Archived: Balmoral Court Care Home

Updated 9 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 1 and 2 December and was unannounced. The inspection team consisted of an adult social care inspector, a specialist advisor and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the home prior to our inspection. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We also contacted the local authority that commissions the service. They told us they had last visited the home in August 2015 at which time most of the actions for improvement they had set had been completed.

During the inspection we talked with 16 people living at the home and eight relatives or visitors. We spoke with the managing director, the manager, the deputy manager, and with 18 nursing, care and ancillary staff. We observed how staff interacted with and supported people, including during a mealtime. We looked at nine people’s care records, medicine records, staff recruitment and training records and a range of other records related to the management of the service.

Updated 9 March 2016

The inspection took place on 1 and 2 December 2015 and was unannounced. This means the provider did not know we were coming. We last inspected Balmoral Court Care Home in January 2014. At that inspection we found the service was meeting the legal requirements in force at the time.

Balmoral Court Care Home provides nursing and personal care for up to 62 older people with dementia related conditions and other mental illnesses. At the time of our inspection there were 42 people living at the home.

A new manager had applied to become the registered manager for the home. 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.

We found that parts of the home were not well maintained. All reasonable steps had not been taken to reduce risks and make sure that people’s care was provided in a safe and hygienic environment.

New staff were suitably recruited and there were enough staff to safely meet people’s needs. Systems were in place for protecting people against the risk of abuse and responding to any allegations of harm or abuse.

The home provided a service to people who often had complex mental health needs. The principles of the Mental Capacity Act 2005 had not been consistently applied where people lacked capacity to make important decisions about their care and treatment.

People were supported to receive health care services and maintain their health and well-being. The arrangements for managing medicines did not fully protect people living at the home.

Nutritional needs were assessed and care planned, though food intake was not always properly monitored. We found concerns about the limits on snacks and drinks, support with eating and drinking, and people’s experiences at mealtimes.

Staff were given training relevant to the needs of the people they cared for and told us they felt supported in their roles. Individual supervision and appraisal was not being routinely provided for all staff to support them in their roles and assist with their personal development.

We observed many caring interactions between staff and people living at the home. However, there were times when people’s requests and dignity were not respected.

People had care plans for meeting their needs and staff knew individuals well and how they preferred their care to be given. Care was adjusted in response to changes in people’s needs.

A range of activities were offered to help people meet their social needs and be involved in their local community. We have made a recommendation about developing a more dementia-friendly environment.

People and their relatives were generally happy with the care provided. Any complaints about the service had been appropriately responded to and investigated.

A new manager was in post who was providing leadership to the staff team. The manager and provider were keen to promote an inclusive culture. Checks and audits of standards at the home were carried out. However, these had not been fully effective in making improvements to the quality of the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and treatment, the premises, consent, nutrition, dignity and respect, and the governance of the service. You can see what action we told the provider to take at the back of the full version of this report.