The Care Quality Commission (CQC) has downgraded the rating for Balmore Country House in Ruddington, Nottinghamshire, from good to inadequate, and placed it into special measures to protect people, following an inspection in November.
Balmore Country House, run by Ruddington Homes Limited, is a care home providing personal and nursing care to up to 76 people. It provides support to older people, some living with dementia. At the time of this inspection there were 44 people using the service.
The inspection was prompted in part due to concerns received about the provider's management of incidents which affected the safety of people living at the home.
In addition to dropping from good to inadequate overall, Balmore Country House has also dropped from good to inadequate for how safe, caring and well-led it is. It has declined from good to requires improvement for being effective and responsive.
The home has now been placed in special measures, meaning it must make rapid and widespread improvements, and will be kept under close review by CQC and re-inspected to check on the progress of those improvements.
Greg Rielly, CQC deputy director of operations in the midlands, said:
“When we inspected Balmore Country House, it was disappointing to find leaders and the culture they created didn’t assure the delivery of high-quality care.
“It was concerning that the registered manager and other senior staff didn’t know about the serious risks we found during this inspection, until we told them. Then when we raised our concerns with them, they provided incorrect information and, in some cases, they were reluctant to accept our findings. This raised significant concerns about the culture within the whole staffing team and placed people at risk.
“It was sad to hear some people felt lonely and had limited interactions with staff and others. There were times inspectors had to step in to reassure people and to seek the help they needed as staff weren’t providing it. Also, people’s independence wasn’t always encouraged and at times we witnessed staff actively discouraging people’s attempts at being independent. This is totally unacceptable and people living at Balmore Country House deserve a much better standard of care and to have their wellbeing taken seriously.
“Some areas of the home were in a state of disrepair, meaning it couldn’t be cleaned effectively. Someone’s bedroom had been cleaned by a staff member, however after this had been done, stains remained on the wall and their bed linen was marked with brown stains and dried blood. These poor standards put people at risk of infection.
“Additionally, staff didn’t always call people by their preferred name. One person told us they liked to be called by their middle name, but some staff still continued to use their first name. This person had been at the home for a significant period of time and staff knew their preference, however continued to ignore it. This is disrespectful and must be addressed as a priority.
“We’ve told the provider exactly where improvements are needed and will closely monitor the home to make sure people are being cared for safely during this time.”
Inspectors also found:
- The premises were not always monitored for risk that could impact people's safety
- People did not always receive care and support in accordance with their assessed needs
- People's medicines were not managed safely. There were concerns about the way medicines were stored, used, and disposed of. This placed people at significant risk of harm
- Some parts of the premises were not safe, equipment was left in people's bedrooms and not stored safely
- There were concerns about some staff and their approach and attitude to providing safe and compassionate care for people
- The home was not well managed. The provider had not ensured the registered manager had sufficient support to carry out their role effectively
- Staff performance was inconsistent and poorly monitored. Some staff carried out their roles well, others, did not. This has impacted people's health and safety
- Staff had received the training the provider had deemed a requirement for them to carry out their role effectively. However, staff performance was not appropriately monitored.
However:
- Some staff were kind and caring with their approach and people liked this
- Accidents and incidents were investigated and reported appropriately.
The report will publish on CQC’s website in the next few days.