Boston West Care

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 Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. However, we identified whilst care needs had been assessed, guidance for staff was not consistently detailed, had not been reviewed at the frequency the provider expected or correctly reflected people’s current needs. The provider was already aware of this and was taking action to complete a review and update all care records by 31 October 2025.

Whilst care plans lacked specific details in places, no person had come to harm, and people were supported by a staff team that knew them well. Clinical assessment tools were used to assess and monitor people’s individual needs, such as skin care, malnutrition, and deterioration in a person’s health.

New and improved communication systems and processes had been introduced to share information with staff, including changes in people’s health, care, and treatment needs. We reviewed records that confirmed actions taken by nursing staff in response to changes in a person’s needs, such as liaising with external health and social care professionals.

Staff informed us that they were kept updated by the nurse on any changes affecting a person’s care and treatment, which was discussed daily during the shift handover.

Through discussions with a relative, we learned that their family member had recently been seen by an external health professional regarding an infection. Antibiotics were prescribed, and wound care instructions were provided. Upon reviewing the individual’s care records, we found their care plans had been appropriately updated to reflect this guidance, ensuring continuity of care and alignment with clinical recommendations.

Relatives expressed confidence that staff were familiar with and assessed and monitored their family members’ individual needs. One relative shared, “[Name] has been struggling with their mobility. Staff picked this up quickly and acted upon it with a referral to the GP.” This reflects a proactive approach to care and effective communication between staff and external health professionals

The provider planned and delivered care and treatment to people, taking into account what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s care plans confirmed staff were provided with guidance on people’s routines, preferences and what was important to them. Whilst we observed some inconsistencies in the level of detail, the provider was aware of this and was taking action to make improvements.

Relatives confirmed they had been involved in discussions about important information to support staff in understanding what was important to their family member regarding their care.

The manager had recently introduced ‘resident of the day’. This is a person-centred care initiative used to ensure each person received focused attention and a thorough review of their wellbeing on a rotating basis. This approach helps ensure care remains responsive, inclusive, and tailored to each individual. The person, or their relative or representative, is involved and consulted.

Information for kitchen staff was available to inform them of individuals' dietary needs, any relevant risks, and their preferences. People had a choice of menu, and drinks and snacks were available throughout the day and evening. Where people were at risk of malnutrition, this was known and planned for. For example, foods were fortified to increase their calorific value, people were supported with their prescribed food supplements, and their weight was monitored. Additionally, food and fluid intakes were recorded and tracked. Where concerns had been identified about weight loss, this had been reported to the GP.

We identified that the menu was not reflective of the different nationalities of the people who lived at the service. The manager agreed and informed us that they were working on sourcing a different food supplier and planned to review the menu with input from people and relatives.

We received positive feedback about the quality of the food. A person said, “The meals are good, especially the vegetarian, it's cooked well.” A relative said, “The food is good in both taste and presentation. I visit every day and have lunch and enjoy it.”

The provider’s policies were found to be up to date and reflective of current best practice and legislation.

The provider did not always work well across teams and services to support people.

External professionals told us they had experienced concerns regarding communication with the service, particularly in relation to the changes of mangers. This had contributed to communication challenges, including instances where people were referred multiple times for the same issue due to gaps in internal communication coordination.

The current manager was actively working to strengthen communication channels and develop more robust systems and processes to ensure consistency and clarity.

Internally, new and improved communication procedures had been introduced to enhance the flow of information among staff. While these changes marked a positive step forward, additional time was needed for the revised practices to become fully embedded and consistently applied across the service.

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 have received targeted training to enhance their knowledge and competency in meeting people’s health care needs. This included clinical training for nursing staff, with formal competency assessments to ensure safe and effective practice.

People’s health conditions, care and treatment needs were assessed, monitored and reviewed. Care records confirmed how people were supported to access health care services. When external professionals had made recommendations, we saw examples these had been implemented and added to people’s care plans. This reflected a responsive and integrated approach to care delivery.

People and relatives were positive about how staff met health care needs. A relative said, “Health needs are well met by the service, sometimes there's been difficulties with the hospital cancelling appointments last minute but that's the hospital not the care home.” Another relative said, “I like to be fully involved in health appointments. Staff will notify me when the letters have arrived. On one occasion, we were unable to attend a hospital appointment because of a holiday; however, the nurse attended the appointment with them.”

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.

Staff worked in partnership with external healthcare professionals to support people in achieving positive health outcomes. This collaborative approach ensured that care was both clinically effective and aligned with personal preferences.

For example, 1 person actively directed their own treatment decisions. Records confirmed the person took the lead in managing their pain relief, and correspondence with their GP demonstrated that their wishes had been shared, respected and implemented. This highlights the service’s commitment to empowering individuals and fostering meaningful involvement in their care to achieve positive outcomes.

Nursing staff told us of the clinical tools they used to assess, monitor and escalate changes to people’s care and treatment needs.

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

Staff had access to the provider’s Mental Capacity Act 2005 (MCA) policy and had received appropriate training. This supported staff’s understanding of MCA principles. Throughout our visit, we observed staff consistently seeking consent and offering people choices before delivering care or support, this reflected respectful care practice.

Where people lacked the capacity to consent to specific decisions, MCA assessments and best interest decisions were completed. From the examples we reviewed, these clearly outlined the assessment process, including who was consulted, and decisions confirmed that the least restrictive options were considered.

Relatives confirmed they were actively involved in discussions and decisions regarding their family member’s care and treatment, reinforcing a collaborative and inclusive approach.

Where individuals had DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) orders or advanced decisions in place, these were appropriately recorded and communicated to staff, ensuring that care delivery aligned with the person’s expressed wishes.