Balmoral Court

Updated 9 February 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. This was a focused inspection to check whether people were receiving safe care and treatment after a serious incident had occurred with a person.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection site visit was carried out by an inspector and two pharmacist inspectors. A second inspector, a professional advisor and two Experts-by-Experience supported the inspection remotely. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Balmoral Court is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. Having consideration of the coronavirus pandemic, we gave the registered manager a short period of notice of our arrival. This was to ensure safe systems were in place to protect everyone.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 16 people and 26 relatives by telephone and video calls, about their experience of the care provided. We made observations around the service.

We reviewed a range of records. This included eight people's care records. We reviewed multiple medicine administration records and accompanying records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management and governance of the service were reviewed.

We spoke with nine members of staff, including the registered manager, activities coordinator, administrator, nursing and care staff.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 9 February 2021

Balmoral Court is a care home providing accommodation and nursing and personal care to older people and younger adults. The service can support up to 99 people. People are accommodated in four units, including a male only and a female only unit. People are supported with physical and mental health needs, including people living with a dementia related condition. At the time of inspection 93 people were using the service.

People’s experience of using this service and what we found

The service was exceptionally well led. The provider's vision and values were person-centred to make sure people were at the heart of the service. This vision was driven by the exceptional leadership of the registered manager.

The service supported some people with complex needs. There was clear evidence of collaborative working and excellent communication with other professionals to help meet people's needs and maintain their placement wherever possible. A healthcare professional commented, “I continue to enjoy working with the team at Balmoral. The management maintains a stable staff team and communicates well with my practice.”

People's equality and diversity as unique individuals with their own needs was respected by staff. The service was flexible and adapted to people's changing needs and wishes and promoted their independence. People’s care records were well-personalised and up-to-date.

There was a strong and effective governance system in place. Processes were in place to manage and respond to complaints and concerns. People and relatives recognised that their views were valued and respected.

People and relatives stated staff were kind, caring and supportive of people and their families. Comments included, “Carers are amazing, I take my hat off to the staff” and "I like the way staff do things, they are very polite, very friendly and always have a smile.”

People were involved in decisions about their care. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People said they felt safe with the care they received. One relative commented, "Staff have a nice attitude with people, they are safe the way staff support them.” There were enough appropriately skilled staff to meet people’s assessed needs. Robust vetting procedures were in place when recruiting new staff. Staff training was up-to-date.

The service was following safe infection prevention and control procedures to keep people safe.

Medicines management procedures were in place. People did not report any concerns with their medicines.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published July 2019).

Why we inspected

This focused inspection was prompted by the notification of a specific incident, following which a person using the service died. This incident was subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about the management of people’s safety. This inspection examined those risks and we reviewed the key questions of safe and well-led and parts of effective and responsive. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the relevant domains of this report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service.

Ratings from previous comprehensive inspections for those key questions inspected but not rated were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Balmoral Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.