This unannounced inspection took place on 21 and 25 July 2017.

Belmont is situated in a rural location on the outskirts of Longridge. The service is registered to provide personal care and accommodation for a maximum of 49 people. Accommodation is provided in 46 bedrooms with en suite facilities. The home is a single storey building divided into four units, each with its own lounge, dining room and kitchen. There are two other large communal rooms mainly used for activities and social functions, and outdoor areas people can use. At the time of the inspection 41 people lived at the service.

At the last inspection on 17 April 2015, the service was rated ‘Good’. At this inspection we found the service remained Good.

People had received their medicines as prescribed and staff had been trained in the safe management of medicines. We found areas that required improvement in the medication storage. The registered manager took immediate action to make the required improvements during the inspection. Medicines were stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans had been put in place to ensure people’s health and well-being were maintained.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People’s consent to various aspects of their care was considered and where required DoLS authorisations had been sought from the local authority. However, improvements were required in relation to staff knowledge and understanding of mental capacity.

Staff had received regular training and supervision to ensure they were supported in their role.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty. Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. However people who received support, or where appropriate their relatives, were not adequately involved in reviewing their care records. The registered manager had identified this before our inspection through their audits. People’s independence was promoted.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “The food is very good, I get a choice and I get enough.” We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to participate in activities of their choice and a range of activities that had been organised. We observed the activities coordinator engaging people and offering a range of activities. People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of care at Belmont. These included, regular internal audits of the service, surveys for residents, staff and resident meetings to seek the views of people about the quality of care being provided. We found improvements were required to ensure that issues and concerns identified in audits were overseen by the registered manager and action plans were signed to demonstrate that the remedial work had been undertaken and completed by those responsible.

Belmont Residential Care Home is situated in a rural location on the outskirts of Longridge. The service is registered to provide personal care and accommodation for a maximum of 49 people. Accommodation is provided in 46 bedrooms with en suite facilities. The home is a single storey building divided into four units, each with its own lounge, dining room and kitchen. There are two other large communal rooms mainly used for activities and social functions, and outdoor areas people can use.

This unannounced inspection took place on 17 April 2015. We last inspected this service on 20 February 2014 and the home was compliant with the regulations we checked during the inspection.

People’s views about the service were very positive. Our observations and the information held with the records matched the positive descriptions that people who lived at the home gave us.

The systems and procedures operated at the home were designed to enable people to live their lives in the way they chose, depending on their ability. The care and support offered to people was personalised and people’s dignity was put first.

The risks linked to people developing further health and social care problems were minimised as far as possible. The care provided was orientated around the person and took account of people’s assessed needs, preferences and choices.

The service and staff respected and involved people in the care they received. For example, all the care plans viewed showed the person’s choices and personal preferences. The care planning process had involved the person or their relative when they were written and their views were reflected in the plans. People told us they had input into the menus or activities at the home and we saw that the choice of meals was varied.

Staff members took into consideration the Mental Capacity Act (2005) for people who lacked capacity to make decisions. People’s mental capacity was assessed and there was information available for the staff that helped them support a person with fluctuating capacity. We saw consistent approaches from staff with staff explaining to people before they undertook a care process, other staff gave the person information about the care and support they were in receipt of.

Staff were provided with effective support, induction, supervision, appraisal and training. The service had a system to manage and report accidents and incidents. When action plans were needed to monitor people's safety these were produced. The service had a quality assurance and, where appropriate, governance systems in place.

There were effective accountability systems in operation within the home. If care tasks or records were not completed, action was taken by the Registered Manager or management team to address the issues and ask people for a clear explanation as to why they had not undertaken their responsibilities properly.

There was a registered manager in place at the time of our 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.

People’s care and treatment was planned and delivered in a way that helped to ensure their health, welfare and safety. People were cared for as they wished by well trained staff. People described staff as doing a good job, great fun, kind and caring, polite and courteous. Visitors told us staff were attentive to people’s needs, always around and very pleasant. Activities provided for people were very good, age appropriate and met the different needs of all the people at the home.

People were provided with a good diet that catered for their needs. “I like my food, its good and I can have what I want”. Meals served were homemade and the menus showed meals were varied and nutritionally balanced.

We observed people living in the home were comfortable around staff and showed no signs of fearful or concerning behaviour. Staff communicated well and appropriately with the most vulnerable people, such as people with dementia. Staff were trained to safeguard people and they understood their duty of care to protect people using the service from harm.

People were cared for by staff who had been recruited properly and were of proven good character.

People were given good opportunities to give their views as to whether the service and accommodation provided met with their needs and expectations. High standards of quality monitoring were carried out to ensure people’s health welfare and safety.

People had a good assessment of their needs and they agreed their care and support. People told us they were treated with kindness and respect. People had very good care plans that placed them at the centre of their care and were kept under review. People also told us they could choose the gender of their carer and staff respected this. The provider had good policies and procedures in place to ensure people’s dignity was respected. Not everyone could express their views. We observed some good care practice. People were well dressed and staff spoke to them respectfully. One person told us “They(staff) help me I get a little unsteady on my feet so they make sure I have my frame at hand”. Staff knew which people were assessed as being at risk of falling, developing pressure ulcers or may not eat enough and had guidance for best practice to reduce these risks.

We found family members were happy with the care of their relation. One person wrote ‘I can’t describe to you what it is like to be separated from the person you have loved and cherished for over 60 years. However I am greatly comforted by the knowing that . Is in safe hands and that you do all in your power to make her happy and comfortable. Thank you and God bless’.

There were no rules imposed on people or any institutional practices observed. Staff were trained to protect people and recruitment practices were safe in ensuring people employed were of proven good character. People knew the complaints procedure.