Bonnington Nursing Home Care Home Service Adults 205 / 207 Ferry Road Edinburgh EH6 4NN

Transcription

1 Bonnington Nursing Home Care Home Service Adults 205 / 207 Ferry Road Edinburgh EH6 4NN Inspected by: Averil Blair Linda Paterson Type of inspection: Unannounced Inspection completed on: 9 June 2011

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 12 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Southern Cross Operations No 2 Limited T/A Ashbourne Senior Living Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Averil Blair Telephone Lo-Call: enquiries@scswis.com Bonnington Nursing Home, page 2 of 26

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 3 Adequate Quality of Environment 3 Adequate Quality of Staffing 0 N/A Quality of Management and Leadership 4 Good What the service does well The service has created a welcoming environment for residents, and residents spoken with during the inspection stated that they felt well cared for, and that the service was improving the environment. What the service could do better As commented in the body of the report, the service is currently undergoing a program of refurbishment, particularly in Mathieson House, and this was seen to be beginning to make a difference to the environment for residents. What the service has done since the last inspection During the inspection staff commented that they felt morale had improved and that the service was improving for residents and staff. Conclusion The service had taken action on issues identified at the last inspection although there were still some outstanding issues which are discussed in more detail in the body of this report. During the inspection the service appeared to provide a welcoming and homely environment for residents. Bonnington Nursing Home, page 3 of 26

4 Who did this inspection Averil Blair Linda Paterson Lay assessor: Not Applicable. Bonnington Nursing Home, page 4 of 26

5 1 About the service we inspected Bonnington Nursing Home is registered to provide care for up to 77 Older People but currently will accommodate a maximum of 70 people. Before the 1st April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS) took over the work of the Care Commission, including the registration of care services. This means that from 1st April 2011 this service continued its registration under the new body, SCSWIS. The home is situated in a residential area on the east side of Edinburgh, close to local shops and other amenities. It is accessible by public transport. Accommodation is provided in two buildings - Mathieson House to the front of the property and Garden House to the rear. Accommodation in both buildings is on three floors in a variety of single and double bedrooms which can be accessed by stairs or a lift. The double bedrooms are currently being used as single rooms but one had been used recently for a married couple who chose to share. The Home is situated in private grounds with parking to the front of each building. There are garden areas which can be accessed from both houses. In its brochure, the Home states that its aim is "the provision of the highest standard of care in an environment which is both welcoming and homely. We will actively encourage individuality, promoting independence and physical and social well being". Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 3 - Adequate Quality of Environment - Grade 3 - Adequate Quality of Staffing - N/A Quality of Management and Leadership - Grade 4 - Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Bonnington Nursing Home, page 5 of 26

6 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection We completed this report following an unannounced inspection. The inspection was carried out by Social Care and Social Work Improvement Scotland Inspectors Averil Blair and Linda Paterson. The inspection visit was carried out on 8th and 9th June The purpose of the visit was to focus on the requirements and recommendations in the previous report. At this inspection we gathered evidence from various sources.this included: Discussion with service users and relatives. A review of a records and other documentation, including the following: - supporting evidence from the self assessment - resident's personal plans - minutes of staff and resident's meetings - questionnaires issued by the service. - training records - supervision records - activities records - audits - repair and maintenance procedures We also spoke with a range of staff which included - - the Depute Manager - Registered Nurses - Carers - Activities Co-coordinator Observation of staff practices. Bonnington Nursing Home, page 6 of 26

7 Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection report continued Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Bonnington Nursing Home, page 7 of 26

8 What the service has done to meet any requirements we made at our last inspection The requirement The provider must ensure the premises are kept in a fit state of repair to enable residents to make choices about ventilation and to enable their window to be opened should they choose to do so.this is in order to comply with SSI 2002/114 Regulation 10 (1) Fit premises- a requirement to ensure the premises are fit and (2) a requirement to ensure the suitability and good repair of the premises. This also takes account of National Care Standards Care Homes for Older People Standard4.1 Your environment. Timescale: Within two weeks of receipt of this report. What the service did to meet the requirement Action was seen to have been taken on this requirement, see Quality Theme 1 Quality Statement 2 for further information The requirement is: Met The requirement The provider must ensure residents are consulted about their care needs and choices. In order to do so the provider must ensure that individual care reviews are held at least once every six month period. This is in order to comply with SSI 2002/114 Regulation 5 Personal plans - a requirement to review the personal plan of a resident. This also takes account of National Care Standards Care Homes for Older People Standard 6 Support arrangements. Timescale: Within two months of receipt of this report. What the service did to meet the requirement For further information on this requirement see Quality Theme 1 Quality Statement 2. The requirement is: Met Bonnington Nursing Home, page 8 of 26

9 The requirement The provider must ensure that care plans are kept up to date. This is to comply with SSI 2002/114 Regulation 4 welfare- a requirement which makes provision to meet residents health and welfare needs. This also takes account of National Care Standards Care Homes for Older People Standard 5 Management and Staffing.This also takes account of National Care Standards Care Homes for Older People Standard 6 Support arrangements. Timescale: Within two months of receipt of this report. What the service did to meet the requirement Some action was seen to have been taken on this requirement, see Quality Theme 1 Quality Statement 3 for further information. The requirement is: Not Met Inspection report continued The requirement The provider must ensure that where restrictive measures are used that there is an adequate explanation of its use and informed consent must be sought and obtained from the resident and or their representative for any device which may be considered restrictive. This should be reviewed regularly. This is to comply with SSI 2002/114 - Regulation 4 (1) (a) requirement to met the health and welfare needs of service users and 4 (c) a requirement about restraint.this also takes account of National Care Standards Care Homes for Older People Standard 6 Support arrangements. Timescale: Within one month of receipt of this report. What the service did to meet the requirement For further information on this requirement see Quality Theme 1 Quality Statement 3. The requirement is: Not Met The requirement The Provider must review and improve the decor in Mathieson House and submit to the Care Commission timescales for the completion of any work to be carried out.this is is to comply with: SSI/114 Regulation10 (1)(b) - a requirement relating to fitness of premises.ssi/114 Regulation 4(1) (b) - a requirement relating to dignity of service users. This also takes account of National Care Standards Care Homes for Older People Standard 4.8 Your environment. Timescale:Two weeks to submit timescales for completion. What the service did to meet the requirement For further information on this requirement see Quality Theme 2 Quality Statement 2. The requirement is: Not Met Bonnington Nursing Home, page 9 of 26

10 The requirement The Provider must ensure that all medication is stored appropriately and staff are aware of their responsibilities in regard to the storage of medication.this is to comply with SSI /114 4(a) Regulation 4(1) - a requirement relating to health and welfare.this also takes account of the National Care Standards for Older People Standard Keeping well - medication.nursing and Midwifery Council (2007) Standards for Medicine Management. Timescale:One month. What the service did to meet the requirement Action had been taken on this requirement. See Quality Theme 2, Quality Statement 2. The requirement is: Met Inspection report continued The requirement The Provider must review and improve the bathroom provision. This is to comply with: SSI/114 Regulation 4(1) (a) - a requirement relating to health and welfare. SSI/114 Regulation 4(1) (d) - a requirement relating to infection control. SSI/114 Regulation 4(1) (b) - a requirement relating to dignity of service users. This also takes account of National Care Standards Care Homes for Older People Standard4.2 Your environment. Timescale:Within 2 months. What the service did to meet the requirement This was looked at in Quality Theme 2 Quality Statement 3. The requirement is: Not Met The requirement The Provider must ensure that a system is in place to check that staff are aware of their professional responsibilities in relation to providing care. This is in order to comply with SSI 2002/114 Regulation 13 (a) and (c)(i) a requirement about competent staff and training of staff. Also taking into account National Care Standards Care Homes for Older People Standard 5 Management and staffing arrangements and SSSC Codes of Practice for Employees Section 2.1,2.2,3.1. Timescale: Within two months. What the service did to meet the requirement Action had been taken in regard to this requirement, see Quality Theme 4 Quality Statement 2. The requirement is: Met Bonnington Nursing Home, page 10 of 26

11 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Inspection report continued Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service submitted an electronic self assessment prior to the inspection which identified some of the systems and evidence for each quality statement. Although it included a comprehensive list of evidence available it did not completely reflect some of the good practice which took place within the service. Some of the gradings the service awarded themselves were appropriate, but in some cases we did not find the evidence to support the gradings they had awarded themselves. Taking the views of people using the care service into account 6 residents were spoken with during the inspection and a further 5 returned Care Standards Questionnaires prior to the inspection. All spoke positively about the service although some made comments about the domestic support in the home. We did not see any evidence of this during the inspection. Taking carers' views into account 4 relatives returned Care Standards Questionnaires prior to the inspection. All either agreed or strongly agreed that the quality of care was good. Comments included "standards and staffing have improved", "better continuity of staff over the last year", and "staff are very aware of my relatives dietary needs and help with her food". Bonnington Nursing Home, page 11 of 26

12 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Overall grade awarded for this theme: 3 - Adequate Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The service was able to provide good evidence in support of this statement. A participation strategy was in place, and had been made available throughout the home At the most recent residents' and relatives' meeting they identified that they would like the meetings to be held more regularly and this had been arranged. Minutes of the meetings had been taken, and were seen displayed throughout the service. A variety of topics were discussed, and this included activities, meals and contents of the service's self assessment. There was evidence that action was taken as a result of residents' comments, for example the success of activities and outings had been evaluated, and those most enjoyed had been included in the activities programme. Personal plans sampled on the day of inspection showed that residents, and where appropriate, their relatives, had been involved in the writing of care plans. Residents were also seen to have been involved in care plan reviews, and relatives could also contribute if the resident wished. Residents and relatives had been involved in a survey to identify how they felt the service should grade themselves in their self assessment. Staff had also been involved in this process. There was a relatives notice board with up to date information about what was happening in the home displayed. A range of other information was also displayed on these boards, such as local support groups and previous inspection reports. The service was able to show that residents had been involved in the selection process of new staff, and this included the newly appointed Manager. Bonnington Nursing Home, page 12 of 26

13 The service had done some work on the identified areas for improvement in the previous inspection report, and this included the publication of a residents' newsletter. Relatives and residents could be seen to have been involved in this. They had also had the opportunity to be involved in the self assessment of the service and of its self grading. An active and responsive complaints procedure was seen to be in place and actions could be seen to have been carried out following resolved complaints. Areas for improvement Although the service had looked at some areas, the service had not yet found a way to capture the opinions of those residents with cognitive impairments and/ or communication difficulties. The previous relatives meeting had not been well attended, and although this had been beneficial to those attending, the service should consider potential alternative methods of giving relatives the opportunity to be involved in decisions in the service. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service strengths The service was able to provide good evidence in support of this statement. During the inspection we saw a range of methods used to make sure that residents had the opportunity to make choices in how they received their care. Information for staff was available in personal plans, and showed where and how residents had been able to make their choices known. This included some very personalised details for staff, such as the conditions one resident liked to have in place to make sure they had a good nights sleep. The Activities Co-ordinator was able to demonstrate how she encouraged residents to comment on the activities provided, and how she used this information in planning future activities. Some of this information was displayed in monthly newsletters, along with other news items, and highlighted family stories of residents. Residents had had the opportunity to take part in a survey on the service they received and this had had a positive response. Residents had had the opportunity to be involved in the selection of staff, and this had appeared to be successful. Bonnington Nursing Home, page 13 of 26

14 A choice of food was available at every meal, and residents and staff confirmed that alternatives would be provided if residents did not wish to have any of the choices on the menu. Comments books were available for use in all units and these were reviewed by senior staff. Two requirements had been made at the last inspection, one related to residents being able to choose to open their windows, and action had been taken by the service to ensure that this was possible. The second requirement related to residents being consulted about their care needs, especially during reviews. The service had made efforts to ensure that reviews had taken place for all residents, and that minutes had been taken to identify any action points. Areas for improvement Personal plans included the opportunity for recording social profiles of individuals, but information contained in these sections was minimal and did not necessarily reflect the information known by staff. This could be used to greater effect to widen the range of activities available to residents. During the inspection it was observed that there could be periods of time where where there was no observable stimulation for residents. This may have been due to staff being busy else where, but although staff were observed to have good relationships with residents there was no structure to their involvement. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Personal plans sampled on the day of inspection gave clear information on the care and support needed by each resident. These also identified personal preferences as to how individual residents would like to receive their care. One example of this was where staff were informed that a resident "likes to go to bed around 10pm, and likes the windows and curtains closed. She likes her door locked overnight ". Appropriate risk assessments had been carried out, for example relating to nutritional needs, and skin condition. These had led to care plans being put in place to provide staff with detailed information on resident's needs. An audit of care plans was carried out by senior staff and these could be seen to concentrate on quality of information not only quantity of paperwork. Bonnington Nursing Home, page 14 of 26

15 Positive outcomes could be seen for some residents, for example one service user had reached an appropriate weight having been admitted with "compromised nutritional status". Good links could be seen to be in place with local associated professionals such as GPs and CPNs, and this was reflected in care plans. Residents and relatives spoken with during the inspection commented positively on the quality of care received. Areas for improvement Although audits were in place and had been carried out by senior staff with an emphasis on the quality of recording rather than simply ensuring that "boxes had been ticked", it was difficult to see how more formal follow through of action points had been carried out. The Deputy Manager was able to confirm that the Quality Team would pick samples of residents with specific care needs and track whether they had been audited and action points followed through. It would be beneficial for residents if this could be formalised to ensure that action points were carried out. A requirement made at the previous inspection identified that care plans should be kept up to date. Although care plans could be seen to have been evaluated on a monthly basis, identified changes to care did not always result in changes to care plans, and as a result the requirement remains in place. A further requirement was made which stated that consent to measures which could be considered restrictive should be recorded. Although there was some evidence that these measures had been discussed with some residents and or their relatives, they had not been consistently recorded, and the requirement therefore stays in place. Grade awarded for this statement: 3 - Adequate Number of requirements: 2 Number of recommendations: 0 Requirements 1. The provider must ensure that care plans are kept up to date. This is to comply with Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 No 210, 4(1) (a) a requirement which makes provision to meet residents health and welfare needs. This also takes account of National Care Standards Care Homes for Older People Standard 5 Management and Staffing and Standard 6 Support arrangements. Timescale: Within two months of receipt of this report. 2. The provider must ensure that where restrictive measures are used that there is an adequate explanation of its use and informed consent must be sought and obtained from the resident and or their representative for any device which may be considered restrictive. This should be reviewed regularly. This is to comply with Bonnington Nursing Home, page 15 of 26

16 Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 No 210, - 4 (1) (a) requirement to meet the health and welfare needs of service users and 4 (1) (c) a requirement about restraint.this also takes account of National Care Standards Care Homes for Older People Standard 6 Support arrangements. Timescale: Within one month of receipt of this report. Bonnington Nursing Home, page 16 of 26

17 Quality Theme 2: Quality of Environment Grade awarded for this theme: 3 - Adequate Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths This statement was not inspected in detail and full information can be found in Quality Theme 1, Quality Statement 1. During the inspection it was observed that residents had been able to personalise their own rooms, and this was confirmed by residents and relatives. Meetings of residents and relatives meetings also included environmental issues, and the service was able to evidence that residents had been involved in choosing colour schemes etc for some of the renovation works. Areas for improvement See Quality Theme 1, Quality Statement 1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths The service was able to provide good evidence in support of this statement. During inspection the service was seen to be neat and tidy, with no malodours. Staff had received training in aspects of health and safety, including infection control. The service had a system in place for dealing with any identified maintenance issues. This included both action taken in house by handyman staff, and also repairs completed by external firms. The service identified in its self assessment that it had a comprehensive system of planned maintenance which included a record of all checks carried out, and this was confirmed to be in place at inspection. Action had been taken on the storage of medication which was to be returned to the pharmacy, and the requirement made at the last inspection was therefore met. Bonnington Nursing Home, page 17 of 26

18 Areas for improvement It had been identified in the previous inspection that the service was required to carry out some essential maintenance and renovation, and although it was observed to have been commenced the service had identified that it aimed to be completed by August of 2011 and the requirement therefore stays in place and will be followed up at the next inspection. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 0 Requirements Inspection report continued 1. The Provider must review and improve the decor in Mathieson House and submit to the Care Commission timescales for the completion of any work to be carried out.this is to comply with Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 No 210, 10 (2) (d)- a requirement ensuring that environments are decorated and maintained to a suitable standard. This also takes account of National Care Standards Care Homes for Older People Standard 4.8 Your environment. Timescale: by 31st August Statement 3 The environment allows service users to have as positive a quality of life as possible. Service strengths Although not all areas of the statement were inspected, the service was able to evidence that the environment adequately encouraged a positive quality of life for residents. During the inspection residents and relatives confirmed that they felt the environment generally suited their needs, and, in the case of Mathieson House, renovations had been carried out with their involvement. There was easy access to the garden from various points in the home, and there was evidence that residents had the opportunity to make use of the garden. Residents were able to personalise their rooms with their own furniture, and having met a requirement made at the last inspection, residents were able to open their windows safely. The Activities Organiser was able to describe opportunities residents had to enjoy visitors such as poetry readers, entertainers, and church groups. Bonnington Nursing Home, page 18 of 26

19 Areas for improvement A requirement was made at the last inspection that bathroom provision should be improved. During the inspection it was confirmed that while each unit in Garden House had two bathrooms, only one was available on each floor for a variety of reasons. This should be evaluated to improve the access to bathing facilities for residents, and the requirement remains in place. The service should also evaluate access to the upper floor in Mathieson House in the event of failure of the existing lift. Records showed that one resident found it difficult to sleep when unable to access her own bedroom during a period when the lift was out of order. Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements 1. The Provider must review and improve the bathroom provision. This is to comply with Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 No 210, 4 (1) (a) relating to health and welfare. This also takes account of National Care Standards Care Homes for Older People Standard 4.2 Your environment. Timescale: Within 2 months. Bonnington Nursing Home, page 19 of 26

20 Quality Theme 3: Quality of Staffing - NOT ASSESSED Bonnington Nursing Home, page 20 of 26

21 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths This statement was commented on in more detail in Quality Theme 1, Quality Statement 1. Areas for improvement See Quality Theme 1, Quality Statement 1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths The service was able to provide good evidence that staff were involved in determining the direction and future objectives of the service within the constraints of the providers financial situation. Staff spoken with during the inspection were generally very positive about the service they provided and the support they received from Senior Staff. All commented that supervision was now in place and covered a range of issues such as training and personal development, practice issues and general issues about the units. Staff remained positive despite publicised difficulties with the provider, and it was noted that they felt that they had been communicated as well as they could have expected by the provider. Team meetings had been held for all staff, and agenda items included induction for new staff, teamwork, the service's self assessment, and the use of agency staff. Bonnington Nursing Home, page 21 of 26

22 Areas for improvement The service identified in its self assessment that they were looking at encouraging staff to hold Unit meetings, at which they would identify where and how they could improve care in a chosen quality standard. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths Audits were carried out in a number of areas by the Depute Manager. Residents and relatives were encouraged to comment on the service during resident and relatives meetings, and minutes were kept of these meetings identifying action points and actions carried out. Reviews were seen to be carried out on a more regular basis and involved residents and, where appropriate their relatives. Residents and relatives were encouraged to highlight areas of concern at these reviews. Although at the time of inspection the Managers post was vacant the Depute Manager had continued to encourage staff, residents, and relatives to comment on the service. During the inspection feedback from residents and staff confirmed that the Depute Manager took any concerns on board and where possible took action. Feedback was also available from visiting professionals such as GPs and agency carers to confirm this. Regular company audits were being undertaken by the quality management team within the organisation. The service could be seen to have taken action following feedback from the previous Care Commission inspection. Areas for improvement The service identified in its self assessment that it aimed to develop nursing and care staff to be involved in auditing aspects of the service. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Bonnington Nursing Home, page 22 of 26

23 4 Other information Complaints One complaint had been received by the Care Commission since the last inspection. An action plan had been received and the service had begun work on the identified actions. This will be followed up at the next inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information None noted. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Bonnington Nursing Home, page 23 of 26

24 5 Summary of grades Quality of Care and Support Adequate Statement 1 Statement 2 Statement Good 4 - Good 3 - Adequate Quality of Environment Adequate Statement 1 Statement 2 Statement Good 4 - Good 3 - Adequate Quality of Staffing - Not Assessed Quality of Management and Leadership Good Statement 1 Statement 2 Statement Good 4 - Good 4 - Good 6 Inspection and grading history Date Type Gradings 13 Oct 2010 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 4 - Good Management and Leadership 3 - Adequate 11 May 2010 Announced Care and support 2 - Weak Environment 2 - Weak Staffing 3 - Adequate Management and Leadership 2 - Weak 7 Oct 2009 Unannounced Care and support 3 - Adequate Environment 2 - Weak Staffing 3 - Adequate Bonnington Nursing Home, page 24 of 26

25 Management and Leadership 3 - Adequate 9 Jun 2009 Announced Care and support 1 - Unsatisfactory Environment 2 - Weak Staffing 2 - Weak Management and Leadership 1 - Unsatisfactory 27 Nov 2008 Unannounced Care and support 2 - Weak Environment 2 - Weak Staffing 2 - Weak Management and Leadership 3 - Adequate 27 Jun 2008 Announced Care and support 2 - Weak Environment 2 - Weak Staffing 2 - Weak Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Bonnington Nursing Home, page 25 of 26

26 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by SCSWIS. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@scswis.com Web: Bonnington Nursing Home, page 26 of 26