CQC report explained · a nursing home
What the CQC found at Belsfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2022
Requires Improvement; inspectors found exceptionally caring and responsive support, but medicines were not always managed safely.
Inspectors visited on three dates. The first visit was unannounced. They spoke with people, relatives, staff and health professionals. They observed care, checked the home, reviewed care and medicines records, and looked at management systems.
The main safety problem was medicines management. Staff were not always clear about who needed thickened drinks, records did not always show when thickener was used, some instructions for as-needed medicines were not person-centred, and controlled drug records were not always accurate. Inspectors found no evidence that people had been harmed, but said these problems put people at risk.
The home was rated Good for effective care. It was rated Outstanding for caring and responsive care. Staff were described as kind, respectful and highly person-centred, with meaningful activities and strong support for people's independence.
The overall rating was Requires Improvement. Well-led was also Requires Improvement because the home's checks had not identified and fixed the medicines problems. The previous overall rating was Outstanding, published in March 2019.
Kind and respectful care
Inspectors found a calm and compassionate culture. Staff knew people well and treated them as individuals, with a strong focus on equality, dignity and human rights.
“People received highly personalised and compassionate care which considered their rights to equality and acknowledged diversity.” from the report
Personalised support
Care plans reflected people's preferences, life histories and changing needs. Staff used detailed information to understand how to support each person.
“Care plans were discussed with people and clearly reflected their preferences and personal history.” from the report
Meaningful activities
People could take part in activities matched to their interests, abilities and past lives. Examples included trips out, fishing, celebrations and use of a magic table.
“People were given plenty of opportunities to take part in a wide range of activities, which contributed positively to their well-being.” from the report
Staffing and training
There were enough staff to meet people's needs safely, including one-to-one support for many people. Staff received wide-ranging training and regular supervision.
“There were enough staff on duty to meet people's needs safely.” from the report
Thickened drinks
seriousSome staff did not know which people needed thickened fluids. Records did not always show when thickener was added, so inspectors could not be sure people received these drinks safely.
“Some staff were not aware of which people needed their fluid thickened.” from the report
Medicine instructions and records
seriousInstructions for as-needed medicines were not always personal enough to guide staff who did not know people well. Controlled drug balances were also not always accurate, and one prescribed pain relief patch had not been given the day before the inspection.
“Controlled drug balances were not always completed accurately.” from the report
Checks did not catch medicine problems
needs fixingThe home's audits and checks did not identify and address the medicines issues. This contributed to the Requires Improvement rating for well-led care.
“The provider's systems had not been effective in identifying and addressing the issues related to safe management of medicines, highlighted in the safe section of this report.” from the report
- 01What changes have been made to ensure every person who needs thickened drinks is clearly identified?
- 02How do you record when thickener is added to drinks, and who checks these records?
- 03How are as-needed medicine instructions made personal enough for staff who may not know someone well?
- 04What checks are now in place for controlled drug balances and prescribed patches?
- 05What progress has been made on the action plan requested by CQC?
The inspection began as a focused inspection about infection control and concerns about unexplained injury, then widened to a comprehensive inspection covering all five key questions after medicines concerns were found. This explanation was written from the published report of 1 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, February 2022
Inspected but not rated; inspectors found strong infection control, visiting arrangements and staffing during the COVID-19 pandemic.
This was a targeted inspection. Inspectors looked at infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19. The inspection was announced 24 hours in advance.
Inspectors were assured that the home used personal protective equipment safely, supported testing, managed possible outbreaks and followed visiting, shielding and social distancing guidance. They also found that non-exempt staff and visiting professionals were meeting the COVID-19 vaccination requirement.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or full ratings for all five areas of care.
Support for visits
The home supported relatives to visit as often and for as long as they wished. It also used a large viewing screen to help people living with dementia recognise relatives by video link.
“The registered manager understood how essential social contact was to people's wellbeing.” from the report
Visitor safety checks
Visitors had their identity and temperature checked, were tested and were given personal protective equipment before entering.
“The provider had an excellent system to check visitors' identity and temperature before entering the home.” from the report
Infection control
Inspectors were assured that the home used PPE safely, supported testing and had arrangements to prevent and manage infection outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Staffing levels
The provider reported maintaining staffing levels during the pandemic and recruiting staff to meet people's needs.
“Throughout the pandemic, the provider maintained exceptional staffing levels equivalent to each employee assisting no more than two people during the day.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the home's current arrangements for visits and infection control?
- 02How does the home now manage COVID-19-related staff shortages?
- 03What are the home's current staffing levels on days, nights and weekends?
- 04How does the home support people living with dementia to keep in contact with relatives?
- 05When were the other areas of care last fully assessed, and what were the findings?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 5 February 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.
Every inspection of Belsfield House
3 rated inspections over 6 years: the service has slipped, from Outstanding to Requires improvement.
- October 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- March 2019Outstandingstayed OutstandingSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- July 2016OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 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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32 live-in carers within about an hour of Blackpool
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 £1,250 a week. 31 can care for a couple. 12 years' experience on average.
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.