Beeches 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

At the last inspection the service was in breach of regulations relating to safe care and treatment, premises and equipment and staffing. At this inspection, enough improvements had been made, and the provider was no longer in breach of these regulations.

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 did not always make sure people’s care and treatment were effective because they did not always check people’s health, care, wellbeing and communication needs.

Staff did not always ensure information in people’s care plans was robust. There was a notable difference to the level of detail in some people’s care plans, and information sometimes conflicted. For example, to the frequency of positional changes, level of falls risk or people’s Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) status. Specific care plans had not been completed for everyone who needed them; including mobility, communication and oral hygiene care plans.

However, an electronic system was used to record care interventions, and managers were alerted to missed tasks. People and relatives confirmed they were involved in the care planning process and care plans were regularly reviewed. One person told us, “When I moved in the staff spoke to me about what I wanted and what I needed. They know me well.”

Following feedback, the deputy manager assured us care plans would be reviewed and action taken to amend conflicting information and implement oral hygiene care plans.

The provider did not always plan and deliver people’s care and treatment with them, including what was important to them, or do this in line with legislation and current evidence-based good practice and standards.

The provider did not always ensure people’s nutrition needs were met. One person had been regularly refusing meals because they did not like the texture or presentation of their pureed diet; required to prevent choking. Observations and records evidenced this had a negative impact on their enjoyment of food, food intake and weight. Issues had been ongoing, but resources had not been provided to make the required improvements in a timely manner.

Records did not evidence people were always offered the required amount of fluid as stipulated in their care plans. People did not always have a drink available to encourage intake; and we received mixed feedback about people’s access to fluids.

However, the deputy manager shared guidance and sourced additional training to ensure staff were aware of current best practice; and people were very complimentary about their meals. One person told us, “The food is just lovely.”

Following feedback, the registered manager and deputy manager worked closely with kitchen staff to make improvements to stock levels, fortified meals and the presentation of food. Kitchen staff confirmed this had resulted to an increase in food intake saying, “[Person] has been eating a lot better since changes have been made.”

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 registered manager and deputy manager sent emails to share important messages with the appropriate staff. Daily handovers were held to ensure information was cascaded, and regular meetings were held for the different teams.

Staff ensured communication with partners was positive. A staff member said, “We have good communication with other professionals. Discussions are logged on [the electronic system]. A communication book is also in place.”

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.

Staff identified risks to people’s health and wellbeing early, to help prevent deterioration. The deputy manager told us, “Staff are very good at flagging concerns. [Person] went into hospital yesterday. Staff had noticed they were in pain and called me to check on them.”

People had access to regular monitoring and health checks. A weekly ward round ensured new and ongoing healthcare needs could be reviewed, and the appropriate treatment plans agreed.

Staff worked closely with the district nursing team and people were supported to see a GP when they needed to. Records evidenced referrals were made on people’s behalf.

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.

The provider ensured there were effective approaches to monitor people’s care and treatment. Regular monitoring was in place for those who needed it. For example, blood pressure, weights, Malnutrition Universal Screening Tool (MUST) scores and body maps.

Pressure injuries were recorded and monitored, and treatment plans ensured positive outcomes in line with clinical guidance. A relative told us, “[Person] has been cared for in bed for years and has never really had a bed sore. They had a little mark on their chest, but it got sorted out.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider ensured assessments and best interest decision making records were on file, and people’s capacity to consent was documented in their care plans.

Staff had completed training in The Mental Capacity Act 2005 (MCA), to aid their understanding of people’s rights around decision making, and relatives confirmed staff sought consent. A relative said, “They always knock on [person’s] door and always ask [person] if they can reposition or change them.”