The Beeches 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 inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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.

Whilst people's needs had been assessed and most care plans were in place, records were not always updated to reflect changes in people's needs, circumstances and preferences. This meant there was not always clear assurance that people were receiving care and support that was responsive to their current needs and wishes. In response to our feedback, the provider promptly reviewed the care plans identified during the inspection.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The management team had not ensured that best practice in dementia care was consistently embedded. For example, one person was identified in their dependency assessment as displaying behaviours associated with distress. Records relating to this person demonstrated limited exploration of the antecedent, behaviour and consequence (ABC) records completed following incidents. The absence of robust analysis meant opportunities to understand the reasons behind the person's distress and implement strategies to reduce the likelihood of recurrence may have been missed, potentially affecting their wellbeing and quality of life as well as those around them.

Throughout the service, many walls and doors were plain white and did not provide clear visual cues to support orientation and wayfinding. Dementia-friendly design principles recommend the use of contrasting colours, personalised signage and easily identifiable features to help people recognise important areas and navigate their surroundings independently.

Lighting was insufficient in some areas of the service. Adequate and consistent lighting throughout a care environment supports people to navigate safely, reduces confusion and anxiety, and contributes to effective falls prevention. Insufficient lighting increased the likelihood of people misinterpreting their environment, particularly for people living with dementia and those with mobility support needs, reduced balance, impaired vision or a history of falls.

Following our visit, the provider engaged a specialist company to assess the environment and provide recommendations to improve its suitability for people living with dementia. This demonstrated a willingness to address the concerns identified. However, further work was required to ensure the environment consistently promoted people's independence, orientation, comfort and safety.

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.

The management team at the service gave examples of how they worked with internal and external teams and services to ensure people received care which was joined up. We saw evidence that referrals had been made to appropriate services such as dementia support teams, GP’s and district nurses in a timely way.A healthcare professional told us, “I find staff earnestly want to make it work for the [person] and are happy to take on any recommendations to make that possible.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not always supported in a way that promoted their nutrition, hydration and overall wellbeing.

During the lunchtime meal on both days of the inspection, staff were required to oversee and support people across multiple lounge and dining areas simultaneously. This significantly limited their ability to effectively monitor people's wellbeing, coordinate support, and ensure a positive dining experience. A substantial number of people required encouragement, prompting, or direct assistance with eating and drinking to maintain adequate nutrition and hydration. However, staffing arrangements did not provide sufficient oversight across all areas where meals were being served.

We observed occasions where people experienced delays in receiving support with their meals and drinks, and mealtimes were frequently disrupted as staff responded to competing demands elsewhere in the service. There was a lack of overall coordination and oversight of the dining experience, resulting in support not always being organised in a way that ensured people received timely assistance. This created a reactive approach to care delivery and reduced opportunities for staff to provide unrushed support, encourage independence, and promote a calm and enjoyable mealtime environment.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

We found a lack of consistency in the provision of meaningful and therapeutic activities to support people's wellbeing, independence and quality of life. Feedback from people and their relatives regarding the activities available was mixed. While some individuals spoke positively about opportunities to participate in organised activities, others felt there was limited variety and insufficient engagement throughout the day. This meant people did not always have equitable access to stimulation and occupation that reflected their interests, preferences and abilities.

During our observations, many people spent extended periods of time seated in communal lounge areas with minimal engagement from staff or involvement in structured activities. Opportunities for meaningful social interaction, sensory stimulation and personalised engagement were therefore not always maximised. This was of particular importance given that many people were living with dementia or other conditions where regular therapeutic activity can help maintain cognitive function and emotional wellbeing.

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

Records did not consistently demonstrate that the principles of the Mental Capacity Act 2005 (MCA) had been applied where decisions involved restrictions on people's rights or freedoms. We found limited evidence of decision-specific mental capacity assessments and best interests decision-making processes for individuals who may have lacked the capacity to make certain decisions about their care and treatment. As a result, it was not always clear how decisions had been reached, who had been involved in the process, or whether people's views, wishes and preferences had been fully considered.