CQC report explained · a nursing home
What the CQC found at De Baliol
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found safeguarding systems, enough staff, safe recruitment, safe medicines management and infection control arrangements.
- Effective?
- Good
- People's needs were assessed and staff were trained and supported. Inspectors noted that some staff were more skilled than others at communicating with people living with dementia, and further training was planned.
- Caring?
- Good
- People and relatives spoke positively about the care. Inspectors observed kind and respectful interactions and found that people's privacy, dignity, independence and choices were respected.
- Responsive?
- Good
- People generally received personalised care and had access to activities, trips and community links. Further meaningful activities for people in the dementia care unit were still being considered.
- Well-led?
- Good
- Inspectors found a cheerful atmosphere, stable staffing and systems for checking quality and safety. They said quality monitoring should include the experiences of people living with dementia.
What inspectors found, January 2020
Rated Good; inspectors found safe, kind and well-organised care, with some dementia support improvements still needed.
This was an unannounced inspection on 4 December 2019. Two inspectors and an Expert by Experience spoke with five people, seven relatives and staff. They also reviewed care plans, medicines records, training records, recruitment checks and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, clean premises, kind care, personalised support and good links with health professionals.
The report also identified improvements still being developed. These included dementia care training, more detailed care plans for distressed behaviour, more meaningful activities in the dementia care unit and closer checks on the experience of people living with dementia.
Stable staff team
People were supported by a consistent team who knew them well. Inspectors found there were enough staff to meet people's needs.
“People were cared for by a consistent and stable staff team who knew people well.” from the report
Kind and respectful care
People and relatives spoke positively about the care. Inspectors saw caring interactions and found that privacy, dignity and independence were respected.
“People and relatives spoke positively about the home and the care provided.” from the report
Community activities
The home supported people to continue hobbies, go on trips and stay connected with the local community. Animals, children and outdoor space were also recognised as important to wellbeing.
“The home had a mini bus and people went out on trips to help ensure they remained involved in the local community where many of them had lived.” from the report
Positive atmosphere
Inspectors found a cheerful culture. Staff said they felt valued and enjoyed working at the home.
“There was a cheerful atmosphere and positive culture at the home.” from the report
Dementia communication skills varied
needs fixingSome staff were more confident and skilled than others when communicating with people living with dementia. Further dementia care training was planned.
“We noticed that some staff were more skilled at communicating with people living with dementia than others. Further dementia care training was planned.” from the report
Some risk plans lacked detail
needs fixingCare plans for people who displayed distressed behaviours were not always detailed enough. The registered manager said this would be addressed.
“Care plans were in place to guide staff on how to support people who displayed distressed behaviours. These were not always detailed.” from the report
More dementia activities needed
needs fixingInspectors asked the home to develop further meaningful activities in the dementia care unit to support engagement and wellbeing.
“We spoke with the registered manager about further meaningful activities which staff could undertake with people to help promote their engagement and wellbeing.” from the report
Meal time experience needed checking
needs fixingLunch in the dementia care unit was busy. Inspectors asked the home to monitor meal times so they promoted social interaction, independence and involvement.
“We spoke with the registered manager about monitoring the lunch time experience for those living with dementia to ensure meal times were a were a positive, social experience which promoted people's independence and involvement.” from the report
- 01What dementia care training has been completed since the inspection, and how is staff communication with residents now checked?
- 02Have care plans for people who display distressed behaviours been made more detailed?
- 03What meaningful activities are now available in the dementia care unit?
- 04How do you monitor lunch times to make sure people living with dementia are supported to be independent and involved?
- 05What was the outcome of the checks on the underfloor heating in areas of the home that were warmer than others?
This was an unannounced planned inspection covering all five CQC questions, and each rating remained Good from the previous inspection. This explanation was written from the published report of 9 January 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.
What inspectors found, May 2017
Rated Good; inspectors found safe, kind and responsive care, with some care plans still being standardised.
Inspectors made an unannounced visit on 20 April 2017. They spoke with people, relatives and staff, and checked recruitment files, care plans and records about quality and safety.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that earlier fire safety problems had been addressed. They also found suitable medicines systems, enough staff, updated infection control and a clean, well-maintained home.
People were supported with food, health care, activities and decisions about their care. Staff were described as caring and respectful. Care plans were being updated because their detail varied, and some were more generic than others.
A new manager was in post and was registering with CQC. The home had audits, meetings and action plans to monitor quality and safety.
Fire safety improved
The fire safety problems found at the previous inspection had been addressed. Regular training and drills were taking place.
“At this inspection, we found that the provider had acted to make the necessary fire safety improvements.” from the report
Safe medicines
Inspectors found no gaps in the medicine administration records and found the correct amount of a controlled drug. Staff had training and competency checks.
“We checked medicine administration records (MARs) and found no gaps.” from the report
Kind and respectful staff
Inspectors saw caring interactions, privacy being respected and staff involving people in decisions about their day.
“We observed courteous and caring interactions between staff and people.” from the report
Activities and community links
The home offered group and individual activities, including activities for people cared for in bed. A minibus had been secured to support outings.
“A minibus had been secured for sole use by the service and staff were very pleased about this and looking forward to planning outings.” from the report
Quality monitoring
The home used audits, daily checks and regular meetings to monitor people's health, safety and the running of the service.
“A range of monthly audits and daily checks were carried out.” from the report
Care plan detail varied
needs fixingCare plans were being updated, but inspectors found that some were less personal and less detailed than others. The manager had identified this and was reviewing all plans.
“We found that the level of detail between care plans varied, and some appeared more generic and less personal in style.” from the report
Feedback action plans being changed
minorThe manager said previous surveys did not always make clear what action had been taken. A more formal action plan system was being introduced.
“They had therefore developed their own action plan and were in the process of changing the system to include formal action plans.” from the report
Minor fire safety suggestions remained
minorAn independent fire safety review had made minor suggestions for improvement. Maintenance staff were carrying these out.
“An external independent fire safety review had recently been completed, with minor suggestions for improvement which were being carried out by maintenance staff.” from the report
- 01How much progress has been made in making every care plan personal and equally detailed?
- 02How will you show families what action has been taken after surveys or other feedback?
- 03Have all the minor suggestions from the independent fire safety review now been completed?
- 04What is the current position on the new manager's registration with CQC?
- 05How will activities and outings be planned for people who are cared for in bed?
This was an unannounced inspection covering all five areas, and all five ratings were Good; the previous fire safety breach from January 2016 had been addressed. This explanation was written from the published report of 24 May 2017 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 De Baliol
3 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 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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