Belmont House is registered to provide accommodation and personal care for up to 24 older people. Nursing care is not provided by the service. If nursing care is required this is provided by community nurses working for the local primary care trust.

This unannounced inspection took place on 1 and 3 November 2016. The service was last inspected in February 2014 when it met the regulations that were inspected.

A registered manager was employed at the service. The registered manager is also one of the providers. They were supported in their role by a deputy manager and a team of senior care staff. 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 received individualised personal care and support delivered in the way identified in their care plans. However, some care plans did not contain detailed information on how staff should meet particular needs. The registered manager was taking action to address this.

There were some regular activities for people to participate in. These included visiting musical entertainers and craft sessions. Staff were able to spend time with people on an individual basis. We saw staff helping one person with a jigsaw puzzle and other staff painting people’s nails.

People’s needs were met as there were sufficient staff on duty. During the inspection we saw people’s needs were met in a timely way and call bells were answered quickly. However, care staff told us around supper time could be very busy as they had to serve supper as well as help people eat. The registered manager told us they were looking to change menus and routines in order to address this.

People’s needs were met by kind and caring staff we saw that people were relaxed and happy in staffs’ presence. One visitor told us “Staff are very good, give people a cuddle if they need one.” One person told us the staff were all lovely, “They will do anything for you.” Another person said “I’m comfortable, warm and well fed – what more can I ask for?” They went on to say “It’s my home.”

People’s privacy was respected and all personal care was provided in private. People were discreetly assisted to their own bedrooms for any personal care. Staff knocked on people’s bedroom doors and waited before they entered. When they discussed people’s care needs with us they did so in a respectful and compassionate way.

A member of staff had been appointed ‘dignity champion’ and their role was to ensure people’s dignity was upheld at all times. However, we saw large stocks of incontinence products stacked in people’s bedrooms. This meant that anyone entering the bedrooms would know the person had continence difficulties. The registered manager agreed this was not dignified and said they would look at alternative storage arrangements.

Risks to people’s health and welfare were well managed. Risks in relation to nutrition, falls, pressure area care and moving and transferring were assessed and plans put in place to minimise the risks. For example, pressure relieving equipment was used when needed. People’s medicines were stored and managed safely. People were supported to maintain a healthy balanced diet. People received regular visits from healthcare professionals and were supported to maintain good health. Visiting professionals told us they had never had any concerns about the care provided by the service.

People and their relatives could be involved in planning and reviewing care if they wished. Visitors told us that they could visit at any time and were always made welcome. They also said that staff always kept them informed of any changes in their relative’s welfare.

Staff knew how to protect people from the risks of abuse. They had received training and kn

There were 20 people living at Belmont House at the time of our inspection. We spoke with nine people who live at the home, two care staff, deputy manager and the manager who is one of the providers of the home.

We found that people's privacy and dignity were respected and upheld by care staff. People we spoke with confirmed this.

People who live at the home told us they were well looked after and were happy. Another person commented “I only have to ask for something and it’s done, all the staff are very good”.

People had been protected from unsafe or unsuitable equipment. This was because the provider had systems to ensure care staff were trained to use it and that regular servicing was carried out.

Records we looked at confirmed that the provider gave serious consideration to recruitment decisions. People were cared for, or supported by, suitably qualified, skilled and experienced staff. The service had an effective, robust recruitment procedure in place. One person we spoke with said “All the staff here are very, very good, I can’t fault them”.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

We asked care staff how they were confident that people had consented to what they were doing. One care worker told us that “we explain what is going to happen and if people agree this is fine. If people decline we leave it and come back. We respect what people say”.

We asked people about the care they received and the people we spoke with told us that they were happy with their care. One person who had lived at Belmont for four years said “I have always been satisfied”, another person said staff “do a wonderful job”.

Staff we spoke to told us how they administer medication and we observed medication being given at lunch time. We saw that staff took time to explain about the medication and followed procedures to ensure people were safe.

We asked staff if they felt they had the time to do their job properly. One carer told us that “99% of the time we have enough staff, we don’t feel rushed. It is a calm and relaxed environment”.

We asked a relative of a person receiving care at Belmont what they would do if they were unhappy about something. They told us they would “go to the manager if they were unhappy about something”. They told us that the manager was “very approachable”.

We met with eleven of the 20 people who were living at Belmont House at the time of this visit, in their private room, in the lounge or the dining room, and we were able to observe others.

People told us that they get the help they need – ‘I press the button and they come’ said one person, ‘Staff are satisfactory, they get things promptly’, said another.

We saw that peoples’ appearance was well cared for. People looked clean, men were clean-shaven and all were nicely dressed. One person told us they had a bath at a regular time that suited them, and that staff ‘wash them down’ every day. ‘They must keep records – they remember what I need’, said one person who had not lived at the home for very long and was impressed with the staff’s reliability. Another person told us that staff did their shopping to make sure they have the clothes they needed.

We saw staff treating people with dignity and respect at all times, communicating clearly and sensitively with people, and responding promptly to the differing needs of people in the room. ‘Staff are always patient’, we were told by one person in the lounge.

All the people who live at Belmont House came down from their room for lunch. People who needed help to eat their meal were given that help sensitively and discretely. We saw that people were given alternative food according to their dietary needs.

People were easily able to get into the garden through the conservatory. ‘It’s comfortable here – you are not boxed in’, we were told.