Headquarters BC Care Ltd

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 newly registered 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 provider 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.
Care plans contained some detail about people’s needs and daily routines, which helped to support staff to care for people. For example, 1 person’s care plan clearly outlined their personal care requirements, dietary needs, and daily routines, helping staff understand how to support them in a consistent way. People and relatives told us they felt their needs were being met by the care staff, and staff were able to speak to people in their preferred language to aid communication. Staff completed daily care notes in detail.
However, there were gaps in some care plans relating to people assessed medical needs which meant staff were not provided with specific guidance and knowledge on how to meet people’s need.
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.
During the assessment, we found people’s care was not consistently delivered in line with current best practice or evidence-based guidance. While body maps were in place to record observations such as skin integrity, other clinical monitoring tools were not being used to track changes in people’s health or wellbeing over time. This limited the service’s ability to identify emerging risks or evaluate whether care interventions were effective.
There was no evidence that recognised clinical guidance was being routinely referenced or implemented in care planning or review processes. This meant care was not always underpinned by nationally recognised best practice standards. For example, there were no structured tools in place to support the monitoring of conditions or symptoms for people prescribed medicines for anxiety or high-risk medications such as anticoagulants (blood thinning medication).
Leaders were not consistently monitoring care practices to ensure these aligned with policy or current guidance. Spot checks and audits were limited, and there was no evidence of systematic review of care plans or direct observation of staff practice. This lack of oversight reduced the provider’s ability to evaluate the quality and effectiveness of care, or to drive improvements in line with evidence-based standards.
 

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 people moved between different services.
During the assessment, we found limited evidence of effective communication and collaboration, both within the staff team and with external professionals. Professional visit notes were not kept, meaning the provider did not have a clear record of input or advice from other professionals or services involved in people’s care. This lack of information reduced the ability of staff to respond promptly to changing needs, as they may not have been fully aware of the support provided by others or any incidents that occurred between visits.
For example, 1 person attended day centres, but there were no records to reflect the day centre’s involvement or the impact this had on the person’s overall care and wellbeing. Similarly, where people had requested to take part in community or social activities, there was no formal documentation showing planning, coordination, or collaboration between the service and other agencies to support these initiatives.
Within the staff team, there were no regular meetings with care staff to discuss best practice, share updates, or reflect on care delivery. This lack of structured internal communication and joint working limited opportunities for learning, consistency, and the continuous improvement of care. Staff told us they worked well together day to day; however, without formal systems for sharing information and coordinating care, there was limited assurance that people consistently received well-coordinated and person-centred support.
 

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.
Records showed people received care which supported them to live healthier lives and respected their personal choices, cultural backgrounds, and religious requirements. Care plans included information about people’s dietary preferences, routines, and any health conditions that affected their daily lives. Staff were knowledgeable about these needs and provided support in ways that promoted people’s wellbeing and independence.
People were offered appropriate support with food and drink in line with their needs, preferences, and religious or cultural expectations. Relatives confirmed staff understood and respected these requirements. A relative told us, “[Person] can be fussy with food, but [Person] tells the carers what they want to eat, and they cook it right.”
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it.
During the assessment, we found systems for monitoring and improving outcomes required strengthening. Clinical monitoring tools for tracking moods and behaviours were not in place for people and there were gaps in the information available to staff about people’s assessed needs and medical conditions. This meant staff may not have had the full guidance needed to recognise or respond appropriately to changes in people’s health or behaviour.
For example, 1 person was prescribed medication to support their anxiety, but their care plan did not include information about why it had been prescribed or what staff should monitor to assess its effectiveness. Similarly, another person was prescribed a high-risk medicine to prevent blood clots, but their care plan did not include guidance about the potential risks or what signs staff should be alert to and report.
However, people and their relatives told us care was delivered by staff in a way that maintained people’s comfort and wellbeing. Staff described how they would report concerns in people’s changing health.
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.
During the assessment, we saw that consent for care was recorded for most people. However, there were some gaps in how consent was obtained and documented. For example, 1 person did not have a signed consent form in place, and in another case, consent had been signed by a family member, but it was not clear whether this person held lasting power of attorney (LPA) to make decisions on the individual’s behalf.
We also noted that for 1 person who could not consent, there were no Mental Capacity Act (MCA) assessments or Best Interests Decisions (BID) recorded for any of the care decisions in the files reviewed. This meant there was limited assurance that decisions were being made in accordance with legal requirements or best practice guidance.
There was little evidence people or their representatives were actively involved in reviewing their care plans. While an audit was present at the back of care files, this only recorded whether amendments had been made or if the plan remained accurate, rather than demonstrating engagement with the person or their family.
These gaps in documentation and review meant people’s rights were not consistently safeguarded, and there was limited evidence of involvement in decision-making.