Balgowan Nursing Home

Updated 16 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal

requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of an inspector.

The service type

Balgowan Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 unannounced.

What we did before the inspection

We reviewed the information we held about the service and the service provider, including the previous inspection report. We used the information the provider sent us in the provider information return. This is

information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We looked at notifications and any safeguarding alerts we had received for this service. Notifications are information about important events the service is required to send us by law.

During the inspection

We looked around the service and met with the people who lived there. We used the Short Observational Framework for Inspection (SOFI) during lunch. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 11 people in more detail to understand their views and experiences of the service and we observed how staff supported people. We spoke with seven visitors and had contact with three further visitors following the inspection visit. We met with the registered manager and nine members of staff, including house keepers and members of the kitchen team. We reviewed the care records of seven people who were using the service and a range of other documents. For example, medicine records, staff training records and records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at resident and staff meeting minutes, recruitment processes, accident and incident records over a period of six months, training and supervision data. We spoke with two professionals who regularly visit the service.

Updated 16 January 2020

About the service

Balgowan Nursing Home provides accommodation, nursing and personal care for up to 40 older people. Accommodation is provided in an old detached building with two newer purpose-built wings. At this inspection, there were 35 people living in the home. Accommodation is arranged over two floors. Access to each floor is gained by a lift, making all areas of the home accessible to the people who live there and visitors.

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

People continued to receive safe care and support by staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people. One person said, “It’s a good place to live and the staff look after our safety,” and “There is a locked door system, so no one can get in without being checked, very safe here.” Medicines were given safely to people by trained and knowledgeable staff, who had been assessed as competent. There were enough staff to meet people's needs. The provider used a dependency tool to determine staffing levels and if extra staff were needed, these were provided. For example, if a person was unwell and needed one to one care to keep them safe. Staffing levels were regularly reviewed following falls or changes in a person's health condition. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs. Safe recruitment practices had been followed before staff started working at the service. Infection control was well managed and the home was well-maintained and free from hazards.

Staff knew people and their needs well and received the training they needed to meet people’s needs safely and effectively. The training matrix tracked staff training and this had ensured all staff received the training and updates needed to provide safe consistent care. The staff rotas confirmed that staff deployment was consistent and that staff skills were considered when planning the rotas. A first aider and fire officer was deployed on each shift. A plan of supervision to support staff was available and this also included competency sessions on training received. One staff member said, “We have regular supervision, handovers and staff meetings. We can go to the manager anytime we need to.” People’s nutritional and health needs were consistently met with involvement from a variety of health and social care professionals. Peoples’ weight was monitored and fortified food provided when necessary. People enjoyed the food and comments included, “Good choice and usually tasty,” and “We get a good variety and plenty of fresh fruit and vegetables.” Visitors felt the chef was “Good” and the food always ‘nutritional’ and ‘looked nice’.

People 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.

Everyone we spoke to was consistent in their views that staff were very kind, caring and supportive. People were relaxed, comfortable and happy in the company of staff and we saw positive staff interactions during the inspection. Visitors told us, “Good staff, always friendly and welcoming,” and “I can’t praise the staff enough for their good humour and kindness.” People’s independence was considered important by all staff and their privacy and dignity was also promoted.

Activities reflected people’s preferences and interests. People were encouraged to go out and meet family and friends and families were welcomed in to the home. Trips out were arranged to places of interest and to the local theatre.

Staff were committed to delivering care in a person-centred way based on people's preferences and wishes.

People were involved in their care planning as much as they could be and families told us that they were involved in the well-being of their loved ones. One visitor said, “The nursing staff keep me updated with any health issues with regard to my relative and are very quick to contact the GP and practice nurse with any concerns with my relative’s health as well as other health professionals.”

People were encouraged and supported to be involved in the running of the home and there was an ambassador who was very involved in the running of the home. For example, the ambassador led the resident’s meetings and met and greeted new people to help them settle in to the home.

People, their relatives and health care professionals had the opportunity to share their views about the service. Complaints made by people or their relatives were taken seriously and thoroughly investigated. The provider and registered manager were committed to continuously improve. They had developed structures and plans to develop and consistently drive improvement within the service and maintain their care delivery to a good standard.

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 25 May 2017)

Why we inspected:

This was a planned inspection based on the previous rating.

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.