Balmoral Care Home

While we did not find evidence to suggest that falls were being managed inappropriately, we identified areas for improvement in record-keeping and oversight related to this aspect of care.

During the inspection, we found breaches of legal regulations relating to the management of risk associated with medicines and the environment. We also identified concerns regarding governance and oversight, including the monitoring of care records, maintaining contemporaneous documentation, and taking timely action in response to identified shortfalls.

Whilst people felt safe, there was a lack of oversight to ensure action was taken in response to shortfalls. Care plans were in place but were not always detailed, consistent or personalised and daily records did not reflect that care was being given in line with agreed plans. There was limited evidence that people or families had been involved in decisions around care. Staff were not always readily available to provide timely support to people, and this impacted on the levels of care, mental stimulation and activities people could engage with.

People spoke positively about the food and people’s weight was generally stable. There was evidence that the provider and staff worked closely with other stakeholders to meet people’s needs. Staff knew people well and were able to identify changes in their health and make appropriate referrals. There was limited evidence of how consent was sought from people in terms of decisions around care or daily life.

People spoke highly of the staff team, and we observed kind and caring interactions between staff and people. Whilst staff knew people well, they were often very busy and forgot to consider people’s dignity when providing support, for example by moving a person in a toileting sling in the communal areas, not removing the sling whilst people were sat in lounge chairs, or forgetting to remove clothes protector after people had eaten.

Care plans were not always sufficiently personalised and there was a lack of opportunities for staff to engage with people and provide stimulation and activities. Staff worked hard to try and fill shortfalls due to the challenge of recruiting an activity worker. People were supported to have access to visiting community groups and occasional trips out into the community and the provider worked with other health services to meet people’s needs. There were numerous compliments from families whose relatives had been cared for at the home prior to their death.

There were some shortfalls in the oversight maintained from the provider and registered manager. Audits were completed but these did not always cover relevant areas or lead to the required action being completed in a timely way. Staff had mixed experiences and had not always felt supported by the management team. Whilst a recent survey had been completed there was limited evidence of action taken in response, at the time of our visit. The registered manager was working with the local stakeholders to develop an action plan and was committed to driving improvements where these were needed.