CQC report explained · a nursing home
What the CQC found at Belmont House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found risks from incomplete care records, staffing concerns and weak quality checks.
This was a focused inspection carried out over three visits in August and September 2022. Inspectors spoke with people, relatives and staff, and reviewed care plans, medicines records, audits and policies.
The home was not always safe. Records did not always explain people's needs or show that important checks, such as food and fluid monitoring, repositioning and bowel monitoring, had been completed. Some people also reported waiting too long for call bells and activities.
The home had safe recruitment, safeguarding procedures, medicines systems and infection control arrangements. The building was clean and safe, and staff understood people's needs. However, quality checks did not reliably find poor care or missing records.
The overall rating is Requires Improvement. Safe and Well-led were both rated Requires Improvement. This was a focused inspection, so the other three ratings were carried forward from the previous inspection.
Safeguarding
Staff understood safeguarding procedures. Concerns were reported to the local authority and action was taken to reduce risks.
“Staff had a good understanding of safeguarding and action was taken to mitigate risk.” from the report
Safe environment
The building was clean, maintained and safe. Regular checks and fire evacuation practice were carried out.
“The environment was clean, well maintained and safe for the people living there.” from the report
Medicines support
The electronic medicines system supported safe administration. People were involved and their preferences were understood.
“The provider was using an electronic medication system to effectively and safely administer people's medicines as prescribed.” from the report
Approachable leadership
People, relatives and staff felt able to raise concerns. Inspectors said the manager acted promptly when problems were identified.
“People, staff and relatives felt confident in raising any concerns with the registered manager.” from the report
Incomplete care records
seriousImportant monitoring was not always recorded, including food and fluid intake, repositioning and bowel monitoring. Care plans did not always give staff up-to-date guidance.
“Care records did not always provide enough guidance for staff around how to deal with people's known needs or behaviours.” from the report
Staff availability
needs fixingStaff were not always available quickly enough. People reported long waits for call bells and not enough staff for activities.
“Other people told us they had to wait long times for call bells to be answered and that there wasn't enough staff to run activities in the service.” from the report
Weak quality checks
seriousAudits and checks did not reliably identify missing monitoring records, poor care experiences or possible gaps in safeguarding notifications.
“The new systems and processes which had been implemented since our last inspection were not effectively embedded where poor practices had not been identified.” from the report
- 01How have you improved care plans and made sure they give staff current guidance about each person's needs and behaviours?
- 02How do you now check that food and fluid charts, repositioning records and bowel monitoring are completed every time?
- 03What staffing levels are planned for each unit, and how will you prevent long waits for call bells?
- 04What has changed in your audits so they identify missing records and poor experiences of care?
- 05What progress has been made on the action plan required after the breaches of Regulations 12 and 17?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 15 October 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, December 2020
Belmont House Care Home is rated Requires Improvement; inspectors found risks from weak care records, health monitoring and management oversight.
This was an announced focused inspection on 17 and 18 November 2020. Inspectors reviewed Safe and Well-led because information held by CQC raised concerns. They spoke with people, a relative and staff, and checked care, medicines, staffing and management records.
People were at risk of avoidable harm because care plans were not always up to date. Records did not consistently show how staff monitored hydration, nutrition, weight loss or pressure area care. Accident and incident records were completed in places, but management checks did not show patterns or lessons learned.
People and staff said routines could feel rushed. Some people waited for support and missed morning refreshments. Medicines, the building, equipment and infection controls were generally managed well, but records for medicine patches were not always clear.
The overall rating changed from Good at the previous inspection to Requires Improvement. The home breached regulations about safe care and treatment and good governance. The provider had action plans, but inspectors found that improvements had not been sustained.
Medicines and equipment
Inspectors found that medicines were safely managed and that the building and equipment were safe. Fire drills and evacuation practices were carried out.
“The building and equipment were managed safely. Staff took part in regular fire drills and evacuation practices to ensure they were able to respond in an emergency.” from the report
Infection control
The inspection found assurance about several infection control arrangements, including PPE, testing and preventing or managing outbreaks. Inspectors gave advice about distancing and staff arrangements.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Open staff culture
Staff described an open culture and said they knew who to approach for support. Inspectors also found that staff aimed to provide person-centred care despite staffing pressures.
“I would say it is an open and honest culture. We can always have open and honest discussions. It is not a blame culture.” from the report
New management approach
Staff welcomed the new manager's approach and described it as supportive. The manager had started involving staff and people in plans for change.
“The new manager came and introduced themselves and they seemed quite supportive.” from the report
Incomplete care and health records
seriousCare plans did not always explain the care people needed. Records did not consistently show action taken when people lost weight or were at risk of dehydration.
“People were at risk of avoidable harm because care plans did not always contain up to date information about the care and treatment people required.” from the report
Rushed staffing and delayed support
needs fixingPeople and staff said routines were rushed. Some people waited for help and missed morning refreshments, so inspectors recommended better checks on staffing deployment.
“I call, and no one comes. This is quite often. I try to make my way to the door to show physically that I need help, that seems to work better for a response.” from the report
Weak management oversight
seriousThe provider's checks had found some problems, but they had not produced lasting improvement. Some checks also missed poor monitoring of people's health outcomes.
“Systems were either not in place or were not operated robustly enough to effectively ensure safety and quality.” from the report
Medicine patch records
minorMedicines were generally managed safely, but records did not always show whether medicine patches had been moved to different areas of skin.
“Where people used medicine patches it was not always clear on records if they had been rotated to different parts of the skin to prevent irritation.” from the report
- 01How are you now making sure every care plan contains current instructions, including diabetes care and pressure area care?
- 02How do you monitor people's hydration, nutrition, weight and pressure areas, and what happens when there is a concern?
- 03How do you check that staffing is safely deployed at busy times, including the morning routine?
- 04What changes have been made to review accidents and incidents and make sure lessons are acted on?
- 05How do you now check that medicine patch records show where patches have been applied and rotated?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 15 December 2020 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 House Care Home
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- August 2013
Registered with the Care Quality Commission on 22 August 2013.
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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