Belsfield House

An assessment has been undertaken of a service that is used by autistic people or people with a learning disability but at the time of the assessment was not registered as a specialist service. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The service had made improvements and is no longer in breach of regulations relating to safe care and treatment. Staff now assessed and mitigated risks in relation to medicines management.

Accidents and incidents were managed well and there was not a high number of falls occurring. People moved between services safely and initial assessments were completed when people first came to this service. People were safeguarded from the risk of abuse or neglect and processes relating to DoLS (Deprivation of Liberty Safeguards) were robust. Incidents of distressed behaviours were managed well and staff ensured people felt safe in their environment. Fire checks were in place and staff were attending fire drills. Staff were recruited safely and the duty rota and people’s feedback evidenced sufficient numbers of staff were employed. We observed some safety concerns in the environment and some concerns relating to infection prevention and control which were rectified during our site visit. Medicines were managed safely, and the service was no longer in breach in this area.

People’s needs were assessed prior to their admission into the service. These assessments were used to write person-centred care plans. People and relatives spoke positively about the food on offer and the support people received. The kitchen had a board detailing people’s unique dietary requirements and staff held regular meetings to communicate any updates or change in people’s needs. Referrals were being made to other healthcare professionals where appropriate and records indicated people’s weights were stable. Staff handovers were innovative and provided the opportunity for learning ensuring people continually received high quality person-centred care. Oral care was prioritised, and people were encouraged to live healthy lives through exercise. Tools for monitoring outcomes were robustly audited by staff including the registered manager and behaviour logs were reviewed to help reduce future risks. People and their relatives were involved in decision making and a range of consent forms were in place. The registered manager was constantly looking at new and innovative ways of improving outcomes for people and case studies evidence how people’s lives had become more fulfilling since their admission to Belsfield House.

Staff spoke highly of this service and felt people were treated with kindness and compassion. One staff members comments included, “If my loved one ever needed care, this is the first place I would choose.” Staff were observed to be kind and caring towards people and always treated people with dignity. A dignity champion was in place, and people’s dignity was discussed during handovers. Staff knew people well and had knowledge of people’s life history. Care plans held extensive records of people’s preferences as well as a board in each person’s bedroom which detailed people’s preferred activities. Activities were recorded for each person and held a detailed account of how the activity impacted the person including the impact it had on their wellbeing and mood. People’s independence was encouraged and staff responded to people’s needs in a timely manner. Staff had nothing but praise for the service and felt supported by the management team. Staff wellbeing was clearly a priority.

People were at the centre of their care and treatment. People and their relatives were involved in the care planning process, and the service had been personalised to meet people’s specific needs. Reasonable adjustments were in place including signage and specialised equipment. People felt listened to and relatives told us complaints were acted on promptly. Staff knew what to do should someone have a concern, and contingency plans were in place for emergency situations. People’s advanced wishes had been taken into consideration. Concerns were raised in relation to staff communication and language barriers. Work was ongoing in this area including additional staff training to minimise this risk.

Thought had gone into the design and décor of this service to enhance people and staff wellbeing. The services core values were displayed and discussed with staff during supervisions. Supervisions and regular staff observations gave managers a chance to sit down with staff and highlight any areas of concern. There was a positive culture at this service where everyone felt listened to. Questionnaires were sent to staff; people and their relatives and regular meetings were taking place. Staff were aware of the term freedom to speak up and staff felt they were treated fairly. Lessons learnt processes were robust and partnership working ensured continuity of care. There were a range of audits and quality checks in place, however, some of these systems needed improving to ensure all areas of concern were identified. Work was needed in relation to policies and procedures to ensure they were robust and up to date.