Beckoning House Limited

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 this service. This key question has been rated 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 service 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.

The registered manager told us they carried out a full assessment of people’s needs before they started using the service to ensure their needs could be met. This involved meeting people and getting feedback from health professionals involved in the person’s care. However, we found this was not reflected in a person’s care plan and risk assessment accurately.

The person’s care plan and risk assessment was not always personalised, and records we looked at failed to demonstrate people’s needs were being regularly reviewed to ensure their support plans continued to reflect their needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. A care plan we looked at, did not include information about a person’s nutrition and hydration needs. For example, staff told us they helped a person prepare their meals. There was no detail of meal preparation, or of any enhanced monitoring, risks or related health conditions. This meant staff did not always have access to the information they needed to work with the person.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when they moved between different services. The person’s care plan did not contain information about involvement with other professionals and how staff worked in partnership with others to help ensure people received personalised care and support.

Staff meetings and supervision sessions were in place to ensure staff were provided with current information to work together to support people. A staff member told us, “I have regular supervision, and I find it very valuable.”

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 support people to live healthier lives and where possible, reduce their future needs for care and support.

Although a relative told us they were involved in monitoring and reviewing the person’s health and wellbeing needs, information in the person’s care plan was generic and not personalised to the individual using the service. Care plans did not include the person’s preference on how they would like their healthcare needs to be supported and their level of independence.

A member of staff told us, “I familiarise myself with a person’s care plan and get to know the person before supporting them. I want to make sure they can live their best life.” Although a relative mentioned being involved in monitoring the individual’s health, the care plan was vague and lacked personalisation. The provider did not consistently help people manage their health and wellbeing, which limited their ability to remain independent, make choices, and feel in control.

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.

The registered manager told us they had systems in place to monitor care outcomes and used this information to develop the service. For example, they had sent out a survey to obtain feedback on the quality of care. However, the survey response/s we viewed was not dated and the feedback themes and trends or to see where improvements were needed.

The provider’s processes for monitoring and improving people’s outcomes was not always robust. This meant people were at risk of receiving care that did not fully meet their assessed needs or support them to achieve the best possible outcomes.

Consent to care and treatment was sought in line with legislation and guidance. People we spoke with told us they were able to make informed choices.

Staff had received training in the Mental Capacity Act 2005 (MCA). Staff understood the need to gain consent from people to support them with their care needs and in making decisions. Staff told us, “I have completed my training, and I understand the importance of gaining consent from the people I support.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions. However, this was not always documented in a person’s risk assessment. While still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.