128 Beech Hill

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.

This is the first assessment for the service under the new provider. This key question has been rated outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 ensured that people’s care and treatment was always effective by thoroughly assessing and regularly reviewing their health, care, wellbeing, and communication needs in partnership with them, their families, and relevant professionals. Initial and ongoing assessments captured detailed information about each person’s abilities, routines, and specific support requirements, ensuring care was tailored, responsive, and personalised.

People’s wishes, preferences, and choices were consistently sought, listened to, and embedded within their care plans, ensuring they led their own support and received consistent, meaningful care that fully respected their autonomy. For example, one person’s care plan detailed specific preferences for how they received their medicines and language to avoid, reflecting a deep understanding of what could impact their wellbeing. Another person’s mental health needs were comprehensively recorded, including how their mental health presented and the individual’s preferred strategies for support during episodes. This ensured care was always delivered in a way that respected their choices and promoted their dignity, safety, and wellbeing.

Care plans and risk assessments were comprehensive and practical, providing staff with clear guidance on proactive strategies. For example, one person’s care plan included strategies to manage anxiety during health appointments, while another used social stories and intensive interaction to support communication and emotional needs. Staff were observed consistently following Positive Behaviour Support (PBS) plans, which incorporated individual preferences and proactive strategies to reduce distress. This approach ensured that assessments directly informed personalised, effective care, enabling staff to respond to changing needs and support each person’s wellbeing, independence, and engagement consistently.

The provider always planned and delivered people’s care and treatment with them, focusing on what mattered most to them and in line with legislation and best practice. Staff used innovative, evidence-based approaches to support people to understand and engage in their care and treatment.

Staff used personalised, easy-read social stories to help a person understand a serious change to their physical health that required complex and invasive medical treatment and surgery. Social stories were used to enable the person to understand each step of their treatment journey including diagnosis, appointments, medical procedures, and aftercare. During their recovery, staff supported the person to understand how they might feel, including the expected effects of their condition and treatment. Staff explained the signs and symptoms that would require further investigation and provided guidance on how to raise any concerns. This helped to ensure the person felt informed, reassured and able to seek appropriate support if needed. Appointments were planned around the person’s routines and mental health needs, with morning appointments arranged to reduce anxiety and support engagement.

We observed staff responding sensitively to another person’s anxiety about an upcoming medical appointment. Staff took time to listen, explore concerns, and clearly explain each stage of the visit including travel, the waiting room and speaking with the medical professional. This person-centred approach reduced anxiety and enabled the person to feel supported and in control.

The provider always worked well across teams and services to deliver seamless, person-centred care. Information about people’s needs was shared effectively when people moved between services, meaning people only needed to tell their story once. Strong, consistent partnership working between staff, healthcare professionals, and families ensured people received coordinated care that reflected their needs and preferences.

For example, when a person received a difficult health diagnosis the local GP practice assigned a learning disability (LD) nurse to the person. They worked closely with staff to support the person to understand their treatment using resources such as easy read literature and tailored explanations. Staff accessed NHS videos and other recognised training resources to strengthen their knowledge and ensure they could appropriately support the person during their treatment and recovery. This included guidance on how to communicate effectively with the person about their condition and care in a way that was clear, sensitive and tailored to the person’s level of understanding. The registered manager and staff said healthcare professionals took time to build trusting relationships with the person, staff, and family, including engaging in conversation that was important to the person. This enabled the person to feel supported, understood, and able to engage meaningfully with decisions about their care and treatment.

Staff teams worked flexibly and collaboratively to ensure familiar staff supported the person to attend hospital appointments 50 miles away. This exceptional teamwork provided continuity and reassurance for the person and was supported by strong leadership. The registered manager said she was “Very proud of the team during this period.” The wider household also showed empathy and adaptability, contributing to a highly supportive and inclusive environment.

The provider supported people to manage their health and wellbeing in ways that promoted independence, choice, and control. People had good access to healthcare professionals, including national health screening programmes and routine dentist and optician check-ups. People were enabled to take part in physical exercise using local facilities or equipment in the home. A person received dietary advice from well-being advisor and was referred to the gym by their GP. The person told us they did not wish to attend the gym and instead preferred swimming. Staff respected their choice and arranged for swimming sessions to take place. This included support from a personal trainer in the pool to ensure the activity was safe, structured and aligned with the person’s health and wellbeing needs.

People spoke positively about the quality of their meals. They told us they had unrestricted access to food and drinks and were supported to go food shopping, promoting choice and independence. One person told us, “I enjoy eating well.” Staff promoted healthy eating and supported people to make appropriate dietary choices where required. Care plans reflected personalised approaches to support. For example, one person’s plan outlined their preferred method of encouragement, such as staff suggesting, “Maybe have a healthier snack” or “Maybe have a decaf drink or squash.” The care plan acknowledged the person might not always welcome the suggestion but may choose to accept it, demonstrating a respectful and person-centred approach to promoting healthier options.

The provider routinely monitored people’s care, wellbeing and treatment to continuously improve it. Staff communicated through comprehensive handovers and shared care planning updates. They ensured outcomes were positive and consistent, and met both clinical expectations and the expectations of people themselves. One person told they had followed exercises recommended by their doctor to resolve a medical issue, saying, “I feel fine, I don’t have pain.” People attended annual health checks, which included monitoring weight, blood pressure, and medication. Referrals were made to specialist professionals to support people’s mental health and wellbeing. Care planning recorded outcomes of medical appointments and daily notes recorded staff interactions, support given and any changes in peoples wellbeing.

Care records included goals such as holidays and hobbies, respecting people’s preferences and capturing ideas for new activities and interests. One person preferred not to have goals which they described as ‘boring and patronising’, unless they were planning for holidays and Christmas. They told us they were able to make their own mind up about things and that was important to them.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff upheld people’s rights under the Mental Capacity Act 2005 (MCA). They worked with people, families and professionals to ensure decisions reflected people’s wishes and feelings. Staff demonstrated knowledge of the MCA and ensured any restrictions such as 1-1 staffing were proportionate to the level of risk.

We observed people being supported using the least restrictive options and treated with dignity and respect. For example, asking before providing care and entering rooms. Care records contained decision-making assessments and outcomes in line with legal requirements. People told us they understood why they lived at the home and described their independence with daily living, making choices and being listened to.