Ballater House

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff confirmed they had time to read people’s care plans before delivering care. One staff member told us, “I read the care plans and the risk assessments before we start any care.” This ensured staff were aware of people’s needs and how to best support them.
 

People’s care plans were reviewed on a regular basis. The regional manager said, “Generally care plans are reviewed each month or sooner as required.” We identified this was correct from people’s care plans.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff were delivering care in line with principles of Right Support, Right Care, Right Culture (RSRCRC). The RSRCRC regulation outlines principles of good care and support for people with a learning disability and autistic people to ensure they lead as normal life as any other individual in society. This includes empowering people to make choices about their care where possible and being able access their local community as much as they wish to. We identified that staff were delivering this care and supporting people to be confident and empowered. The regional manager told us, “RSRCRC is very much about bespoke individual access, it’s about making sure their life is what they’re wanting it to be. One person absolutely loves to play pool so goes to the pub down to the road to play. We have a minibus, or we can get public transport. We make sure we make bespoke packages for them.”

RSRCRC also considers the layout of the service and whether it promotes people’s independence. We observed there were no locked doors within the interior of the service. This allowed people to move freely around all areas of their home.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We observed staff working well together as a team throughout the day. Staff would inform other staff members where people were in the building or if someone required something from the cook. The regional manager told us, “There’s always a bit of back of forth between support workers and nurses, but they work well together. Handovers are on [the care planning system] and there’s a verbal handover too.”

Staff who had particular interests in certain topics had been made ‘champions’. This meant they were responsible for providing information and best practice guidance to other staff members to achieve high quality care to people. There were currently champions in areas such as safeguarding, dignity and IPC, but the management team were looking to expand this further.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We observed guidance on how to support people during extreme hot weather was on display around the service. Staff also had access to information on React to Red, an initiative aimed at raising awareness and providing resources to prevent pressure ulcers in care settings.

Referrals to the speech and language team (SALT) were completed when people required professional input around eating and drinking concerns such as choking. This resulted in people receiving modified texture diets and thickener for drinks to ensure they could continue to enjoy a nutritious diet safely.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff ensured clinical aspects of people’s care were monitored and improved. For example, one person developed a pressure sore on their heel. With staff intervention alongside the support of a tissue viability nurse, the pressure sore had now healed. This meant the person was more comfortable and experiencing less pain.

Systems were in place to ensure people who required a texture modified diet received this. Each person’s dietary requirements were displayed in the kitchen. This included people’s dietary likes, dislikes, allergies, texture modified diets and how to prepare this. The cook was able to tell us the different levels of texture modification for people’s food and confirmed she had completed her refresher training in this area recently. This ensured people could continue to eat nutritious meals whilst the risk of choking was managed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff’s knowledge around consent and mental capacity was comprehensive. One staff member told us, “A service user with diabetes might want to put more sugar in their cup of tea. I will let them know that the quantity is too much. We respect his decision, and we let the nurse in charge know.” Another staff member said, “We assume everybody has capacity unless proven otherwise. First of all, you have to ask for consent before you do anything. If the person refuses, then the person reserves the right to refuse. There are restrictions – we have DoLS (deprivation of liberty safeguards). Most of the time, DoLS is for safety. They have to be watched closely when we go outside so they don’t come to any harm. Watching [person] from a distance is the least restrictive way. I think holding his hands for example would be too restrictive. Overall, it’s proportionate.”

Relatives were involved in decision making where there was a requirement to do so. One relative told us, “They consult me with things like flu jabs and things. They asked for my permission about the COVID jab. I look after his finances, so they contact me for money for clothes and things every so often.”

The provider had a DoLS tracker in place, which recorded when these were applied or, which professional was involved in the process, the date they were authorised and the date they expired. This ensured restrictions on people’s rights were legal and the least restrictive options.