The Inspection took place on 12 November 2018 and was unannounced.

Belvoir House Care 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.

Belvoir House Care Home provides accommodation for up to 24 people living in one adapted building. The home provides care for older people some of who may be living with dementia. There were 20 people living at the home when we inspected.

There was no registered manager in post 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.

This was the first inspection of the home since the provider purchased it. Therefore, this is the first time the home has been rated Requires Improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care plans contained the information needed to support staff to provide care tailored to people’s individual needs. They also contained the risk assessments to minimise the risk to people while receiving care. However, pressure care was not always provided in line with the risk assessments. People received coordinated care at the end of their lives as the staff worked with healthcare professionals to ensure people received the care needed at this time of their lives.

The number of staff needed to care for people was assessed but due to sickness people were late receiving their care. Recruitment processes ensured that staff were safe to work with people living at the home. Staff received the training and support needed to provide safe effective care. Policies were in place to support effective care. Staff knew how to keep people safe from the risk of abuse.

People were offered a choice of meals and were supported to eat safely and maintain a healthy weight. Medicines had not always been available to people and recording of medicines did not always support the safe management of medicines. The home was clean and staff knew how to use protective equipment to keep people safe from the risk of infection.

Staff were kind and caring and took the time to get to know people. They offered people choices in their lives and involved people in their care. People’s ability to make decisions was assessed. However, when people had arranged for others to make decision on their behalf the paperwork to confirm this was not available. At times people’s dignity was not maintained. Activities were provided, however at times the activities may not be supportive of people living with dementia.

Systems to monitor the care people received had not identified the concerns around the management of medicines. However, they had identified all the other concerns we found. In addition, complaints and incidents had been investigated and action had been taken to improve the safety and quality of care provided. The environment did not support the needs of people living with dementia and was not maintained to an acceptable standard. In addition, linen in the home was in poor condition.