Archived: Bethany Homestead

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. People were not involved in the planning of their care.

People and relatives, we spoke with told us they had not been involved in the person’s ongoing care plan or review of this. This meant people were not supported to be involved in decisions that impact their lives. There were no systems in place to ensure people and their relatives were involved in their care planning and their voices were heard. We brought this to the managers attention who told us they planned to introduce 6 monthly reviews with the involvement of people and their relatives. However, there was no time scale given for this.

People had expressed their wish to have their meals together, however this was not always facilitated by staff, who failed to understand the importance of maintaining this relationship.

One person’s relative told us their loved one had not been out since arriving at Bethany Homestead apart from attending the chapel on site.

The provider did not have systems in place to explore local community groups to help facilitate people’s interest, however there was a well-established male voice choir which people told us they enjoyed.

There were shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff did not have enough skills or support to understand the needs of people living with dementia. For example, they had not identified that people struggled to know what was on the menu or finding their way around the home.

The provider did not have reliable systems to ensure people who spent their time in their rooms always had access to their drinks or staff if they could not use their call bells. This meant people were at risk of not receiving care in a timely way.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People did not have access to their care plans in a format that was suitable for their needs.

People living with dementia did not always have information in different formats. Where these were available, they were not accurate. For example, information about meals.

People living with poor sight had access to talking newspapers and bibles.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Whilst the manager held residents’ and relatives’ meetings, they had not ensured all people were aware of these, or that the format used to advertise these were accessible. For example, relatives told us they did not use email and would prefer to be told by letter or phone calls. This meant not all people’s relatives were given the opportunity to take part. People we spoke with told us they had not needed to make a complaint but if they needed to, they would feel comfortable to do so. However, one person told us they did not know how to make a complaint. The manager had suggestion boxes available for people to provide feedback, not all people were mobile and could access this.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People who required 2 staff to provide their care did not receive responsive care to their needs, as staff did not respond to their call bells promptly. This meant people were not always able to access support when they needed it. The manager told us they were going to review the deployment of staff to improve call bell response times.

However, people told us they were supported to attend appointments, relatives told us they were contacted if there had been a fall or if people required hospital admission.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. Staff received training in equity, diversity and human rights.

The service had no systems in place to ensure all people had access to advocates if required, not all people had family to support them in making decisions about their care. People did not have access to advocacy. This meant the manager could not be assured all people had the same access to their voices being heard and their rights respected. When we brought this to the manager’s attention, they told us they would talk to individuals regarding advocacy to ensure all people knew what was available to them.

The Manager introduced care champions, for example, one member of staff was an incontinence champion, they had completed continence referrals for all and ensured people had a good supply of incontinence products.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff liaised with the GP when people’s health deteriorated, however, there was not always a reliable system in place to record people’s preferences for place of care. Staff did not have a clear understanding of who had do not attempt cardiopulmonary resuscitation (DNACPR) forms in place, as the service failed to have an up-to-date system in place planning for future care.