CQC report explained · a nursing home
What the CQC found at Balmore Country House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2024
Balmore Country House rated Inadequate and placed in special measures; inspectors found serious risks involving medicines, infection control, premises, dignity and management.
This was an unannounced inspection by three inspectors. They visited on 8 and 9 November 2023, with inspection activity ending on 16 November. They spoke with people living at the home, relatives and staff, and checked care records, medicines records, staff files and management records.
Inspectors found serious problems with medicines, including unsafe storage and disposal. Some areas and equipment were dirty or unsafe. People were not always given dignified care, listened to, or supported to remain independent. Some people also experienced loneliness and inconsistent support.
There were enough staff according to the home's dependency assessment, and staff recruitment checks were completed. Some staff were kind and caring, food choices were available, and the Mental Capacity Act and liberty safeguards were applied appropriately. However, staff performance was inconsistent and management checks had failed to identify serious risks.
The overall rating fell from Good at the previous inspection, published in April 2020, to Inadequate. Safe, caring and well-led were rated Inadequate. Effective and responsive were rated Requires Improvement. The home was placed in special measures.
Recruitment checks
The report says staff recruitment checks were completed, including identity, qualification and criminal record checks.
“Staff were recruited safely. Relevant checks were completed to ensure staff were suitable to work with people.” from the report
Accident reporting
Accidents and incidents were investigated and reported through the appropriate processes.
“The provider had the processes in place to enable the appropriate staff members / management to investigate accidents and incidents and to report them to the relevant authorities.” from the report
Food choices
People generally liked the food and could ask for alternatives. Care records included guidance for people with specific dietary needs.
“People told us the food, on the whole was good, and they had choices about what meals they would like.” from the report
Consent and choice
Inspectors found that the Mental Capacity Act and liberty safeguards were being applied appropriately.
“We found the MCA and DoLS were being applied appropriately.” from the report
Unsafe medicines
seriousMedicines and thickeners were stored insecurely, some without clear dates or labels. Controlled drugs were not disposed of safely, creating a significant risk of harm.
“People's medicines were not managed safely. There were concerns about the way medicines were stored, used, and disposed of.” from the report
Poor infection control
seriousInspectors found dirty equipment, stained bedding and carpets, clinical waste left on bathroom floors, and personal care products in the wrong bathrooms.
“Some areas of the home were in a state of disrepair meaning it could not be cleaned effectively.” from the report
Unsafe premises and equipment
seriousInspectors found unsafe flooring, hot exposed pipes, an unlocked unsafe room, and equipment stored in bedrooms or left insecurely.
“The provider's failure to ensure safe premises and equipment placed people at increased risk of harm.” from the report
Dignity and independence
seriousPeople were not always kept clean, comfortable or respectfully dressed. Inspectors also saw staff stop people walking or otherwise discourage their independence.
“The provider failed to ensure people were always treated with dignity and respect.” from the report
Weak management checks
seriousAudits and staff reviews did not identify serious risks. The provider had not given the registered manager enough support to manage the home effectively.
“Quality assurance procedures were in place; however, these were ineffective.” from the report
Loneliness and slow responses
needs fixingSome people said they felt lonely and wanted more company. Staff sometimes walked past people calling for help or did not respond quickly enough.
“Some people and a relative told us they or their family members experienced loneliness at the home.” from the report
- 01What immediate changes have been made to the storage, labelling, administration and disposal of medicines?
- 02How are dirty equipment, stained bedding, clinical waste and damaged surfaces now being dealt with and checked?
- 03What has changed to make sure people are treated with dignity and their choices about walking, dressing and personal care are respected?
- 04How are staff performance and day-to-day care now being monitored, including the response to call bells and people calling for help?
- 05What conditions has the CQC imposed, and what progress has been made with the required action plan?
This was an unannounced full inspection covering all five key questions, including the care provided and the premises. This explanation was written from the published report of 25 January 2024 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, April 2020
Balmore Country House was rated Good; inspectors found kind, safe care, but noted some record-keeping and cleaning issues.
This was an unannounced inspection on 11 March 2020. Two inspectors and a specialist nurse advisor spoke with people living there, managers, staff and a visiting healthcare professional. They observed care and checked care records, medicines records, staffing information and quality checks.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. People were protected from abuse, received medicines safely and had enough staff to meet their needs. Staff were described as kind and respectful, and people had choices about their care, food and activities.
Inspectors found some areas needing attention. Building work had affected cleaning, some care records did not show that care had been provided, an internal fire door did not fully close, and end of life wishes were not always recorded. The home took immediate action on some of these issues and said it would improve its checks and records.
Enough staff
Inspectors found staffing levels were sufficient and people were supported without being rushed. Call bells were answered quickly.
“People were supported by enough staff to meet their care needs.” from the report
Kind and respectful care
Staff knew people well and treated them with kindness. They protected people's privacy and supported their choices.
“People were treated with kindness by care staff who knew them well.” from the report
Detailed care planning
Care plans included people's needs, preferences, routines and important relationships. They were reviewed and updated when needed.
“People's care plans were well structured and easy to follow.” from the report
Good activities and relationships
People could join activities in the home and local community. Staff also supported contact with relatives, including by telephone or video calls.
“The provider ensured different activities were available within the care home; including singers and dancers, arts and crafts, massage therapist, and comedy acts.” from the report
Cleaning during building work
needs fixingThe kitchen was not clean in all areas. Dust from the building work and unclean dining equipment were found, although the manager arranged cleaning and replacement equipment immediately.
“People's food was prepared in a kitchen which was not clean in all areas.” from the report
Care records
needs fixingRecords did not always show that care had taken place, including regular repositioning intended to prevent pressure wounds. The managers said they would address this with staff.
“Records of care received by people were not always completed.” from the report
Fire door
seriousAn internal fire door did not fully close. The managers said they would arrange for its closing device to be repaired.
“However, we found that an internal fire door did not fully close.” from the report
End of life wishes
needs fixingSome people's end of life preferences, including spiritual and cultural needs, were not recorded. This could make it harder for staff to understand those preferences.
“People's wishes and preferences about end of life care were not always identified.” from the report
Quality checks
minorThe home's audits had not spotted the minor environmental problems found during the inspection. Managers said they would strengthen the audits, particularly during building work.
“The quality audits had not identified the minor environmental issues we found during the inspection.” from the report
- 01Has all building work finished, and how are cleaning standards now checked in the kitchen and other affected areas?
- 02Has the internal fire door been repaired, and when was it last checked?
- 03How do you now record regular repositioning and other care tasks so records show what has been done?
- 04How are each person's end of life, spiritual and cultural wishes discussed, recorded and kept up to date?
- 05How do your quality audits check for environmental problems and incomplete records?
This was an unannounced inspection covering the premises and care provided, with all five CQC questions assessed. This explanation was written from the published report of 30 April 2020 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 Balmore Country House
4 rated inspections over 8 years: the service has slipped, from Requires improvement to Inadequate.
- January 2024Inadequatecurrent ratingdown from GoodSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- April 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 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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