Bywell 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Initial assessments were completed prior to admission and were incorporated into people’s care plans. Assessments were conducted in person and included the views of people and their relatives. A relative commented on the process and told us, “[Registered manager] wanted to know about likes, dislikes, food and needs and wants. I said [person] likes the garden. Even since then [registered manager] makes ongoing notes and includes it in the care plan.” Relatives and where possible, people were invited to view the service before moving in. A relative told us, “When I went to Bywell, the next day I said I wanted [person] to see it. [Registered manager] said to bring them in for lunch, it was all very open. Whilst we had lunch [registered manager] was talking to [person] getting to know them.”

The provider did not always effectively plan people’s care and treatment using nationally recognised assessment tools. The malnutrition universal screening tool (MUST) or a similar tool was not integrated into people’s care records, limiting proactive identification of malnutrition risk. Staff did, however, monitor people’s weight and escalated concerns to professionals. We discussed this with the registered manager who told us they would assess people using the MUST as a priority. Other assessment tools were utilised well, for example, the Waterlow tool which ascertains people’s risk of developing pressure damage. We saw staff had quickly escalated concerns about a person’s pressure area to the district nursing team upon their admission to the service. Staff arranged for equipment to be in place and accurately followed treatment plans. There were marked improvements noted for the person in a short period of time.

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. There was a strong working partnership with health and social care professionals, with timely referrals and reviews. A health care professional told us, “I reduced a patient’s medication as it was thought it was making them more agitated. The home were clear [person] did not need more medication. Since reducing other medications [person] has calmed down. Staff know [person] and chat to them and give them space. They (staff) seem to be very friendly and well meaning.” Another said, “[Registered manager] is very responsive to advice, they act on things in a timely manner and ensures that advice is listened to.The residents appear happy and well cared for.”

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. People were supported to maintain health and wellbeing through regular monitoring, nutrition, and exercise. Activities included exercise to music and park walks, promoting physical health and social engagement. The registered manager said, “I am particular (about nutrition), my fitness and nutrition advice gets passed over here.” The menu was rotated according to people’s preferences and the season. People’s dietary requests and requirements were managed well. People told us about the food, their comments included, “I find the food quite nice.” And “No complaints about the food, its good and plentiful.”

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 and managers tracked weight, falls and skin integrity, and escalated concerns to professionals when needed. A health care professional told us, “My advice is acted upon, requests to elevate legs or escalate concerns are followed promptly. There’s a renewed understanding of why care planning is important.” We observed a person being supported to elevate their legs to reduce swelling, this advice was documented in their care records.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, mental capacity assessments had not always been formally recorded. Staff sought consent before providing care and understood the principles of the Mental Capacity Act 2005 (MCA) principles, but assessments required review to ensure decision-specific detail. We spoke with the registered manager about MCAs who told us they were aware of this and had plans to reassess people within the coming months. Consent forms were completed with people’s legal representative where appropriate, and advocacy was arranged for people without relatives. We observed staff respectfully requesting permission and offering choices before supporting people. A person told us, “They always ask my opinions, I'm satisfied with everything.”