CQC report explained · a residential care home
What the CQC found at Bannigans
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments did not always contain enough detail for staff to reduce known risks. Some records for as-required medicines also lacked information about when and why they should be given, although people received medicines as prescribed.
- Effective?
- Requires improvement
- The home did not always follow the legal rules about consent and restrictions. Mental capacity records were confusing or contradictory, and required safeguards and advocacy were not always in place.
- Caring?
- Good
- Staff were observed to be kind, approachable and respectful. They supported independence, privacy, communication and involvement in decisions, although some daily records used language that was not respectful.
- Responsive?
- Good
- People had personalised support plans and were supported with activities, exercise, shopping, relationships and family contact. Information was provided in formats people could understand.
- Well-led?
- Requires improvement
- Management systems did not reliably identify or fix gaps in care plans, risk records, consent and safeguards. New checking systems had been introduced, but they were still at an early stage.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found caring and responsive support, but concerns about consent, risk records and management oversight.
Inspectors visited without notice on 15 and 30 November 2023. They spoke with all four people living there, two relatives and five staff. They reviewed care records, medicine records, audits, accident and incident records, and recruitment files.
People were generally treated kindly and supported to make choices, keep relationships and take part in activities. Staff understood people's health needs, including Prader-Willi syndrome, and people received their medicines and health support.
However, records did not always explain risks clearly enough for staff. The home had not always followed the legal safeguards for restrictions on food, drink and kitchen access. Its audits had identified some of these problems but action had not been completed.
The overall rating changed from Good at the previous inspection, published in 2018, to Requires Improvement. Safe, Effective and Well-led were Requires Improvement. Caring and Responsive remained Good.
Kind and respectful support
People and relatives said staff were kind and caring. Inspectors saw staff communicate clearly, show compassion and provide personalised care.
“People and relatives told us staff were kind and caring. We observed staff were friendly and approachable.” from the report
Activities and relationships
People were supported to follow their interests, attend activities and maintain contact with family and friends.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Health support
Staff monitored people's health, supported appointments and understood important needs linked to Prader-Willi syndrome.
“People were supported to attend regular health checks, vaccinations, dental appointments and health screening.” from the report
Safeguarding and medicines
Staff knew how to recognise and report abuse. Medicines were given as prescribed, and staff had training and competency checks.
“People received their medicines as prescribed.” from the report
Restrictions and consent
seriousThe home restricted access to food, drink and kitchens without consistently recording consent, best-interest decisions or the required safeguards. Inspectors said people were at risk of restrictions on their liberty without suitable protection.
“People were at risk of having restrictions on their liberty without the suitable safeguards in place.” from the report
Incomplete risk information
seriousSome support plans did not give staff enough detail about known hazards or health conditions. This could make it harder for newer staff to provide safe and consistent support.
“People's support records did not provide enough information for staff to understand or reduce the risk.” from the report
Weak management oversight
seriousAudits had identified consent and safeguard problems, but the home had not acted on them. Quality checks also failed to identify incomplete, out-of-date or contradictory records.
“The provider failed to have all the systems in place to make improvements identified in audits or identify where improvements to the quality of the service was required.” from the report
Some medicine records incomplete
needs fixingRecords for some as-required medicines did not contain all the information staff needed. A new system for non-prescribed medicines still needed to become established in practice.
“Some areas of recording 'as required' medicines did not have all the information staff needed to understand when and why they should give these medicines.” from the report
Language in daily records
minorSome daily records used terms that did not reflect the respectful, strengths-based support inspectors observed. The provider said it would improve staff practice.
“People's daily care records sometimes contained less respectful terminology, such as people having 'outbursts' and referring to people as 'aggressive' and having 'challenging behaviour'.” from the report
- 01What has been done since the inspection to record consent and best-interest decisions for restrictions on food, drink and kitchen access?
- 02Which people now have, or have applied for, Deprivation of Liberty Safeguards authorisation, and how is the least restrictive option being checked?
- 03How have risk assessments been updated for self-harm, food and drink restrictions and related health conditions?
- 04How are managers checking that care plans are complete, current and consistent, and that audit actions are finished on time?
- 05How are as-required and non-prescribed medicines now recorded, including when and why they should be given?
This was an unannounced inspection covering all five key questions, including infection prevention and control; the report says the previous overall rating was Good in 2018. This explanation was written from the published report of 24 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, July 2018
Bannigans was rated Good; inspectors found safe, kind and personalised care, with no serious risks or concerns identified.
The CQC carried out an unannounced comprehensive inspection on 24 May 2018. One inspector spoke with three people and staff, observed care, checked the home, and reviewed care records, medicines, staff files and quality checks.
The home supports up to four adults with complex needs linked to Prader-Willi Syndrome. All four places were occupied. Inspectors found enough trained staff, detailed risk plans, safe medicines management and regular reviews of people's care.
People were supported with food, health care, activities and daily choices. Staff treated people with kindness and respect, protected their privacy, and helped them keep links with family and friends.
The overall rating and all five question ratings were Good. This was unchanged from the previous inspection on 12 May 2016.
Specialist risk support
Staff understood the specific risks linked to Prader-Willi Syndrome and used individual plans to support people's independence while keeping them safe.
“Staff were mindful of, and acted upon, specific risks associated with Prader-Willi syndrome (PWS)” from the report
Kind and respectful staff
Inspectors saw relaxed and positive relationships. Staff respected people's individuality, dignity, privacy and choices.
“The interaction between staff and the people they supported was positive and relaxed.” from the report
Personalised care
Care plans reflected people's needs, preferences and communication requirements. Activities and outings were tailored to each person.
“Activities, including outings into the community, suited people's individual likes and dislikes and were tailored to their capabilities and motivation.” from the report
Good oversight
The manager carried out regular checks on care, staff practice and records. Suggestions from people and relatives were used to review the service.
“People received a service that was monitored for quality throughout the year using the systems put in place by the provider.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you manage my relative's food access and diet, including any limits outside mealtimes?
- 02How would my relative be involved in reviewing their care plan and risk assessments?
- 03What training do staff have in Prader-Willi Syndrome and how often is it refreshed?
- 04How would you support my relative's preferred activities, community outings and family relationships?
- 05How would my relative or our family raise a concern or make a complaint, and how would you respond?
This was an unannounced comprehensive inspection covering all five CQC questions; the overall rating remained unchanged from the 12 May 2016 inspection. This explanation was written from the published report of 17 July 2018 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 Bannigans
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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