We inspected the service on 02 October 2018. The inspection was unannounced. Belvidere residential home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates people.

On the day of our inspection 23 people were using the service.

At our last inspection on 21 October 2015 we rated the service good in all the key questions and at this inspection; we found the service remained ‘Good’ again in all areas. At this inspection we found the evidence continued to support the rating of good There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used. People received their prescribed medicines safely and these were managed in line with best practice guidance. Accidents and incidents were analysed for lessons learnt and action was taken to reduce further risk.

People continued to receive an effective service. Staff received the training and support they required to meet people’s individual needs. People were supported with their nutritional needs. Staff identified when people required further support with eating and drinking and took appropriate action. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to comfort people when they were distressed and made sure that emotional support was provided. People’s independence was promoted.

People continued to receive a responsive service. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. People had opportunities to pursue their interests and hobbies, and social activities were available. There was a complaint procedure and action had been taken to learn and improve where this was possible.

The service continued to be well-led. There was an open and transparent culture and good leadership, oversight and accountability. People received opportunities to share their feedback about the service and staff felt valued. The provider had quality assurance checks in place on quality and safety.

Further information is in the detailed findings below.

Belvidere is registered to provide accommodation for up to 28 older people who require accommodation and personal care. People who live there may have a range of needs which include dementia, physical disability and sensory impairments. At the time of our inspection 28 people were using the service. Our inspection was unannounced and took place on 21 October 2015. The last inspection took place on 05 June 2013 and all the regulations were met.

The manager was registered with us as is required by law. 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 told us they felt confident that the service provided to them was safe and protected them from harm. Staff we spoke with were clear about how they could access and utilise the providers whistle blowing policy and that they knew how to keep people safe.

Medicines were given appropriately with audits carried out daily. Medicines that were refused or not given were recorded and disposed of appropriately.

We observed there were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People told us that they were able to raise any concerns they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and used a variety of communication methods to establish their consent and/or understanding.

People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration. People were supported to access a range of health and social care professionals to ensure their health needs were met.

Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

Staff were aware of how and when to access health care for people and assisted with this when required. People were involved in the planning of care and staff delivered care in line with people’s preferences and wishes.

Information and updates about the service were made available to people in meetings and to relatives verbally.

The complaints procedure was displayed in a clear and understandable format to maximise people’s knowledge and understanding of how to make a complaint.

People, relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective.

Quality assurance audits were undertaken regularly by the provider. The registered manager had also ensured that checks on staff were undertaken periodically out of normal working hours.

On the day of our visit there were 28 people living at the home.

We spoke with four people, three relatives, two visiting professionals, the manager and six staff members.

All of the people we spoke with were happy with the care and support they received. Care was described by people as, “Brilliant” and, “Marvellous.” A relative said, “It’s the best.”

People appeared comfortable and relaxed around staff and each other. All of the people we spoke with all said they felt safe. We saw that safeguarding policies were in place to guide staff as to the action to be taken when reporting abuse. Staff knew what they should do.

The building was of a suitable design and layout for the people who used it. All of the people we spoke with told us that their rooms were nice and that the home was a nice place to live.

All of the people and relatives that we spoke with were very complimentary about the staff and the management at the home. A relative said, “They are lovely, every one of them.”

There was an effective and easy to access complaint system. People told us they would feel confident to raise a complaint if they needed to.

Belvidere Residential Care Home provided a good standard of care. People we spoke to were complementary about the staff saying, " staff are very kind," and " the staff are lovely." A nurse visiting the home said," the staff are very helpful and polite, they respect people's dignity." The home is striving to improve the activities it offers to people. Two designated activity coordinators were planning an activity programme to include gardening, cooking, arts and crafts, bingo and trips out to see shows. It is important that staff are updated on the safeguarding of vulnerable adults, Mental Capacity Act and Deprivation of Lliberties to ensure staff have up to date knowledge of safeguarding and referral mechanisms. There is an established system of quality monitoring in place. We found that the home would benefit from redecorating to create a more pleasant environment for people to live in.