Balmoral Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The service was effective. Care plans were reviewed, contained people’s wishes and we received feedback from visiting professionals that they thought they were detailed and robust. Positive Behaviour Support plans could be more detailed to contain specific information on what people’s behaviour may look like. Staff demonstrated they knew people well. Staff worked well with partner agencies to undertake assessments and transitions into the service. Staff supported people to maintain their health and well-being. People were supported in relation to their rights and people had access to independent advocacy services.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives and professionals working with the service said the service managed risks and when people became distressed very well. One social worker told us, "The nurse allocated to the service user I was working with showed me a care plan that was detailed, highlighting risk and observations as a new resident. It was evident time had been spent to get a good understanding of the service user's needs and how best to manage these in their best interests."

Staff spoke positively about person centered care. One staff member said, "Keeping people's dignity and making sure that person feels valued ensures we give proper treatment and maintain their privacy at the same time." We were also told that they knew how to access peoples preferences, "These are in their care plan, but we also have memory posters outside their doors that include their hobbies and life history." However, we did observe that memory posters were not in place for all people.

Care plans were holistic and covered health, wellbeing and communication. However, some care plans were limited. For example, a mental health care plan for one person was not specific to describe what 'confused or agitated' behaviour may mean for them and the positive behaviour support plan for another person did not describe what 'agitated/distressed' meant. This may mean staff may not be able to support the person in a consistent way. We looked at hospital passports. These were relevant for people, however were limited in terms of how it described how people understood communication and how they also communicated.

People we spoke with told us the food was "OK," and there was a choice. People were able to request alternatives if they didn’t like what was served. People also told us that hot drinks were offered frequently. However, feedback we received from relatives was more mixed regarding food quality and availablity of drinks. Relatives we spoke to told us that staff used distraction techniques to find positive outcomes for people with challenging behaviours who used the service.

Staff told us that there was in-house training around fluid and nutrition training as well as people's specific needs such as diabetes. This information was recorded into their care plan and staff were given time to read them. A staff member told us, "I have recently had autism training which was really useful and I learnt a lot to support a specific person." They also told us, "We never rush meals and go at the person's pace. We make sure everyone gets what they need. If they don’t want to eat something on the lunch menu, we ask in the morning if they'd like an alternative."

We saw care plans were reviewed, contained people’s wishes and we received feedback from visiting professionals that they thought they were detailed and robust, However, we felt that more information could be included to ensure that staff had clear guidance and information about people's needs. For example, for one person needed an "as and when required" medicine but there was no detail of when this needed to be given to ensure it was effective. We reviewed seven days worth of 10 at 10 meetings held daily at the service between key senior staff from all departments and units within the home. This showed actions needed for the forthcoming day, activities and appointments and showed there was a communication strategy between the senior team.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People we spoke with were positive that their views and rights were upheld. Relatives described examples of consent being sought for COVID-19 booster vaccinations. Feedback from visiting professionals was also positive relating to the service enabling people to be supported to manage their behaviours via de-escalation techniques rather than the use of restraint.

Some people who used the service were supported with an advocate, the registered manager also told us "We have good relationships with Your Voice Counts". Staff were aware of the importance of gaining consent for treatment and as well as when a best interest decision may be required. Staff understood what to do if someone refused consent. A unit manager we spoke to told us, "We always ask for their permission. Sometimes it may be someone who can't consent but we still talk through what we are doing."

Care plans did guide staff to encourage and support people to make daily decisions where people were able. Mental Capacity Assessments and Best Interest decisions were considered where people were unable to make decisions.