Becket House Nursing 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 that people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (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 assessed people’s needs before they moved into the service to ensure they could meet the person’s individual requirements. People had care plans setting out the care and support they required, and these were regularly reviewed, but we found these were not always up to date.

For example, 1 person had a mobility care plan which provided conflicting information about the person’s level of support required. This could place them at risk of receiving care which was not in line with their current needs.

We found care notes to be brief and concise, for example staff noted when they chatted with people and how they had supported people’s needs.

The service delivered people’s care and treatment with them, including what was important and mattered to them.

The provider reviewed risk assessments regularly using recognised tools to help assess people’s needs and make changes, if necessary. These included Waterlow for assessing people’s risk of developing pressure ulcers and Malnutrition Universal Screening Tool (Must) used to assess people’s risk of malnutrition. Staff said that if they saw any changes in people’s needs, they would inform the nurse in charge or the registered manager.

The service worked well across teams and services to support people. Records showed people were supported to access external health professionals, including when they needed to attend hospital appointments.

An external professional said, “The manager appears to have an ‘open door’ approach for the residents, their families and visitors and is welcoming to all.”

Feedback from staff and relatives confirmed this. A relative told us, “An optician and a chiropodist come into the home. I am always made aware when an appointment is due for [person] and if I am not available to take them, staff will arrange patient transport, and someone will go with them.”

The service did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. We observed that people did not always receive a positive mealtime experience. People were asked to choose their meal preference days in advance. Menus were not available in the dining room or in people’s rooms. People received both main dish and their pudding at the same time. Mealtimes were not person centred in their approach.

We feedback our findings and the provider said they would be making changes to mealtime service.

We received positive feedback about the food. A person said, “The food is good,” and a staff member said, “The food is good, if they don’t want it, they can ask for something different.”

The service monitored people’s care and treatment but at times some issues were not identified or acted upon promptly. This meant the provider could not always assure themselves that people were achieving the best outcomes possible. For example, we found concerns in medicines administration processes, conflicting information in risk assessments and safeguarding concerns not being promptly acted upon.

We could not be assured that the service always effectively reviewed and monitored care constantly to ensure positive outcomes. For example, some people’s topical creams had been prescribed to people to have twice a day, there were gaps in Topical Medication Administration Records (TMAR) where people had not received the topical cream as prescribed.

The registered manager responded promptly when issues were brought to their attention during the assessment.

The majority of feedback from relatives confirmed they were happy with the support provided and felt their loved one’s needs were monitored well. One relative said, “I have 100% trust in them, and I know that if [family member] is ill, I will be notified immediately, even if it is in the middle of the night.”

Where a person did not have capacity to make their own decisions, or had fluctuating capacity, the provider had not consistently completed Mental Capacity Act assessments. This meant the service had not acted in line with the Mental Capacity Act (MCA) (2005) code of practice.

The registered manager was proactive on acting on our findings and Mental Capacity Assessments were completed where needed.

Staff received training in the MCA and understood what consent was. A staff member told us,” If someone doesn’t want me to help, I will ask another member of staff to do it.”

We observed staff consistently offering people choices and seeking consent before any care or support was delivered.