Bethany House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 did not always make sure people’s care and treatment were effective because they did not consistently check and discuss people’s health, care, wellbeing, and communication needs with them.

Care plans were not always accurate or comprehensive, and information was inconsistent across documents. For example, mobility care plans, falls risk assessments, and moving and handling assessments contained mixed details, and references to equipment in unrelated plans, such as a wheelchair noted in an oral health care plan. Nutrition care plans did not reflect specialist diets, despite care notes referring to fortified drinks.

Important health needs were not always addressed in care planning. There were no care plans for mental health or alcohol dependency, and constipation was noted without further guidance. Bowel monitoring records conflicted with care plans, which stated one person was fully continent, while staff confirmed they used aids at night.

During the assessment, managers had to check with staff to confirm people’s current needs. Managers acknowledged that care plans were reviewed monthly but agreed they should also be updated promptly when needs change.

Despite these issues in documentation, we found limited impact on the care people received.

The provider delivered people’s care and treatment in line with legislation and current evidence-based good practice and standards.

Systems were in place to monitor people’s nutritional intake and weights, and action was taken to manage risks associated with dehydration and malnutrition. Care plans identified the level of support needed from staff to prevent malnutrition and dehydration and this information was available to staff working in the kitchen. People were offered a choice of meals and alternative options were available. Regular refreshments were made available to people and accessible in the dining room. Chefs had freedom to develop menus and prepared meals using fresh produce. They told us, “Nice meals are the highlight of some people’s day”. Everyone we talked to spoke positively about the food which is offered. One person said, “The choice of food is good, it always smells and looks tasty – very tempting”.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Senior staff members completed daily handover meetings to ensure key information was shared with the rest of the staff team about changes to people’s needs. Staff followed guidance given by health professionals, to help people manage any health conditions and feedback from 2 health care professionals was positive regarding the care people received. A visiting professional commented on how proactive staff had been in requesting their visit. People told us the staff team worked well together, one person said “The care is alright, and I just feel safe here. The staff discuss what they are going to do to me before they do it. I think the staff work well together. I don’t have any concerns; everything is easy going”.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff closely monitored any changes in people’s health and acted promptly when concerns arose. They ensured timely referrals to appropriate health professionals to address emerging issues. Staff incorporated treatment plans into individual care plans to ensure continuity and consistency of care. In addition to responding to health concerns, staff supported people to maintain their overall wellbeing by facilitating access to routine and preventative services, including dentists for oral health, opticians, and chiropodists for foot care. This proactive approach helped to reduce risks, promote comfort, and support people to maintain their independence and quality of life.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff responded promptly when people’s health needs declined, ensuring that any deterioration was addressed without delay. Where specialist input was required, appropriate referrals were made. Staff worked collaboratively with professionals to ensure people received the right treatment to reduce risks, prevent further decline, and promote positive health outcomes. For example, we found one person had experienced improvements in existing pressure damage since their admission to the service.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider failed to ensure the correct procedure was followed in relation to the Mental Capacity Act 2005 (MCA). MCA provides a legal framework for supporting people who may lack the ability to make certain decisions for themselves. Although staff completed training in relation to the MCA and understood the importance of seeking people’s consent before delivering care, mental capacity assessments were not completed in line with the requirements.