Balmoral Court Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At the last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met.

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

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and they did not ensure staff worked in partnership with people, to decide how to respond to any relevant changes in people’s needs. The care records were written in a person-centred manner but did not always provide enough detail about how to support people. We found 12 of the 15 staff we asked to discuss peoples’ needs could not explain their conditions, how they were progressing at the service, provide information about their history, or tell us why they were living at the service. The registered manager told us not to ask care staff as they would not know but told us nurses would. We found most nurses could answer simple questions about people’s needs. However, frequently staff said, “I’d like to say they have [a condition] but can’t be sure so wouldn’t want to be say it was [a condition].” The registered manager failed to recognise staff lacked knowledge about the people they supported, and this lack of knowledge meant we could not be assured the information contained in care records was accurate.

There were some shortfalls in how the registered manager understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. They displayed a negative attitude towards people who lived in the area and thought the area was unsafe so tended not to encourage people to access local community facilities. This meant activity coordinators often looked for events outside of the area and people were not supported to integrate into the local community. We discussed this with the provider who took immediate action to address these issues.

The registered manager did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information was not available in a variety of formats or in ways, which would assist people understand what support was being offered. The care records contained limited information about people’s communication needs and no communication passports were in place for people whose first language was not English or used sign language. People were unaware of the support plans staff were following in relation to them and there was no evidence to show they had seen the care records. Relatives told us they had not seen the care records.

The registered manager did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People confirmed they knew how to raise concerns but at times did not feel they were listened to. The registered manager’s inability to critically review the service meant they did not act on feedback from people. They did not continually evaluate and use information to improve services at Balmoral Court. A person said, “The home manager rules the service with fear and intimidation.” We raised this with the provider, and they took immediate action to address the issues.

The registered manager did not always make sure that people could access the care, support and treatment they needed when they needed it. They had not ensured staff fully understood people’s needs and how they were to work with people. Staff understood how to access specialist health or social care support people might need. The multidisciplinary team visited weekly and ensured people received care and treatment in a timely manner.

The registered manager did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. There was a culture within the service whereby staff did not feel confident to challenge any inequalities they observed or seek to find solutions to the barriers people faced. We raised this with the provider, and they took immediate action to address the issues.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People reported differences in how staff supported them to plan for the future. The lack of knowledge staff displayed meant we could not be assured they understood how people might want to be supported now or in the future.