Balmore Country House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider and then registered manager had made significant changes to the service since our last inspection. This had seen improvements in the quality of the care people received and outcomes. Auditing processes, whilst still in their infancy, had addressed previous concerns and issues and had seen improved outcomes for people. Staff performance was now robustly monitored. The registered manager had received support from senior management, and this had seen improvement in their performance and ability to manage this home effectively. Work was still needed to ensure staff were informed of and worked towards the provider’s aims, values, and strategy. Staff felt able to speak up and raise any concerns. They felt able to do so without fear of recrimination. The registered manager had an ‘open-door’ policy that welcomed feedback from staff.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The vision, aims, and strategy had not yet been communicated to the staff. However, staff were aware of the need to continue the current improvements to ensure people received safe care and treatment.

The provider was currently developing their vision, aims and strategy for their group of services and individual homes for Balmore Country House. This is important to ensure that staff are aware of what is expected of them and how they can make positive contributions to the successful running of this home. Staff have not yet been made aware of what these aims are and therefore we have been unable to assess their understanding. However, the provider’s focus since our last inspection had been on making the necessary and immediate changes to the culture of the staffing team, ensuring a more person-centred, caring, and compassionate approach from staff and management. There were improvements seen throughout the assessment.

Staff felt supported by the registered manager and provider. They felt there had been improvements since the last inspection and this included improvements in the way the home was managed.

Since our last inspection the registered manager had received support and additional training from senior management. This had resulted in a more confident, able, and organised approach from the registered manager, which has resulted in improved performance amongst staff and improved experiences for people. A review of staff roles and responsibilities had been completed. Some staff had been given additional responsibilities, with others changing roles. This was to ensure the appropriate staff, with the right skills and experience were in place to embrace and implement the requirements of the provider and the registered manager. High performing staff had been encouraged and supported to obtain externally recognised qualifications such as their Level 3 and Level diplomas in adult social care. Both of these qualifications equipped staff to carry supervisory and management roles. This increased the skills of staff resulting in the sustaining of high quality care for people.

Staff felt able to raise any concerns they had about the service, and they felt confident the registered manager and/or the provider would act on those concerns. A staff member said, “The managers are very open minded, and they are willing to listen and help with any concerns that we have.” The registered manager welcomed feedback from staff and told us they provided a safe ‘space’ for them to do so. This included an ‘open door’ policy enabling staff to speak with them at any time, or discussions during supervisions and/or team meetings.

The provider had an open and transparent approach that empowered staff to drive improvement and to raise concerns with the confidence they would be acted. The provider had ensured that staff had the opportunity to speak up in a range of forums such as supervisions and team meetings. Whistleblowing procedures were in place. The registered manager understood their responsibility to report any concerns to external agencies. Records showed this had been completed when required.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us they had clearly defined roles and responsibilities. They told us they discussed their roles during regular supervision. Staff welcomed the opportunity to discuss any issues they had about the roles with senior staff. The registered manager felt they had effective auditing processes in place that enabled them to oversee the running of the service and to identify any issues before they impacted people’s health and wellbeing. The registered manager told us they were aware that the improved auditing processes had not been in place for long and they needed to ensure the short-term improvements to the home were maintained and continued. The registered manager understood the statutory and regulatory requirements of their role. This included notifying the CQC of a relevant incidents. Records viewed showed this process was effective.

More robust governance and auditing procedures were in now place. These covered a wide range of areas that could impact the health and safety of people. Regular audits of medicine processes, staff training, accidents, incidents, and complaints took place. These processes, amongst many others, helped to reduce the risk to people’s health and safety and provide them with higher quality care. It was acknowledged that the new auditing processes were effective in reducing the immediate risks to people. However, the provider was continuing to work alongside the registered manager to ensure standards remained high, staff were fully committed and involved and identified risks were acted on quickly. This was a work in progress and will be reviewed again at our next assessment. The provider had emergency contingency plans in place should be a sudden event that could affect the smooth running of the service. This included; poor weather planning, staff sickness and national events such as COVID. People’s care records were stored safely. Paper records were stored in locked cabinets. Electronic records were password protected. The registered manager was able to identify if unauthorised people had access records. This helped to keep people’s personal data secure.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.