CQC report explained · a nursing home
What the CQC found at Bonaer Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staffing levels were sufficient, recruitment checks were completed and medicines were managed safely. Inspectors recommended getting further professional advice because some moving equipment was difficult to manoeuvre safely.
- Effective?
- Good
- Staff had suitable training and supervision, and people received appropriate food, drinks and health referrals. The home could not always show that lasting power of attorney documents had been checked.
- Caring?
- Good
- Inspectors found a relaxed and happy atmosphere. Staff knew people well, respected their choices and protected their privacy, dignity and independence.
- Responsive?
- Good
- Care plans were personalised, informative and updated when people's needs changed. People had a varied programme of group and individual activities, including trips into the community.
- Well-led?
- Good
- The home had motivated staff, supportive leadership and quality checks. Inspectors said action had been taken to address issues from the previous inspection.
What inspectors found, April 2019
Rated Good; inspectors found kind, safe and personalised care, with some equipment and premises issues to follow up.
This was an unannounced inspection on 11 March 2019. Inspectors reviewed earlier information, spoke with seven people, three relatives, five staff and a visiting health professional. They observed care, including at lunchtime, and checked care records, medicines records, recruitment files and other documents.
The home was supporting 27 people. Inspectors found people were relaxed and comfortable, staff were kind and responsive, and there were enough staff. Medicines, safeguarding, infection control, care planning, activities and links with health professionals were generally managed well.
There were some matters to improve. Staff struggled to move some equipment safely through narrow areas. Some carpets and corridors needed work, one bathroom was difficult to clean and two sinks had high water temperatures. The home was rated Good in all five areas, improving from Requires Improvement at the previous inspection.
People felt safe
People consistently said they felt safe. Staff understood safeguarding procedures and knew how to respond to concerns.
“People consistently told us they felt safe and were reassured by staff team's friendly and compassionate approach.” from the report
Safe medicines practice
Medicines were stored, given and recorded safely. Records were regularly checked and problems were dealt with promptly.
“Medicines were managed, stored and administered safely and staff were appropriately trained to support people with their medicines.” from the report
Kind and respectful care
Staff knew people well and supported them at a relaxed pace. Inspectors saw staff taking time to talk with people and protect their dignity.
“There was a relaxed and happy atmosphere in the home and laughter was common.” from the report
Personalised support and activities
Care plans included people's backgrounds, needs and preferences. The home offered varied activities and individual support from an occupational therapist.
“People's care plans were informative and provided staff with sufficient guidance to ensure their needs were met.” from the report
Moving equipment was difficult to use safely
needs fixingInspectors saw staff struggling to move equipment around bends and through narrow parts of the home. They recommended further advice from suitably skilled external professionals.
“During this inspection we observed staff struggling to manoeuvre equipment safely around bends and through narrow areas of the home.” from the report
Checks on legal authority were incomplete
needs fixingWhere people had lasting power of attorney, the home did not always show that it had checked the relevant documents.
“However, the service was not always able to demonstrate they had viewed these documents to confirm the information they had been provided was accurate.” from the report
Bathroom and water temperature issues
needs fixingDamage to fittings made one bathroom harder to clean and could have created an infection control risk. Inspectors also found high water temperatures in two sinks, and the provider arranged for a plumber to attend.
“In one bathroom, damage to fittings meant cleaning was challenging and could represented an unnecessary infection control risk. We also found high water temperatures in two sinks tested.” from the report
- 01What further professional advice was obtained about moving equipment through narrow areas, and what changes were made?
- 02Have the damaged bathroom fittings and high water temperatures in the two sinks been fixed?
- 03What is the timetable for replacing the worn carpets and redecorating the upstairs corridors?
- 04How do you now check lasting power of attorney documents before recording the information in care records?
- 05What action was taken after the previous inspection's concerns about choking and pressure area care?
This was an unannounced scheduled inspection that looked at the premises and care across all five CQC questions, including a sample of care, medicines and recruitment records. This explanation was written from the published report of 2 April 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.
What inspectors found, March 2018
Rated Requires Improvement; inspectors found kind and responsive care, but serious checks on choking and pressure equipment had not always been done safely.
This was an unannounced, routine comprehensive inspection on 30 November 2017. Inspectors spoke with people living at the home, relatives, staff and health professionals. They observed care and meals and checked care plans, staff records, medicines records and other documents.
The main problems were with safety. One person did not receive prescribed liquid thickeners for drinks, creating a choking risk. One pressure-relieving mattress was switched off and eight others were set to the wrong weights. The home was in breach of Regulation 12, Safe care and treatment.
The manager acted promptly after the inspection. The home introduced a choking policy, gave staff extra training and brought in checks for pressure-relieving equipment. Inspectors also found good care, effective support, kind staff, enough staff and good activities. The overall rating was Requires Improvement because safety and quality checks were not reliable enough.
Kind staff
Inspectors saw staff supporting people calmly, patiently and with compassion. People spoke positively about the staff team.
“Throughout our inspection we saw that staff provided support with compassion and kindness.” from the report
Good care planning
Digital care plans gave staff detailed information about people's needs and preferences. Records were updated when needs changed.
“People's digital care plans were detailed and informative.” from the report
Activities and family contact
The home had a full-time activities coordinator and offered varied activities. Relatives were welcomed and could share meals with people.
“Visitors were actively encouraged and made to feel comfortable and at home in the service.” from the report
Enough staff
Inspectors found enough skilled staff on duty and saw them respond promptly when people asked for help.
“There were enough skilled and experienced staff on duty to keep people safe and meet their needs.” from the report
Safe medicines systems
Medicines were administered in line with people's needs. Records, storage, ordering and disposal arrangements were found to be appropriate.
“Medicine Administration Records (MARS) had been fully completed” from the report
Choking risk
seriousA person who had been prescribed liquid thickeners received an unthickened drink during the inspection. The home also did not have a choking policy at that time.
“This meant the person was exposed to the risk of choking as liquid thickeners had not been used as prescribed.” from the report
Pressure-relieving mattresses
seriousOne mattress was switched off and eight others were set to incorrect weights. This could have left people at risk of pressure sores.
“The failure to correctly operate pressure relieving mattresses exposed people to unnecessary risk.” from the report
Quality checks missed safety problems
needs fixingThe home's monitoring systems did not identify the choking and pressure-care concerns before the inspection.
“These systems had failed to identify the issues in relation to the management of choking risk and pressure area risks identified in the safe section of this report.” from the report
- 01How are prescribed liquid thickeners now recorded and checked for people at risk of choking?
- 02Who checks each pressure-relieving mattress, how often are the checks done, and what happens if a mattress is switched off or set incorrectly?
- 03Can you show us the choking policy and explain what training staff have completed since the inspection?
- 04How does the quality assurance system now identify safety problems that staff may have missed?
- 05What evidence can you provide that the improvements described after the inspection have been maintained?
This was an unannounced routine comprehensive inspection covering all five rating areas, and the previous inspection in September 2015 had rated all areas Good. This explanation was written from the published report of 20 March 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 Bonaer Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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