Ballater 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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question Good.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The ethos of how people were supported within the service was shared by staff. The regional manager told us this centred around the belief of “This service doesn’t see the diagnosis, it sees the person. Its very person centred, very caring, unique in lots of ways.” This was evident during our assessment. People had very varying care needs due to their mental health and/or learning disabilities. However, staff ensured that people received personalised care to support and enrich the person’s life, rather than just exist. There was an emphasis on ensuring any risks to people were known and understood by staff, but that these did not propose a barrier to people living as normal life as possible.

We identified there had been some recent incidents in relation to the culture amongst different staffing groups within the service. However, we observed the management team were working hard to address these through discussion in team meetings, organising team building events and setting expectations of working relationships between staff.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The newly appointed manager had been at the service for 4 days at the time of our assessment but told us of her plans going forward to ensure she fully integrated into the role and team. They told us, “I’m planning to sit in on supervisions next month. I’m going to be setting up clinical meetings, and staffing meetings for the next month too.”

The regional manager believed in the importance of leading by example and told us that they would often work on the floor and engage with people and staff. We observed that they knew people well and what their needs were, and staff told us they felt valued by the management team.

Relatives felt the service was well led and leaders were approachable. One relative told us, “I think the care is well run. I always thought the service has been managed really well.” Another relative said, “I can talk to the management.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

One staff member told us they did not feel heard, and said, “No I don’t feel heard. The staff don’t feel like reporting anything because they don’t think nothing’s going to happen.” We informed the regional manager of this who gave us assurances of the systems in place to allow staff to speak up freely. However, all other staff we spoke to were positive about being listened to and being able to speak up. One staff member told us, “Yes, you can speak up. They listen.” Another staff member told us they had raised concerns in the past and these had been addressed. The regional manager told us, “There’s a freedom to speak up guardian in the company who does drop-in sessions. In the last 6 months we’ve developed a bespoke whistleblowing training course, and they’ve made that a face-to-face session. We observed speaking up and whistleblowing information was available for staff to view in the staff room.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff had completed equality, diversity and inclusion training. We identified staff meetings focused largely on staff culture to ensure an inclusive working environment for all.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The management team completed regular safety and quality audits which identified any areas for improvement needed. We observed that any areas of improvement had been resolved.

The provider’s quality compliance team completed weekly audits of the service. These were then added to a quality dashboard from which staff were expected to resolve or take action to address the issue within the following week. The regional manager told us, “They focus on different things each week, month, and quarter. It’s on a complete rotation. The managers are then expected to update the compliance team within the week. If it hasn’t been actioned, it doesn’t get removed from the dashboard. Compliance will then check to see if it’s been actioned.”

The provider had also taken the decision to hire an independent auditing company to complete a recent assessment of the service. They had found all areas to be of good quality and the service to be well led.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Staff worked well with external partners to ensure people received smooth and coordinated care. This included local community mental health teams, the GP surgery, and specialist care teams. As previously demonstrated in this report, where there were break downs in the support people received from external partners, staff advocated for people to ensure the effect on them was minimised as much as possible.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The management team listened to and actioned ideas for improvement of the service from staff members. The regional manager told us, “During a team meeting, staff fed back the clocking in machine is in the meeting room which was disruptive for staff so it was moved last week.” We observed the machine was now in the hallway so to not disrupt staff during meetings going forward.

Plans were in place to further improve the service. Some people’s shower rooms were being converted into wet rooms to allow for declines in people’s mobility and balance as they had grown older. This ensured their needs could continue to be met at their home.

Furthermore, staff had requested a team building event which was in the process of being organised. This included hosting 3 different events to allow all staff members to attend over different shifts.