no longer in special measures; inspectors found major improvements, with a few records needing attention.
Inspectors visited without warning on 8 March 2022. They spoke with people living in the home, relatives, staff and health professionals. They reviewed care, medicines, recruitment, training and management records.
The home had improved significantly since its previous Inadequate rating. Inspectors found people were safe, cared for kindly and supported by enough staff. Medicines, infection control, food, activities and complaints handling were also judged good.
A small number of record-keeping issues were found and addressed during the inspection. The home had been in special measures since August 2021, but it is no longer in special measures and all five areas were rated Good.
Enough staff
Staffing had improved and inspectors saw staff responding to people's needs promptly. Recruitment checks were completed before staff started work.
“Staffing levels were appropriate to meet the needs of people who used the service.” from the report
Safe medicines
Medicines were received, stored, given and disposed of safely. Staff explained medicines to people and checks were used to identify issues.
“Medicines were received, stored, administered and disposed of safely.” from the report
Kind and respectful care
People looked comfortable with staff and spoke positively about their care. Staff respected privacy, dignity, choices and independence.
“People looked comfortable and relaxed in the presence of staff.” from the report
Improved management
The home had introduced stronger audits and daily checks. Inspectors found that actions from checks were recorded and progressed.
“A range of quality assurance systems were in place to monitor and improve the service.” from the report
Activities and personal choice
People had access to group and one-to-one activities linked to their interests. Care plans recorded likes, dislikes and what mattered to each person.
“Activities were both communal and on a one to one basis to ensure people were engaged in activities which were meaningful to them.” from the report
One care plan did not match current needs
needs fixingOne person's care plan still described more frequent position changes than were needed after their skin had improved. The manager reviewed this during the inspection.
“one person's care plan did not fully reflect the support they needed” from the report
Missing bed rails assessment
needs fixingA bed rails risk assessment was missing from one person's records. The manager said this had been removed in error and addressed it during the inspection.
“A bed rails risk assessment was missing in one person's care records.” from the report
Out-of-date evacuation records
minorThe emergency evacuation folder included assessments for three people who no longer lived at the home. The information was updated during the inspection.
“the PEEP folder contained assessments for three people who were no longer at the service.” from the report
Controlled drug register housekeeping
minorInspectors discussed housekeeping improvements that could be made to the controlled drug register. The manager said these would be implemented.
“We discussed some housekeeping improvements which could be implemented in the controlled drug register” from the report
- 01How are you checking that care plans continue to match people's changing skin and pressure care needs?
- 02How do you make sure every person using bed rails has a current risk assessment?
- 03How are personal emergency and evacuation plans checked so they only contain current information?
- 04What changes were made to the controlled drug register after the inspectors' discussion?
- 05How will you show that the improvements made since the previous Inadequate inspection remain in place?
This was an unannounced follow-up inspection of all five key questions, including infection prevention and control and COVID-19 vaccination requirements. This explanation was written from the published report of 23 March 2022 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, August 2021
Rated Inadequate and placed in special measures; inspectors found serious shortfalls in staffing, medicines, risk records and management.
This was an unannounced focused inspection on 15 June 2021. Two inspectors spoke with people living at the home, relatives, staff and visiting health and social care professionals. They observed care, checked the building and reviewed care records, staff files, medicines records and management information.
The home did not have enough staff to meet people's needs promptly. Care records and risk assessments were not kept up to date. Medicines systems were not reliable, including records for a controlled medicine. Staff did not receive enough training, supervision or support.
The home did not have effective systems to find and fix these problems. Inspectors also found failures around consent, including unclear mental capacity and best-interest records. People enjoyed the food, and inspectors saw some kind interactions when staff had time.
The overall rating fell from Requires Improvement to Inadequate. Safe and Well-led were rated Inadequate, while Effective was rated Requires Improvement. Caring and Responsive were not inspected, so this report gives no new ratings for those areas.
Food choices
People said they enjoyed the food. Staff recorded meal preferences and special dietary requirements, and people were offered choices at lunch.
“People told us they enjoyed the food served at Belle Green Court.” from the report
Kind interactions
Inspectors saw some kind and caring interactions between staff and people, although this depended on staff having enough time.
“We saw some kind and caring interactions between people and staff, where time allowed this.” from the report
Fire safety
Fire equipment was checked regularly and staff took part in fire drills. Some individual evacuation plans still needed updating or completing.
“Risks to people in the event of a fire had been addressed. There were regular checks of firefighting equipment.” from the report
Medicine storage
The home had improved the storage of medicines since the previous inspection. Medicines were kept securely and at safe temperatures.
“Medicines were stored securely and within safe temperature ranges.” from the report
Too few staff
seriousStaffing did not match people's care needs, including support with personal care and eating. Staff said they were under pressure and had little time for people.
“There were not enough staff deployed to keep people safe.” from the report
Medicines records
seriousMedicine records did not always match, and guidance for as-required medicines and creams was missing. The concern about one controlled medicine was referred to the local authority safeguarding team.
“Systems were not in place to ensure people received their medicines as prescribed.” from the report
Out-of-date risk information
seriousCare records and risk assessments did not reflect important changes in people's needs. This could leave staff without the information needed to provide safe care.
“People's care records did now contain risk assessments. However, these had not been updated to reflect significant changes in need.” from the report
Staff support
seriousThere was no evidence of a complete induction for new staff, and planned supervision did not always happen. The provider could not provide recent supervision or appraisal records.
“Staff did not receive regular supervision to support them in their roles.” from the report
Consent and restrictions
seriousRecords did not clearly show who had authority to agree to care. Where people lacked capacity, some restrictive interventions did not have a recorded best-interest decision.
“We found evidence care and treatment of service users was not always provided with the consent of the relevant person.” from the report
Weak management checks
seriousAudits failed to identify problems found by inspectors. Policies, care records and feedback processes were incomplete or not kept up to date.
“Governance systems and processes had not been fully established and operated effectively.” from the report
- 01What action has been taken to ensure there are enough staff during busy periods, including mealtimes?
- 02How do you now check that medicines, including controlled medicines and as-required medicines, are given and recorded correctly?
- 03How are care records and risk assessments updated when a person's needs change?
- 04How have staff induction, practical training, supervision and appraisals been improved?
- 05What has changed in response to the warning notices and the previous inspection breaches?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and received no new ratings. This explanation was written from the published report of 20 August 2021 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 Belle Green Court
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2020
Registered with the Care Quality Commission on 14 February 2020.
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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