Bearwardcote Hall Residential 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, this key question was rated Inadequate. At this assessment, the rating has improved to Requires Improvement. This reflects progress in the effectiveness of people’s care, treatment and support, with evidence that some improvements have been made since the last assessment. However, further work is needed to ensure care is consistently effective and that good outcomes are achieved for all people using the service.

This service scored 58 (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 had made improvements to care planning processes and monitoring systems since the last inspection. However, further work was required to ensure people and their relatives were consistently involved in planning and reviewing care, and that care records fully reflected people's individual goals, preferences, and desired outcomes.

Improvements had been made to care planning processes. Records showed care plans were reviewed regularly and monitoring tools, such as food and fluid charts and weight records were being completed. However, further work was needed to ensure these improvements were fully embedded and consistently reflected a person-centred approach to assessing and planning care.

Whilst people’s needs had been assessed and care plans contained information about the support required, records did not consistently demonstrate that people and their relatives had been involved in developing or reviewing their care plans. In addition, care plans did not always include personalised goals, outcomes or aspirations that reflected what was important to people or what they wished to achieve and maintain.

The provider had recognised these areas for development and had started to take action to improve the quality of care planning. However, these changes were not yet fully embedded, and their impact could not yet be consistently evidenced across records.

The provider did not consistently ensure that people's care and treatment were planned and delivered in partnership with them, reflecting their individual preferences, priorities and what mattered most to them. Although improvements had been made to support the delivery of evidence-based care and treatment, further work was needed to ensure these improvements were fully embedded and applied consistently across all areas of practice.

Systems were in place to monitor people's care and wellbeing, however, records did not always demonstrate the consistent use of recognised assessment tools or effective ongoing monitoring following changes in people's health or care needs. For example, records relating to falls did not always evidence that appropriate assessments had been completed or to monitor people following a fall.

Care records did not consistently demonstrate the involvement of people and, where appropriate, their relatives in the development and review of care plans. In addition, care plans did not always include personalised goals or outcomes that reflected people's individual preferences, aspirations and desired outcomes.The provider had identified these areas for development. While progress was evident, further work was required to ensure these processes were consistently embedded in practice and that records clearly demonstrated the delivery of person-centred, evidence-based care and treatment.

Staff did not always work together effectively to ensure people received timely and coordinated support. During our observations of mealtimes, there were occasions where staff did not effectively organise or communicate with one another, resulting in delays to the support some people required. This showed there were further improvements needed to ensure teamwork was consistently effective across the service. Staff told us communication within the team had improved and spoke positively about how information was shared. The service ensured referrals for additional support were now being made more promptly when people’s needs change, including access to relevant health and social care professionals.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Improvements had been made to strengthen how people’s health and wellbeing was supported. Care plans had been reviewed and updated to provide clearer guidance that reflected people’s healthcare needs.

Systems and processes had been improved to ensure risks associated with people’s healthcare needs were identified, assessed and managed effectively. For example, staff had access to clear guidance and information on supporting people with long-term health conditions. Staff were supported to recognise and respond promptly to signs of deterioration, resulting in more timely referrals to healthcare professionals and helping people to access the support they needed to maintain their health and wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. The provider had made improvements to strengthen the monitoring of people’s health, wellbeing and care outcomes. Care records and monitoring tools were being used more consistently, supported by increased management oversight and clearer expectations for staff. This helped to ensure changes in people’s needs were identified sooner and appropriate action could be taken to support positive outcomes.

Quality assurance and governance processes had also been improved to provide greater oversight of care delivery and identify areas for improvement. While these improvements were positive, further time was needed to demonstrate they were fully embedded and consistently applied across the service. Leaders were continuing to build on the improvements made, with a focus on ensuring new processes were consistently embedded in practice and continued to support sustained positive outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Improvements had been made to ensure people’s rights were protected and that decisions about their care and treatment were made in line with the Mental Capacity Act 2005. Mental Capacity Assessments (MCAs) had been completed where required, and systems were in place to support the timely completion of best interest decisions and Deprivation of Liberty Safeguards (DoLS) applications.

People’s capacity to make specific decisions was now more consistently assessed and recorded, providing staff with clearer guidance on how to support people to make choices and maintain their independence wherever possible. Staff and leaders had developed their understanding of the Mental Capacity Act and were better able to apply its principles in practice.