CQC report explained · a residential care home
What the CQC found at Balmoral Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rated Requires Improvement, with Well-led rated Inadequate; inspectors found risks in care records, staffing, medicines, consent and quality checks.
This was an unannounced focused inspection after concerns about medicines and the environment. Inspectors visited on 31 August and 15 September 2023. They spoke with people, a visitor, staff and health professionals, observed care, checked medicines and reviewed care, recruitment and management records.
The home was not always safe or effective. Risk, fire safety, care and medicines records were incomplete or inaccurate. Some areas and equipment were unclean or poorly maintained. Staff training and recruitment checks were not always complete.
The home was rated Inadequate for being well-led. Quality checks had not found or fixed several problems, and people were not consistently involved in improving the service. The overall rating changed from Good at the previous inspection to Requires Improvement.
Inspectors found people were generally positive about staff and felt safe. The management team accepted feedback and began taking immediate action after the inspection. The provider must send an action plan, and the CQC will monitor progress.
Kind relationships
People spoke positively about the staff, and inspectors saw staff supporting people safely and responding to requests for help.
“They are very good staff without exception, very kind and thoughtful.” from the report
People felt safe
People told inspectors they felt safe living at the home.
“I feel very safe here because it is well run. Everything is excellent.” from the report
Enough staff during visits
Staff and inspectors observed that there were enough staff to meet people's needs during the inspection.
“Staff told us, and we observed, there were enough staff to meet people's needs.” from the report
Access to healthcare
The home contacted GPs and district nurses when needed, and a weekly ward round took place.
“There was a weekly ward round completed and one visiting professional told us, "The staff are reactive to peoples' needs.” from the report
Management responded
The management team accepted feedback, provided requested information and started addressing problems after the inspection.
“Following the inspection, the registered manager and provider took immediate action to start addressing shortfalls we identified.” from the report
Risk records were incomplete
seriousRisks to people's health and safety were not consistently assessed or managed. Fire evacuation information was incorrect or missing for some people.
“Documentation did not include all the information to guide staff around how to provide safe care and treatment.” from the report
Medicines records were not reliable
seriousSome medicines lacked clear instructions, including as-required medicines. Times for time-specific medicines were not recorded.
“The time given, for 'time specific' medicines were not recorded so we could not be sure people received their medicines on time.” from the report
Staff checks and training
seriousRecruitment records were incomplete, and staff had not all received important training. No staff had completed the Care Certificate described as essential in the home's policies.
“No staff had completed The Care Certificate which was documented as essential in the policies for Balmoral Rest Home.” from the report
Consent was not properly recorded
seriousSome consent forms were signed by people without the legal authority to do so. Capacity assessments and best-interest decisions were not consistently recorded.
“We saw examples where consent had been signed by someone who did not have the legal right to do so.” from the report
Unclean and poorly maintained areas
needs fixingInspectors found visibly unclean equipment and areas, chipped paintwork and poorly fitted flooring. Cleaning records did not show effective oversight.
“During the inspection, we found the environment was unclean in several areas.” from the report
Weak management oversight
seriousAudits had not identified or fixed problems with care records, infection prevention and staff training. Feedback from people was gathered inconsistently and it was unclear how it led to improvements.
“There was not a structured, systematic, effective approach to assess and monitor the service to identify shortfalls and drive improvements.” from the report
- 01What has been corrected in people's risk assessments and fire evacuation records since the inspection?
- 02How do you now record as-required medicines and confirm that time-specific medicines are given on time?
- 03Which staff have completed safeguarding, diabetes, infection control and food hygiene training, and how is this checked?
- 04How do you now assess mental capacity, record consent and make best-interest decisions?
- 05What audits are now in place to identify problems with care records, cleanliness, medicines and staff training?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected, and the previous ratings were used for the overall rating calculation. This explanation was written from the published report of 8 November 2023 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, June 2021
Balmoral Rest Home was rated Good; inspectors found people were safe and the home was well managed, with some medicines records needing correction.
This was an announced, focused inspection on 4 May 2021. Inspectors looked only at Safe and Well-led because the visit followed concerns about risk management, medicines, staffing, recruitment, training, care, the environment and governance.
Inspectors spoke with six people living at the home, five staff and the management team. They checked medicines, staffing, training, care records, recruitment, accidents, quality checks and the building. They found no evidence that people were at risk of harm.
The home was rated Good overall. Safe and Well-led were both rated Good, and the other three question ratings were carried forward from the previous comprehensive inspection. The previous overall rating was also Good.
Safe medicines systems
The home had systems for storing, recording, checking and handling medicines. Staff had medicines training and their skills were assessed.
“Systems for recording, storing, auditing and handling medicines were in place that made sure people received their medicines safely.” from the report
Infection control
Inspectors found the home clean and were assured that infection prevention measures, personal protective equipment, testing and social distancing arrangements were in place.
“People were protected against the risk of infection. We completed a tour of the home and found the environment to be clean.” from the report
Staffing and recruitment
Inspectors found enough suitably qualified staff, and recruitment checks and induction arrangements remained thorough.
“The management team ensured sufficient numbers of suitably qualified staff were available to meet peoples' needs.” from the report
Open management
The management team encouraged feedback, held regular meetings and used audits to monitor care and safety.
“The registered manager and management team created an open culture and encouraged people to provide their views about how the service operated.” from the report
As-needed medicines information
minorRecording sheets for medicines prescribed when needed did not contain enough person-centred information about why the medicines were prescribed. The manager updated them and provided evidence.
“Medicines that were prescribed as when required had recording sheets to support their safe use but these needed updating to have more person centred information about what the medicines were prescribed for.” from the report
Fridge temperature records
minorThe medicines fridge temperature was checked daily and stayed in the safe range, but the highest and lowest temperatures were not recorded as national guidance required.
“The medicines fridge temperature was monitored daily and was consistently in the safe range, but the maximum and minimum temperatures were not recorded as per national guidance.” from the report
- 01How are medicines allergy records checked now to make sure they are accurate?
- 02What information is now recorded about why each as-needed medicine is prescribed?
- 03How are maximum and minimum medicines fridge temperatures recorded and reviewed?
- 04How do you check that the medicines improvements made after the inspection have been maintained?
- 05Which ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 2 June 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.
Every inspection of Balmoral Rest Home
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- June 2021Goodstayed GoodSafe: GoodWell-led: Good
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 4 February 2011.
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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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 £1,250 a week. 31 can care for a couple. 12 years' experience on average.
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