We inspected the Belvoir Care Home on 20 September 2017. The inspection was unannounced. We last inspected the Belvoir Care Home on 15 December 2015 when we found the service was meeting all the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Belvoir Care Home is registered to provide personal care and accommodation for up to 24 older people. There were 18 people using the service at the time of the inspection.

The Belvoir Care Home is a detached property that has been converted and extended. It is situated on a main road in Wardle, close to public transport networks, local shops and facilities. There is ramped access to the front of the home and on-street car parking at the side of the home. There is a small garden to the side and rear of the building with a patio area to the front.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the inspection. 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.

We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff were able to demonstrate their understanding of the whistle blowing procedures (the reporting of unsafe and/or poor practice).

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

The medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.

Procedures were in place to prevent and control the spread of infection and risk assessments were in place for the safety of the premises. All areas of the home were secure, clean, well maintained and accessible for people with limited mobility; making it a safe environment for people to live and work in.

Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained in accordance with the manufacturers’ instructions.

Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and water supply.

People told us they received the care they needed when they needed it. They told us they considered staff were kind, had a caring attitude and felt they had the right skills and knowledge to care for them safely and properly. We saw that staff treated people with dignity, respect and patience.

We saw people looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected.

People's care records contained enough information to guide staff on the care and support required. The records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that people were involved and consulted about the development of their care plans.

Specialised training was provided to help ensure that staff were able to care for people who were very ill and needed ‘end of life’ care.

Staff were also able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met.

To help ensure

Belvoir Care home provides personal care and accommodation for up to 24 older people. There are 16 single and four double bedrooms, with five of the bedrooms having the provision of en-suite toilets. A passenger lift to the first floor is provided. There is a small garden and patio area to the rear and car parking is also available.

We last inspected this service on 4 August 2014 and found that the service was compliant in the regulations we assessed.

The home had 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 who used the service and the visitors we asked told us that Belvoir Care Home was a safe place to live and they were well looked after. Staffing levels were sufficient to meet the needs of people who used the service.

Safeguarding procedures were robust and members of staff understood their role in safeguarding vulnerable people from harm.

We found that recruitment procedures were thorough and protected people from the employment of unsuitable staff.

The home was clean and appropriate procedures were in place for the prevention and control of infection.

Members of staff told us they were supported by management and received regular training to ensure they had the skills and knowledge to provide effective care for people who used the service.

Members of staff had also been trained in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) so they knew when an application to protect a person’s best interests should be made and how to submit one.

Most of the people we asked told us the meals were good. Snacks and drinks were available between meals. We found that people’s weight and nutrition was monitored so that prompt action could be taken if any problems were identified.

People were registered with a GP and had access to a full range of other health and social care professionals.

We saw that members of staff were courteous and treated people with respect. People who used the service were nicely dressed and looked smart.

We saw that care plans included information about people’s personal preferences which enabled staff to provide care that was person centred and promoted people’s dignity and independence.

Some leisure activities were organised within the home. These included games such as dominoes and draughts and reminiscence.

A copy of the complaint’s procedure was displayed near the main entrance. No complaints had been made to CQC or the local authority during the last year.

Members of staff told us they liked working at the home and found the registered manager approachable and supportive.

People who used the service and their representatives told us the home was well managed and would recommend it to others.

We saw that systems were in place for the registered manager to monitor the quality and safety of the care provided.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We spoke with two people who used the service and they both told us they were happy and felt safe living at Belvoir care home. Staff members had completed appropriate training related to safeguarding vulnerable adults which helped ensure people were kept safe at the care home. Staff members we spoke with told us they knew what to do in the event of any allegations of abuse and would not hesitate to report them to the manager.

The care home was clean and hygienic and equipment was serviced and maintained regularly. This helped ensure people who used the service were not put at any unnecessary risk.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The provider told us no recent applications for DoLS had been made but knew the procedure to be followed if an application needed to be made. At the time of our inspection, no person who used the service was subject to a DoLS.

Is the service effective?

There was an advocacy service available for people who used the service. This helped ensure that if people required additional support, they could, or would be supported, to access it.

People`s needs had been taken into account with the signage and layout of the care home. This meant people could move around the home safely and freely. The home had been sensitively adapted to meet the needs of people with limited mobility which promoted their independence.

Is the service caring?

People who used the service were supported by staff members in a patient and unhurried manner. Staff gave encouragement to people but supported them if they thought assistance was required.

People and when possible, their families were involved in regular meetings and completed surveys. This provided them with the opportunity to express their views related to how their care and support was provided. One person told us, "Once you come here you don`t want to leave."

Is the service responsive?

During our inspection, we observed people taking part in several activities during the day. We were told of social outings that had been attended by people who use the service. One person told us, "We went to a place near Blackpool and we had a lovely time. We have been promised another day out soon."

People we spoke with and family visitors knew how to make a complaint if necessary. We looked at the last complaint received and saw it had been managed in accordance with the provider`s policy.

Is the service well led?

We saw evidence that the provider had procedures in place that monitored the quality of service being provided to people who used the service. This helped ensure the service continued to improve.

We saw records of GP and other professional visits. The provider told us they worked well with, and had a good relationship with other agencies. This helped ensure people received care and support when they needed it.

During this inspection we looked at what improvements had been made following our last visit in July 2012. We also spent time observing care practices and spoke with three people who lived at the home, one member of staff and the manager.

We saw that people enjoyed a good rapport with staff. People were encouraged to be as independent as possible and where necessary, were assisted in a gentle and unhurried way.

People who we spoke with told us, “They regularly check on me to make sure I’m alright, they always answer the bell” and “My routine is very flexible, they [the staff] are very accommodating”.

Individual care records were in place directing staff in the delivery of care. These could be enhanced with more personal information about people’s preferences and how they would wish to be cared for.

Suitable arrangements were in place with regards to safeguarding and protecting the rights of people.

Suitable arrangements were in place when recruiting new staff. Adequate staffing levels were available to support people. These were kept under review depending on the care and support people needed.

Staff spoken with told us that there were sufficient staff available to support people. They said they would speak with the manager if they had any concerns and felt supported in their role.

Systems to monitor and review the quality of service provided had been developed. This information helped to identify where the service could be improved further.

During our visit we spent sometime observing staff practice and how they interacted and supported people in their care.

We saw that staff were very attentive and patient with people. Explanations and reassurance were provided when offering support and assistance. People appeared to enjoy polite conversation with each other and staff in a relaxed environment.

We also spoke with people living at the home and their visitors. They told us; “I’m very happy here, give them 10 out of 10”, “The foods great, plenty to eat” and “The staff are wonderful, plenty of time for visitors too, always make us welcome”.

Other comments included; “I’ve no complaints at all”, “You won’t find anything wrong here”, “I’m safe here, I feel safe”, “They are really kind” and “They do more than their best”.

Visitors also commented, “they keep in contact if I need to know anything”, “They always look after us when we visit” and “Nothing is too much trouble”.

During our visit time was spent speaking with people as well as observing interactions with staff. We found overall this to be very positive. People were supported in a dignified and respectful manner, staff were patient, offering reassurance and encouragement where needed.

People spoken with told us; “They (the staff) are very kind”, “The food is nice, you get a choice”, “I can go to bed when I want”, “I’m looking forward to Christmas, it’s my first here”, “Yes, we do activities, I like the knitting and crafts” and “ I’ve made some friends since moving here”.

We also spoke with a number of visitors to the home. They too were very positive about the staff and care provided. They told us; “It’s a wonderful home”, “The carers are wonderful”, “They are so kind” and “We’re always made welcome”.

Interactions between people and staff were pleasant, eye contact was made, language was kind and encouraging and people seemed to enjoy laughing and chatting with staff.

One visitor told us “My relative is in such good health, we can only put it down to the good care they receive”.

Other comments included; “I’ve never had any cause for concern”, “They’ve done a lot of work on the home”, “It’s a homely home” and “They will do things for you, if you can’t manage yourself”.