CQC report explained · a residential care home
What the CQC found at Balmoral House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable risk assessments, enough staff, safe recruitment and safe medicines management. The home was clean and staff followed infection control guidance.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found committed leadership, regular quality checks, open communication and systems for acting on feedback and learning from incidents.
What inspectors found, February 2021
Balmoral House was rated Good; inspectors found safe care, good infection control and strong management.
This was an unannounced focused inspection on 26 January 2021. Two inspectors reviewed infection control, safety and management. They spoke with people using the service, relatives, staff and visiting professionals, and checked care, medicines, recruitment and management records.
The inspectors found people were safe and well cared for. There were enough trained staff, medicines were managed safely, risks were reviewed and the home was clean. Infection control measures, including hand hygiene, protective equipment and extra cleaning, were in place.
The home was rated Good for Safe and Well-led. The inspection did not look at Effective, Caring or Responsive. Those ratings from earlier comprehensive inspections were used in the overall rating, which remained Good.
Infection control
The home was clean and staff had training and guidance on preventing infections, including Covid-19. They used hand hygiene and protective equipment appropriately.
“The service was clean and tidy throughout. Staff had received infection prevention and control training.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and safe recruitment processes to help prevent unsuitable people being employed.
“There were enough staff on duty to meet people's needs.” from the report
Risk management
People's risks were recorded and reviewed. The home also recorded incidents and shared learning with staff to reduce the chance of problems happening again.
“Risk assessments were in place and regularly reviewed.” from the report
Medicines
Medicines were stored, given and disposed of safely. Staff had medicines training and their skills were checked.
“Medicines were safely received, stored, administered and destroyed when they were no longer required.” from the report
Management and feedback
Inspectors found approachable management, regular checks on quality and safety, and evidence that people's suggestions were acted on.
“A clear auditing system was in place to monitor the quality and safety of the service provided.” from the report
Inspectors raised no specific concerns in this report.
- 01How are infection control, hand hygiene and protective equipment arrangements being maintained now?
- 02How do you check that there are enough trained staff on duty for people's current needs?
- 03How often are risk assessments reviewed, and how is learning from accidents or incidents shared with staff?
- 04How are medicines staff trained and checked as competent?
- 05What actions have resulted from recent audits, feedback or suggestions from people and relatives?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 27 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Good; inspectors found safe, kind and personalised care, with some medicine guidance still being updated.
This was an unannounced inspection on 21 January 2019. Inspectors spoke with people living in the home, relatives, staff and a health professional. They reviewed care files, medicine records, staff records and quality checks, and looked around the building.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, had enough staff, received medicines as prescribed and lived in a clean home.
Inspectors found that care plans were now updated when people's needs changed. The home had also improved its checks on the service since the previous inspection, which had been rated Requires Improvement in February 2018.
There were a few shortfalls. Some guidance for staff about certain medicines given when needed was missing, and the menu writing was small with no pictures. Overall, the report says legal requirements were met.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and saw that employment checks were completed before staff started work.
“There were sufficient staff deployed to meet people's needs.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff being patient and friendly, while protecting people's privacy and dignity.
“People and their relatives described staff as kind and caring.” from the report
Personalised care planning
Care plans included people's preferences, communication needs, cultural and religious requirements, and guidance about how to respond when needs changed.
“The care plans and risk assessments were updated when people's needs changed.” from the report
Improved quality checks
Compared with the previous inspection, the home had introduced a wider range of audits and acted when problems were found.
“There was a range of audits carried out, which included records such as care plans and monitoring charts.” from the report
Health and nutrition support
People had access to health professionals and their nutritional needs were monitored. Catering staff understood cultural and religious diets.
“Catering staff were knowledgeable and supported people to follow cultural and religious diets.” from the report
Missing medicine protocols
needs fixingSome protocols explaining how staff should make decisions about medicines given when needed were missing. The report says replacement protocols had been sourced.
“There were some missing protocols, which were used to provide guidance around decision-making for staff when people were prescribed medicines on an 'as required' basis.” from the report
Menu accessibility
minorMenus were displayed, but the writing was small and there was no picture version. Staff did visit people to explain the menu and offer alternatives.
“Menus were on display although the writing was small and there was no pictorial version.” from the report
Staff sometimes rushed
minorOne person said staff could be rushed in the evenings and at weekends. This was raised alongside otherwise positive comments about caring staff.
“The staff are caring, kind and respectful; sometimes a bit rushed in the evenings and weekends” from the report
- 01Have the replacement protocols for medicines given when needed now been put in place, and how do you check staff follow them?
- 02How do you help people who may find the small menu writing difficult to read or who would benefit from pictures?
- 03How do you make sure staffing is sufficient and care is not rushed in the evenings and at weekends?
- 04How are care plans reviewed when a person's needs change?
- 05What improvements have been made since the previous Requires Improvement inspection, and how are these checked now?
This was an unannounced inspection covering all five CQC questions, including the premises and the care provided; the previous inspection in January 2018 was rated Requires Improvement. This explanation was written from the published report of 27 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Balmoral House
4 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- February 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 1 August 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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32 live-in carers within about an hour of North Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 29 can care for a couple. 11 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.