The Beeches Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (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 were at the centre of their care and treatment choices, and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care records did not always contain complete and relevant information about people's lives, needs and preferences. Important information about how people wished to live and be supported was not always clearly documented.

People did not always have access to meaningful opportunities for social engagement and stimulation. There was limited evidence of consistent therapeutic or structured activities being available throughout the day, and we observed many people spending extended periods of time in communal areas with little interaction from staff. The layout and arrangement of seating within shared lounges did not always encourage social interaction between people, with some seating positioned in a way that limited opportunities for conversation, engagement and participation in communal life. A relative told us, “[Family member] is kept in the TV lounge and supervised. [Family member] doesn’t realise their frailty though and is very bored. The TV is on but [family member] doesn’t watch it. I worry that [family member] has no regular activities.”

The lack of meaningful occupation and regular interaction reduced opportunities for people to maintain relationships, express themselves, and participate in activities that promoted a sense of purpose and enjoyment.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Records demonstrated people received care and support from relevant healthcare professionals as required. Staff liaised with GPs, specialist nurses and other professionals to ensure people's assessed needs were met. Where changes in health or wellbeing were identified, appropriate referrals were made and advice provided by professionals was acted upon and integrated into care records.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information about safeguarding, raising concerns and accessing support was available throughout the service. However, the provider had not always ensured that this information was presented in ways that were accessible and meaningful for people living with advanced dementia. Staff demonstrated a good understanding of people's individual communication needs and were able to adapt their approach to support understanding and engagement wherever possible and care plans documented people’s communication needs which helped support effective understanding and engagement.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives were encouraged to share their views about the service. Relatives told us they felt able to speak with staff and managers if they had concerns and described communication with the service as positive. Several relatives told us they felt involved in discussions about their family member's care.

The provider made sure that people could access the healthcare and treatment they needed.

Relatives told us people were supported to attend healthcare appointments and access specialist services when required. Feedback indicated staff acted appropriately when concerns about people's health were identified and took steps to ensure advice and treatment were sought from relevant healthcare professionals. This helped to ensure people had access to the medical support they needed and that changes in their health could be assessed by suitably qualified professionals.

We saw evidence that staff worked collaboratively with a range of health and social care professionals, including GPs, community nurses and other specialist teams, depending on people's individual needs. Records demonstrated healthcare professionals visited the service and provided advice, assessments and treatment to support people's health and wellbeing.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Many people using this service were living with advanced dementia and could therefore have relied on environmental cues to help them remain orientated, maintain their independence and navigate the service safely. However, the environment had not been fully adapted to meet their needs. We observed poor lighting in some areas of the service and a lack of consistent, clear signage to support people to identify key rooms, communal spaces and facilities. In addition, many doors and corridors appeared similar in appearance, providing limited visual cues to help people distinguish between different areas of the service. This increased the likelihood of people becoming disorientated or reliant on staff assistance for tasks they may otherwise have been able to undertake independently. We shared our concerns with the provider who sought advice and support from a specialist dementia company to review the environment and identify opportunities for improvement.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Records included information relating to future care planning, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and details of Lasting Power of Attorney (LPA) arrangements where these were in place. However, end of life car plans required strengthening to ensure future changes in people's care and support needs were recorded and discussed, particularly where people relied on others to support decision-making.