Balmoral Court Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At the last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

We found the provider was in breach of the legal regulation relating to person centred care, respecting people and good governance.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager did not always ensure staff treated people with kindness, empathy and compassion, or respect their privacy and dignity. On the first day of our visit it was very hot and the registered manager realised the heating had not been turned off. At the flash meeting they instructed the unit leads to ensure staff had plenty to drink but did not include the people in this instruction. We observed staff kept themselves hydrated but did not increase the frequency of drinks offered to the people. Some relatives found at times staff needed to be more attentive when supporting people to attend to their personal care. A relative said, “Most staff are good but at times I find [person’s name] is in dirty clothes and looks like they have not had a bath. When I mention it staff come straight away but surely they should have noticed.” Another relative said, “I find some staff seem to be expected to complete all the personal care and this can mean they are stretched and can’t get to everyone. I’m not sure why this happens.” We discussed the issue with the provider and they immediately put measures in place to ensure this did not happen again.

Staff did not treat people as individuals and did not make sure people’s care, support and treatment met their needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. We saw differences between how staff on the various units performed. On many of them the staff spent the majority of the time engaged in activities which did not involve the person. The main activity staff completed on one unit was rotating who they took into the garden for a cigarette. Staff completing 1:1 tasks tended not to engage people in any meaningful conversation or activity. They did not acknowledge people’s individuality. For example, 1 person had been a professional footballer and had played in significant cup games and competitions. Staff did not know what team they played for or when, had not encouraged the family to leave pictures of this time, make memorabilia boxes, establish where the person was in their lived history or reference their career when working with them.

The registered provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. The activity coordinators ensured people were engaged in meaningful activities. However, there were no items available for people to use independently to engage in activities. We were told this was because people “destroyed any item” they were given. During our visits, we observed no one breaking or damaging items or attempting to damage property. Staff could not explain action they had taken to support people to find meaningful occupation and look at what items they could constantly have access to. For adults of working-age there was no equipment such as catering facilities for them to learn or maintain skills they would need to live more independently. We discussed this with the provider who undertook to ensure improvements were made.

Staff listened to and understood people’s needs, views and wishes. They responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. We observed staff were often engaged in conversations and horse-play with each other. Even when in the observation area on units staff missed things such as falls. Staff on some units were attentive and appropriately responded to people’s request for support. A staff member said, “We want to provide a good service. I like getting to know the residents and feeling like you’re making a difference. However, there can be some frustrations with communication and occasional inconsistency in how things are managed.” We discussed these concerns with the provider who took immediate action to support staff to make improvements.

The registered manager promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care. Information we received from various sources suggested a closed culture had developed at the service. People told us and we observed the registered manager found it difficult to accept any criticism of practices within the home. We were told rather than looking to see how improvements could be made the registered manager decided whoever raised the concerns was wrong. This had led to staff being reluctant to disagree with the registered manager’s position that everything was working well. A person said, “The residents and majority of staff are great but the manager, in my opinion, is not so great, I feel they are massively unapproachable and to the point staff members are scared to go to them with any issues.”