The inspection took place on the 18 August 2015 and was unannounced.
Belle Vue Country House provides nursing care and accommodation for up to 41 people. On the day of our inspection there were 31people living at the home. The home specialises in the care of people living with dementia and mental health conditions. The home is a country house spread over two floors with three communal lounges with dining areas and set in large gardens.
The home had a registered manager. 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.
The experiences of people were positive. People told us they felt safe living at the service, staff were kind and compassionate and the care they received was good. One person told us “This place is secure. I have no concerns, this place is fine. I feel safe here, staff are very good.” We observed people at lunchtime and through the day and found people to be in a positive mood with warm and supportive staff interactions.
There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate the risks. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff on duty at all times to meet people’s individual care needs. When new staff were employed at the home the registered manager followed safe recruitment practices.
Staff supported people to eat and they were given time to eat at their own pace. The home met people’s nutritional needs and people reported that they had a good choice of food and drink. Staff were patient and polite, supported people to maintain their dignity and were respectful of their right to privacy. People had access to and could choose suitable leisure and social activities in line with their individual interests and hobbies. These included trips to local attractions, singing, painting and arts and crafts. One person told us “I get involved in the activities at the home. I like my newspaper and playing scrabble. 4 or 5 of us go out for a half hour walk regularly with the activities person. Sometime 8 of us go out in a mini bus to Brighton”.
People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.
The home considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.
The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get the medicine they needed when they needed it. People were supported to maintain good health and had access to health care services when needed. People had sufficient to eat and drink throughout the day.
Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of the needs of people. One staff member told us “I have worked here for many years and we are a really good team, training is good and we really get to know people and care for them in a way they suits them”.
Resident and staff meetings regularly took place which provided an opportunity for staff and people to feedback on the quality of the service. Feedback was sought by the registered manager via surveys. Surveys results were positive and any issues identified acted upon. People and relatives we spoke with were aware how to make a complaint and all felt they would have no problem raising any issues. The registered manager responded to complaints in a timely manner with details of any action taken.
There was a positive and open atmosphere at the home. People, staff and relatives found the registered manager approachable and professional. One person told us “The manager, she is nice always happy to have a chat and see how I am doing”. The registered manager carried out regular audits in order to monitor the quality of the home and plan improvements.