This inspection took place on 24 and 25 October 2016 and was unannounced. Belmont Villa care Home provides nursing and personal care and accommodation for up to 30 people. At the time of our inspection there were 29 people all of whom were receiving nursing care. At our previous inspection in November 2014 we found areas of improvement were needed in relation to quality assurance arrangements and making decisions on behalf of people who lacked capacity. We looked at these areas on this inspection and found improvements had been made and shortfalls addressed.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were good arrangements for the management and administration of medicines however improvements could be made in the administering of "as required" medicines to ensure there was consistency in their use. We have made a recommendation the provider seek advice about the administering of "as required" medicines.

People and relatives told us they felt safe living in the home. One person told us "I trust the staff they always seem to know what they are doing which makes me feel better." A relative said they had no worries or concerns about the safety and wellbeing of their relative. They told us "Whenever I leave I never feel they will not be safe. it is very re-assuring."

Staff demonstrated their knowledge of abuse and responsibilities to report any concerns about possible abuse. Staff were confident the registered manager would act to protect people if told of any such concerns.

People told us staffing arrangements were good and how staff were available and responsive to their requests for assistance and support. There were consistent numbers of staff on duty. Recruitment arrangements ensured employees had the necessary experience and were suitable to work in a care home setting.

People told us they felt confident about staff having the necessary skills and training. One person we spoke with said "The staff all seem well trained."

People told us they enjoyed the activities provided by the home. These reflected the frailty and ability of people in that there was a focus on individual activities which suited people. One person told us "I enjoy just having a chat though I have done drawing and painting which was good." A relative said how the activities had improved: "There seems to be more going on and staff able to spend time with people you see them just chatting which is nice."

People spoke positively about the meals provided in the home. One person told us "I always enjoy my food, it is very good." Another person said "We always get a choice and they know what I like and don't like." We observed the mealtime experience and noted areas which could be improved to make the mealtime a more relaxed and better experience for people. We discussed what we observed and the registered manager agreed to look at making improvements.

People had access to community health services and their GPs when this was requested. Healthcare professionals we spoke with were positive about the care provided by the service. There were good relationships with outside professionals and people had access to specialist support and advice.

People and relatives spoke of caring, courteous, professional and friendly staff. There was a focus on providing a family environment where people felt cared for and respected. This was reflected in comments we received from people and relatives. One person told us "I feel staff respect me and always treat me how I would want to be treated." Another person said "This is better than when I lived at home it is my home." People and relatives told us there were no restrictions on visiti

We found that people living at Belmont Villa were consulted about the support they received and that their consent was obtained. Where people lacked capacity, we found that their relatives or advocates were involved in order to ensure people's best interests were taken into account.

We saw that people's care and welfare needs were being met and the support people received was appropriate to their needs. People were happy with the meals provided and those who were at risk received adequate nutrition and fluids.

We found the management of medications to be safe and there were enough experienced staff available to be able to provide the care and support that people required.

People were able to raise concerns or complaints if needed and these were acted upon.

This unannounced inspection took place on 11 November 2014.

The last inspection of Belmont Villa Care Home was carried out on 13 November 2013. No concerns were raised at that inspection.

Belmont Villa Care Home is registered to provide accommodation and personal care with nursing for up to 31 older people.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were cared for by kind and respectful staff however there were some improvements needed in how some staff interacted with people. We also found some improvements were needed in the keeping of accurate records and the quality monitoring arrangements of the service.

People continued to make decisions about their day to day lives. People were able to make choices about what time they got up, when they went to bed and how they spent their day. People told us “It is up to me how I spend my day. Staff accept it is my decision” and “Staff always ask me what I want to do if I want to stay in my room that is not a problem.” However, Records did not show where people or their representatives had been involved in making decisions and giving consent about their care.

There was a welcoming environment and one where having good relationships between relatives and people living in the home were seen as important. People had the opportunity to access the local community and maintain their interests with varied activities being provided by the home. People also had access to community health services and had their health needs met in an effective way.

People told us they felt safe living at Belmont Villa Care Home. One person told us “staff treat me very well, I have no complaints”. A relative said “My relative is definitely safe here, I can relax knowing this.” Staff had a good understanding of how to protect people from abuse. They were confident of raising any concerns about possible abuse and how the manager would “certainly do something about it”.

There were adequate staffing arrangements and people told us they received care when it was needed and how staff were always available to assist them. People told us they were confident their care was provided by trained and competent staff. Staff received the training and support they needed to fulfil their role and responsibilities.

There was an open and supportive management who were available and made sure people felt able to voice any concerns or unhappiness about the care they received. There were also opportunities for people to give their views about the quality of the service. People were informed and consulted about any changes which directly affected their daily lives.

People told us they enjoyed the food provided by the home and how their likes, dislikes and any specific dietary needs were catered for. One person told us “You cannot fault the food here and there is always a choice, I always enjoy my meals.” There were good arrangements to make sure people’s nutritional needs were met and any concerns were referred to other professionals for support and guidance.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

We spoke with four people who lived at the home and one visitor about their experiences of the care provided by the staff at the home. One person said “I have fun here and I am happy, the staff are good to me.”

Although people were not involved in the planning of their care, they said the staff always cared for them the way they wanted. We were told “staff explain what they are going to do before they start.”

People told us they made daily living decisions such as their appearance, their meals and activities. We were told about the group activities they joined and people were able to decide if they stayed in their rooms or spent time in the lounges.

The relative we spoke with said they were invited to review meetings. The relative said they were asked to sign review statements to show their agreement with the plan of care. We were told the staff kept them informed and they were told about important events that occurred to their relative at the home.

People told us they felt safe at the home and if they had a complaint they would approach the staff. The relative we spoke with said they had made complaints in the past and their concerns were taken seriously and acted upon.

During our visit we observed staff using wheelchairs without footplates to support people with moving around the home, which puts people at risk of injury. When we drew this to the manager’s attention they instructed staff and this was corrected during our visit.