CQC report explained · a nursing home
What the CQC found at Belong Atherton Care Village
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Risk assessments and care plans were reviewed promptly, staffing levels were judged sufficient, and medicines and equipment were managed safely. The home had improved from Requires Improvement in this area at the previous inspection.
- Effective?
- Outstanding
- People received tailored rehabilitation, specialist dietary support and access to equipment and technology. Staff had comprehensive training and worked with health professionals to support people's health and progress.
- Caring?
- Outstanding
- Inspectors found a strong person-centred culture. Staff treated people with kindness, dignity and respect, and supported them to make choices and have control over their lives.
- Responsive?
- Outstanding
- Care was based on people's individual needs, interests and aspirations. The home offered many activities, trips and community links, and staff responded quickly when people's needs changed.
- Well-led?
- Outstanding
- Inspectors found committed leadership, continuous improvement and strong systems for checking quality. Learning from incidents was shared with other services.
What inspectors found, May 2018
Belong Atherton Care Village was rated Outstanding overall, with safe care and especially strong support, kindness, activities and leadership.
The inspection was unannounced on 14 March 2018, followed by an announced visit on 16 March. Inspectors spoke with people living there, relatives and staff. They also looked at care records, medicine records, staff files, the building and quality checks.
The home was rated Good for Safe and Outstanding for Effective, Caring, Responsive and Well-led. Inspectors found that risks, staffing, safeguarding, medicines and equipment were managed safely. They also found well-trained staff, kind and respectful care, personalised support and strong links with the local community.
The home had previously been rated Requires Improvement because risk assessments and care plans were not updated quickly enough when people's needs changed. Inspectors found this problem had been addressed, including through a new electronic care records system. The independent living apartments were not part of this inspection.
Personalised care
People and relatives were involved in planning care around personal wishes, goals and interests. Staff adapted support as people's needs changed.
“People and their relatives told us they had been involved in the planning of their care through the assessment and life planning process and on-going reviews.” from the report
Rehabilitation and progress
The home used tailored exercise programmes, equipment and technology to help people improve mobility and independence. Inspectors saw examples of significant progress.
“There were exceptional outcomes for people.” from the report
Kind and respectful staff
Inspectors observed warm, respectful interactions. People were supported to make choices, maintain their dignity and stay involved in decisions about their lives.
“We saw people were supported to fulfil their dreams and people's achievements were celebrated and their views were sought and acted on.” from the report
Activities and community life
The home offered a wide range of activities, trips and links with schools and local organisations. This helped people maintain interests, make friends and avoid social isolation.
“People were encouraged to make friends, maintain and learn new skills and were provided opportunities to be active participants in their local community.” from the report
Food and specialist diets
Inspectors found strong catering arrangements and a wide choice of food. Staff developed modified meals so people with swallowing difficulties could have similar choices and presentation to others.
“The catering facilities at the care village were exceptional.” from the report
Leadership and learning
Managers promoted continuous improvement and shared learning from incidents with other services. Staff reported regular supervision, useful training and support to develop.
“There was a culture of continuous improvement and management showed enthusiasm and drive to ensure people received outstanding care.” from the report
Hand towels and infection control
minorThe infection control audit scored 96%, but inspectors noted hand towels used as bathroom decoration. They identified these as a possible cross-contamination risk and recorded an action.
“The only action was due to the presence of hand towels which formed part of the bathroom decoration.” from the report
- 01How will you make sure my relative's risk assessments and life plan are updated promptly when their needs change?
- 02How many staff would be available for my relative's needs, and how is this decided on each shift?
- 03How would you adapt meals if my relative has swallowing, nutritional or other dietary needs?
- 04Which activities and community visits could be matched to my relative's interests and abilities?
- 05How would you involve our family in care planning and provide access to care records?
This was a comprehensive inspection covering all five key questions, but the independent living apartments did not form part of the inspection. This explanation was written from the published report of 24 May 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, March 2017
Belong Atherton Care Village was rated Requires Improvement; inspectors found kind care but serious gaps in swallow-risk records and management oversight.
Inspectors carried out an unannounced comprehensive inspection on 19 December 2016 after concerns about a specific incident. They returned on 4 January 2017 to check whether problems had been addressed. They spoke with people, relatives and staff, and checked care plans, medicines records, staff files and policies.
At the first visit, some people did not have up-to-date guidance about unsafe swallowing. Inspectors also found problems with food and fluid records and medicines files. They raised two safeguarding alerts. By the return visit, the swallow guidance, food and fluid records and medicines systems had been improved.
People were treated with kindness and respect. Staff training, consent, care planning and complaints handling were also seen as good. However, inspectors said the management checks had not found the earlier problems, so the service was not consistently safe or well-led.
The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement. Effective, caring and responsive were rated Good. The previous inspection in March 2015 had rated the service Good overall and Outstanding for well-led.
Kind and respectful care
Inspectors saw staff treating people with kindness, compassion and respect. People were supported to keep their privacy and independence.
“We saw people were treated with kindness and compassion.” from the report
Staff training and support
Staff had structured induction, training, supervision and appraisals. Dysphagia training was introduced and provided to many staff after the concerns identified.
“Staff received a comprehensive induction and had access to a range of training to support them in their role.” from the report
Personalised care planning
Care plans included people's life histories, preferences, health needs and daily support. People and relatives were involved in assessments and reviews.
“The life plans we looked at also contained detailed life history information which was captured in 'this is me'.” from the report
Improvements made quickly
At the second visit, inspectors found updated specialist-diet information, completed food and fluid records and safer medicines records.
“We looked at 11 people's care files and found all the food and drink life plans had been updated since our visit on 19 December 2016.” from the report
Swallowing and dietary risks
seriousAt the first visit, some staff did not have current instructions for people needing specialist diets or thickened drinks. Inspectors observed that one person's drink was not thickened as required.
“We found people were not always protected against the risk associated with an 'unsafe swallow' because life plans were not updated timely to provide the required guidance to staff to mitigate the risks.” from the report
Weak quality checks
seriousThe home's audits checked whether care plans existed but did not check whether the detail matched people's current needs. This meant they failed to identify the problems inspectors found.
“We found audits had not been effective as they had not identified the issues raised during our first inspection.” from the report
Activities and time with staff
needs fixingSome people and relatives said there were few activities, outings or opportunities for stimulation. One person said staff interactions could be mainly task-focused.
“A number of people spoken with and relatives of people living at the care village told us there was little stimulation and activities offered to people.” from the report
Management visibility
seriousPeople and relatives gave mixed views about whether managers were visible and approachable. This was a concern alongside the weak quality assurance.
“The registered manager had failed to provide quality assurance or oversight of the service.” from the report
- 01How are current swallowing, food consistency and thickened-drink instructions shown clearly on each household?
- 02How do you check that food and fluid records accurately reflect what each person has received?
- 03What changes have been made to quality audits so they check the detail of care plans, not just whether plans are present?
- 04How are people with restricted mobility supported to attend activities, outings and the gym or bistro?
- 05How often can families speak with the registered manager, and how is management visibility monitored?
This was an unannounced comprehensive inspection on 19 December 2016 followed by an announced visit on 4 January 2017, covering all five key questions and checking improvements made after the first visit. This explanation was written from the published report of 16 March 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Belong Atherton Care Village
3 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- May 2018Outstandingcurrent ratingup from Requires improvementSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
Read what inspectors found at Belong Atherton Care Village →
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Belong Atherton Care Village →
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- April 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 21 March 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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