Bellamy's Cottage

Bellamy's Cottage is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Bellamy's Cottage accommodates up to eight adults who have a learning disability and or autistic spectrum disorder related conditions. At the time of the inspection there were eight people living there, all male. The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service is purpose built and situated within the grounds of the Linkage college campus, close to local amenities. It provides eight single bedrooms and four have en-suite facilities. The accommodation includes a bathroom, shower room, toilets, laundry, kitchen, two sitting rooms, kitchen and a dining room.

The service had a registered manager in post. A registered manager is a person who has registered with CQC 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.

At the last inspection on 29 and 30 March 2017, we rated the service as 'Requires Improvement' and we found concerns in relation to care records, consent and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Responsive and Well-Led to at least good. At this current inspection we found significant improvements had been made in all areas.

People, their relatives and visiting professionals provided only positive feedback about the service. The registered manager had received regular peer and senior management support and we found the management and organisation of the home had improved. Quality assurance reviews were completed more thoroughly and we saw action had been taken when issues had been identified.

The service was operating within the principles of the Mental Capacity Act 2005 (MCA). People were supported to make their own decisions and choices. The registered manager had a much improved understanding of mental capacity legislation. People had assessments of capacity and best interest decisions made on their behalf if they lacked capacity; documentation regarding best interest decisions had been completed. Appropriate applications had been made to the local authority when people's liberty was deprived due to their lack of capacity and need for continual supervision. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People's care plans had improved, with new assessments of need completed for each person. The provider had implemented a new recording format and information was easily accessible. This meant they could better assess and manage risks to people's health and safety.

The organisation's new recording format had been fully implemented and information was easily accessible. Risks to people's health and safety were better assessed and managed. Care plans were detailed, person centred and updated when people's needs changed.

The management of medicines was safe and people received their medicines as prescribed. The medicine administration procedures were more person-centred.

The provider had policies to guide staff in safeguarding people from the risk of harm and abuse. Staff knew how to raise safeguarding alerts if they had concerns.

The environment was safe and clean. Staff used personal, protective equipment to help prevent the spread of infection. Equipment used in the service was checked and maintained to ensure it was safe.

There were sufficient staff on duty to meet people's needs and safe recruitment systems were in place. Staff had access to induction, training, supervision and support, which enabled them to feel skilled when supporting people who used the service. Additional training had been delivered to the staff to equip them with skills and approaches when supporting people with anxious and distressed behaviour. The staff were motivated and proud to work at the home. Morale was high and teamwork much in evidence.

The service worked effectively with a range of health professionals to help ensure good care outcomes. People liked the meals. People received the support they required to maintain adequate nutrition and participated in menu planning and meal preparation where possible.

People had formed caring relationships with the staff that supported them. Staff recognised the importance of helping people maintain their independence, privacy and dignity. Relatives spoke of the family atmosphere at the home and were very complimentary about the staff and their approach.

There was a range of meaningful occupations and activities for people to participate within the service, at the organisation's skill centre and some people attended community day services. Planned visits to local facilities were also completed and people were supported to go on an annual holiday or days out if they preferred.

The complaints policy was available in an easy to read format within the service. People were supported to discuss any issues at the weekly house meetings. Relatives told us they felt able to raise concerns if required. Relatives spoken with were happy with the service their family member received.

People's views and opinions were valued and sought through a variety of mechanisms. These were used to make improvements to plans of care and how the service was run.

The five questions we ask about services and what we found