Balmedie House Care Home Service

Balmedie House Care Home Service Balmedie Aberdeen AB23 8XU Telephone: 01358 742244 Type of inspection: Unannounced Inspection completed on: 20 July 2016 Service provided by: Church of Scotland Trading as Crossreach Service provider number: SP2004005785 Care service number: CS2003000265

About the service Balmedie House is a care home for older people with 34 registered places. It is situated in a quiet area, within extensive grounds in a converted mansion house. The service is provided by Crossreach (Church of Scotland Social Care Council). The aims and objectives of the service are, '... we seek to retain and regain the highest quality of life which each individual is capable of experiencing at any given time'. It aims to do this by maintaining a high standard of care, encouraging involvement in the community, promoting choice and by nurturing a good quality of life for people living with dementia. The service registered with the Care Inspectorate on 1 April 2011. This inspection focused on the standards of care for people living with dementia. We are using a sample of 150 care home services to look in detail at the standards of care for people living with dementia and this service is one of those selected as part of the sample. The areas looked at were informed by the Scottish Government's Promoting Excellence: A framework for health and social care staff working with people with dementia and their carers and the associated dementia standards. It is out intention to publish a national report on some of these standards during 2017. What people told us We spoke to seven people who used the service. They all said how very happy they were with the quality of care they received and they spoke very highly of staff. "Staff are very friendly." "Care is excellent." "I feel safe here." "Staff are very kind - nothing is too much trouble." We also received 12 questionnaires back from relatives, and spoke to five relatives throughout the course of the inspection. They all said that they were very happy with the quality of care. "The home isn't perfect but it's the closest you'll get to perfect." "(The management) respond very quickly to all your comments." "Our mother has been there for... (several) years and it is one of the nicest homes. The care she receives is excellent we have a very good relationship with the managerial staff plus all the carers. Balmedie House has everything she needs there. She is very happy as is all our family." "All the family are totally happy with the home and staff at Balmedie House. Everyone is so friendly and caring it gives all the family a good feeling that our loved one is being so well cared for. We thank everyone at Balmedie for their kindness to my... (relative) and to the family." page 2 of 10

"The quality of care is second to none and the staff are always friendly and polite." "My dad is extremely happy at Balmedie and has been there for over... years and during that time he has been very well looked after and I have had no cause for concern. I also value the extras such as the Christmas meal, BBQ and high teas that the staff organise. It allows me to spend quality time with my dad." "Since my relative moved to Balmedie House... (a number of) years ago his health and outlook on life has dramatically improved. First class care and facilities and superb staff across the board." "Balmedie House is a lovely home for my mum to stay. She has settled in very well now. I believe that she has managed to settle due to the excellent care and friendly, homely surroundings. I visit often and always feel welcome." "Since my mum has gone into the home her health has been much more stable and her moods are generally happier. She is currently more contented that I have seen her in the previous... (number) of years - when dementia was beginning to appear. I have visited at various irregular hours and am always greeted and made welcome and my mother is always being cared for. The laundry is immaculate. The energy going into personal care is impressive. For example, my mother has long hair - not very handy for the carers but every day it is carefully combed... (styled and cared for) into classic and age appropriate styles. They do not need to do this - but they do - and it makes a difference." Self assessment The Care Inspectorate received a fully completed self-assessment from the provider. The provider identified what it thought the service did well and gave examples of improvements in dementia care and the environment. The self-assessment clearly identified key areas that the provider was working on improving and showed how the service intended to do this. The provider told us how the people who used the care service had taken part in the self-assessment process and how their feedback directed the development of their plans for improving the service. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership Quality of care and support Findings from the inspection The service had continued to deliver excellent care and support. Residents were encouraged to improve and maintain their health, wellbeing and quality of life. This was because: page 3 of 10

- staff worked closely with local medical services to provide prompt and timely medical care - the food was appetising, nutritious and regularly improved to align with people's preferences - people were kept alert and active with a range of meaningful activities - friendships were supported and encouraged. We were told: "My mother has been a resident at Balmedie for a number of years and we as a family feel we couldn't wish for better care for mum. Although having dementia and her mind is deteriorating her quality of life is much better because she stays at Balmedie than it would have been had we been caring for her." "We are delighted with the care provided for our relative. He is extremely well supported and looked after. As a dementia sufferer, his quality and experience of life has drastically improved since moving in to Balmedie House." "We have so much to do (activities) it can be hard to choose. We go to bed very tired." "The best thing this home did for me was introducing me to (another resident) and we made friends. We go everywhere together. We've adopted each others families. We get double the visitors now." Staff supported residents with warmth and genuine concern. They understood the impact dementia had on behaviour and wellbeing and helped those people to feel included and have choice about how they spent their time. Staff knew the residents well and enabled them to participate in daily activities, which helped improve people's confidence. Residents told us they felt respected and valued. One person said, "They (the staff) help you learn again. They gave me my confidence back. I was so confused before I came here." We spent time in the communal areas watching how staff and residents interacted. Staff were perceptive to residents' changing needs and took timely action to support residents who looked confused, disinterested or withdrawn. This had a very positive impact on people's moods and created a warm, enjoyable and relaxed atmosphere. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 6 - excellent Quality of environment Findings from the inspection The service continued to provide an excellent environment for people to live. The environment promoted meaningful interaction and purposeful activity. It did this by making creative use of page 4 of 10

the communal areas so that there was space for everyone to enjoy. For example, it had a cinema room so people could watch the TV in peace without disturbing others. It had a sensory room which provided a tranquil setting for people to relax. Chairs were arranged in small clusters in the lounge and this encouraged conversation between residents. Stimulating activities were left around the communal areas to encourage independent activity and these included, crosswords, books, sensory items to explore, artwork and music. We found that the environment promoted wellbeing. Most of the people we spoke to told us one of the main reasons they chose the service was because of the building, its space, character and attractive gardens. The environment was clean, tidy and free from clutter. It had a relaxed and calm atmosphere and felt homely. People had chosen the décor which was of a high standard and well maintained. Residents told us, "It's a home from home", "the gardens are beautiful" and "I feel safe here". It was clear to see the progress the service had made in reducing the number of falls and promoting an active lifestyle. It also provided a calm, safe and secure environment. Residents were able to walk around the home independently, which had handrails, small seating areas where people could rest and clear signage to help people find their way. People were given the time to walk at their own pace and were assisted as required. The service had experimented with different ways to make the environment more accessible for people with dementia and was continually updating the environment in accordance with best practice guidelines and people's feedback. Due to the layout and age of the building there was very little noise transfer between communal rooms. The service proactively reduced noise where possible by, for example, setting the call system to vibrate so it did not disturb people while they were sleeping. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 6 - excellent Quality of staffing Findings from the inspection The service continued to have an excellent quality of staffing, which resulted in positive outcomes for the residents. We could see from the interactions between staff and residents, the commitment staff had to the aims and values of the service. We saw staff provide comfort to people in times of distress, encouragement in times of doubt and friendship in times of uncertainty. The residents spoke very highly of staff and told us that they trusted them and felt safe. The service operated a comprehensive training programme that helped staff develop the necessary skills to provide excellent care. Staff were well-educated about dementia and were seen to use this knowledge to good effect. Staff knew how to structure and deliver activities in a way that helped people participate and remember page 5 of 10

skills that they had forgotten. For example, we saw one resident talking and smiling during an activity who otherwise seldom spoke. Staff were supported to take on additional specialist roles such as dementia ambassadors or oral health champions. They were given advanced training and management support to fulfil these roles. For example, the oral health champion was in the process of re-assessing everyone's oral health needs and how these could best be met in light of staff's new knowledge. Whereas the dementia ambassadors kept up to date with the latest research in dementia and used this to improve their practice. Overall this resulted in a better quality of life for residents. There was a positive and proactive culture among the staff team, that focused not just on the needs of residents, but also on the quality of their lives and experiences. Staff seemed to act intuitively to know just the right amount of support and encouragement to give to residents, while also giving residents the time and space to learn how to do things for themselves. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 6 - excellent Quality of management and leadership Findings from the inspection The service continued to have excellent management and leadership which improved residents' wellbeing and quality of life. Managerial staff spent a lot of time with residents in the communal areas, observing staff practice and speaking to relatives. They used their observations to continually improve the standard of care. They did this by providing feedback to staff, identifying training needs and resolving residents' concerns quickly and efficiently. This embedded the service's value base and promoted a learning culture. It also improved the outcomes for residents. In one case the manager identified that a resident seemed withdrawn and following a few simple changes to their care, the resident seemed much brighter, happier and more engaged. Staff told us they felt supported by managerial staff and motivated to do their best. This technique filtered through the staff into how they treated others, which promoted a cohesive staff team and an enjoyable and homely atmosphere. Several relatives told us that the management was very quick to respond to comments, for example, by making improvements to the environment or by liaising with health professionals to get funding for required items. The service used lots of different ways to engage with residents and relatives and this approach meant that people felt listened to. The service used this information to constantly improve. For example, after meals page 6 of 10

residents' comments were written up on a white board so that kitchen staff could adapt their cooking to suit individual tastes. In addition to this, the service had a, 'make a wish' box. Residents were able to put their wishes in the box and staff would do their best to make it happen. As a result, one resident got to go on holiday, another resident got to visit a renowned golf course. The residents' told us they were dreams come true. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 6 - excellent What the service has done to meet any requirements we made at or since the last inspection Previous requirements What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Enforcement No enforcement action has been taken against this care service since the last inspection. page 7 of 10

Inspection and grading history Date Type Gradings 27 Apr 2015 Unannounced Care and support Management and leadership 28 May 2014 Unannounced Care and support Management and leadership 22 Jul 2013 Unannounced Care and support Management and leadership 26 Jun 2012 Unannounced Care and support Management and leadership 30 Nov 2011 Unannounced Care and support Not assessed Management and leadership 24 Jun 2011 Unannounced Care and support Not assessed Management and leadership 29 Oct 2010 Unannounced Care and support Management and leadership 27 May 2010 Announced Care and support Not assessed page 8 of 10

Date Type Gradings Management and leadership Not assessed 26 Feb 2010 Unannounced Care and support Not assessed Management and leadership Not assessed 1 Jul 2009 Announced Care and support Management and leadership 17 Mar 2009 Unannounced Care and support Management and leadership 8 May 2008 Announced Care and support Management and leadership page 9 of 10

To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 10 of 10