Birnbeck House - Care Home Learning Disabilities

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to person centred care. We found improvements were needed to ensure care and treatment reflected people’s personal preferences and meaningful ways for people to spend their time was offered to people.

This service scored 62 (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 always check and discuss people’s health, care, wellbeing and communication needs with them.

People were not having regular person-centred reviews where any goals and outcomes the person wanted to work towards could be discussed. The interim manager told us these were in the process of being planned but did not provide a time frame for their completion.

Where people had been assessed by health professionals, because of a referral, records of the outcome of the referral were variable. For example, we saw people’s epilepsy plans had been reviewed with a learning disability nurse and documentation provided clear information and instructions on how to support the person with their epilepsy. However, we were informed 1 person’s mobility had been assessed by a physiotherapist for their safety of using the stair lift due to posture concerns. We were advised it had been assessed as safe for them to use the stair lift. However, there was no documented record of this assessment and its outcome. This meant the service could not evidence they were supporting the person to use the stair lift in a way which had been assessed as safe.

People did not have formal care plan reviews, but some relatives told us they had been involved in discussions about people’s care.

People’s care plans provided an assessment of their needs and gave information about people’s health and communication. Relatives told us their loved ones had communication difficulties, but most were not aware if staff were appropriately trained in their communication methods. However, 1 relative told us the person’s key worker, “understands their non-verbal communication well.” 2 people’s care plans recorded they had a vitamin deficiency but did not provide information about how this may affect them or how they should be supported with this. Some people’s health action plans had also not been reviewed for some time. We fed this back to the provider so they could ensure they were reviewed as needed, and people received the personalised care they required.

People had shared staffing hours, and some people also had additional 1 to 1 hours and 2 to 1 hours to meet their needs. From our observations, we were not assured people were provided with appropriate care and treatment that met their needs and was person centred.

For example, we observed people sitting around with little interaction or nothing meaningful to do for long periods of time, except for sitting in a communal room with the television on. People did not appear interested in what was on tv and were not asked what they would like to watch. A daily afternoon group activity was displayed in the hallway of the service; people were not supported to take part in the planned group activity during our visit. We did not see people being offered a choice of activities. We also observed 1 person wait for over 30 minutes for a member of staff to support them with their lunch. Where people are not offered any meaningful ways to spend their time this may lead to a decline in their health and wellbeing due to a lack of engagement and stimulation.

We were told 8 people living at the service chose to go out with other people living at the service. However, we did not see this preference documented in people’s care plans, or evidence of how people had communicated this choice.

Staff told us there were a lack of activities for people but there had been some improvements. One staff member told us, “Now we are taking people out, we were never taking people out before.” A relative told us, “There have been no drivers for the last year which limits where they can go.”

However, staff regularly completed clinical assessment and monitoring tools for people. People’s health concerns for people were recorded by staff and discussed with a nurse practitioner who visited the service weekly.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.