CQC report explained · a residential care home
What the CQC found at Belmont Grange Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2018
Rated Good overall, with Outstanding caring; inspectors found kind, safe care but said dementia activities and the environment needed further improvement.
This was an unannounced comprehensive inspection on 29 June and 12 July 2018. Inspectors reviewed care records, medicines, staff files, training, staffing, complaints, accidents and quality checks. They spoke with people living at the home, a relative, staff and health and social care professionals.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Caring was rated Outstanding. Inspectors found enough suitable staff, safe medicines systems, good support with health and nutrition, and a warm and respectful approach to care.
The home had improved since the previous inspection in March 2017. Earlier problems with consent, quality checks and some environmental risks had been addressed. Inspectors still recommended improvements to the environment for people living with dementia and to activities for them. Care plans also needed further work.
Kind and personal care
Staff spent time with people, respected their choices and built strong relationships. Inspectors found care that was unusually warm and compassionate.
“They offered care and support that was exceptionally kind and compassionate.” from the report
Staffing and safety
There were enough staff on duty to meet people's needs. Recruitment, safeguarding, risk management and medicines arrangements were found to be safe.
“People were supported at all times by sufficient numbers of staff on duty to meet their needs fully and in a timely way.” from the report
Respect for decision-making
The home had improved its assessments and decisions for people who might lack capacity. Staff understood the need to involve people and use the least restrictive approach.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.” from the report
Improved management
The manager had introduced stronger quality checks and created an open culture. Staff said they felt listened to, supported and valued.
“There were quality monitoring systems in place to review the running of the service and identify any improvements required.” from the report
Dementia-friendly environment
needs fixingSome areas lacked suitable colours, signs and personalisation to help people living with dementia recognise and use the home. Outside areas also needed maintenance, including uneven ground and crumbling paint.
“We recommend the service seeks current guidance and advice about suitable environments for people living with dementia.” from the report
Activities for people with dementia
needs fixingActivities were available, but there was not enough meaningful activity for people living with dementia. Records did not always show what people had done or how activities affected their wellbeing.
“We recommend the service seeks current guidance and advice on suitable activities for people living with dementia.” from the report
Care plans need more detail
needs fixingCare plans had improved but still needed to be more personalised and contain all the information staff required. The manager had identified this through audits and was seeking further guidance.
“Whilst improvements had been made to the care plans, the registered manager had identified through audits that they needed further work.” from the report
Complaint information
minorThe complaints procedure needed updating. It contained an incorrect address and did not explain that CQC does not investigate individual complaints.
“However, this needed updating with the correct address and the fact that the Care Quality Commission no longer investigates individual complaints.” from the report
- 01What changes have been made to make the building and garden more suitable for people living with dementia?
- 02How will you provide more meaningful activities for someone with dementia, and how will you record their response?
- 03How are care plans being made more personalised, and how often will my relative and family be involved in reviewing them?
- 04How will you make sure the complaints procedure has the correct contact details and information?
- 05What improvements have been completed since the March 2017 inspection, and what work remains?
This was an unannounced comprehensive inspection covering all five key questions and the premises as well as the care provided. This explanation was written from the published report of 24 August 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
Belmont Grange Limited was rated Requires Improvement; inspectors found kind, personalised care but safety, consent records and management checks needed improvement.
This was an unannounced inspection over two days, on 2 and 6 March 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and checked care plans, medicines, recruitment, training, safety and quality records.
People were generally positive about the care. Staff were kind, knew people well and respected their choices and privacy. Care plans were personalised, activities were provided and medicines were given safely and on time.
However, people were at risk from hot water and an uncovered radiator. Fire safety checks had been missed, and evacuation plans did not give staff enough detail. Mental capacity assessments and best-interest decisions were not always fully recorded, and staff did not all understand how these rules applied to their work.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. The provider had to tell the CQC what action it would take, and the CQC said it would check that action.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff knew people's preferences and supported them to make everyday choices.
“People received care from staff who developed positive, caring and compassionate relationships with them.” from the report
Personalised support
Care plans reflected individual needs, wishes and interests. Staff knew people well and provided support in the way each person preferred.
“The service was responsive to people's needs because people's care and support was well planned and delivered in a way the person wished.” from the report
Activities and social life
The home offered activities such as quizzes, games, flower arranging, music and walks. Staff tried to link activities to people's past interests.
“People were encouraged to socialise, pursue their interests and hobbies.” from the report
Medicines
Inspectors found that medicines were stored securely and given safely and on time. Pain relief and medicines prescribed for use when needed were managed appropriately.
“People received their medicines on time and in a safe way.” from the report
Scalding and burns risks
seriousBath and shower water was too hot, creating a risk of scalding. One radiator was very hot and did not have a protective cover at the time of inspection.
“People were at risk from scalding as water temperatures in baths and showers exceeded the recommended temperature to keep people safe.” from the report
Fire safety records
seriousWeekly fire safety checks had not been completed for two weeks. Personal evacuation plans did not clearly tell staff where to take people during a fire.
“Weekly fire safety checks had not been completed for the two weeks prior to the inspection.” from the report
Staffing review
needs fixingStaffing had been increased, but the dependency tool had not been used properly to decide how many staff were needed. At some mealtimes, fewer staff could have been available to meet people's needs.
“It is recommended the provider use their dependency tool to help them decide on the number of care staff required to meet people's assessed needs.” from the report
- 01How are you now recording decision-specific mental capacity assessments and best-interest decisions, including decisions about bedrails?
- 02How do you check and record the temperature of baths and showers, and how do you prevent scalding?
- 03Have the fire checks and personal evacuation plans been brought fully up to date?
- 04How do you use the dependency tool to decide staffing levels, especially during evening meals and weekends?
- 05What checks now make sure problems found in audits are acted on promptly?
This was an unannounced inspection covering all five CQC questions; the first visit was on 2 March and inspectors returned on 6 March to meet the registered manager. This explanation was written from the published report of 9 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 Belmont Grange Limited
3 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Registered with the Care Quality Commission on 24 November 2014.
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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