Bell House Care Home 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. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.The service was in breach of regulation regarding need for consent.

This service scored 42 (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.

People’s needs were not always accurately reflected in care plans. For example, there was important health information missing. There was no evidence of people having their care needs reviewed with them. One person told us, "I have not seen my care plan." Any required following feedback during assessment, were updated immediately by the provider.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider did not follow key legislation or policies. For example, principles of the MCA, 2005 were not adhered to. The provider’s safeguarding information was also outdated. The provider has advised us how they plan to improve practice to ensure this meets legislative standards and best practice.

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.

Professionals told us the provider needed to improve how they worked with other services. For example, we were told there is at times poor communication from the provider with the GP.

The provider did not 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, or where possible, reduce their future needs for care and support.

Key health information was missing from people’s care plans. Professionals told us staff had at times not followed requests regarding people’s health. There was a lack of stimulating activities for people. People and relatives provided mixed feedback regarding activities. One relative told us, "There could be more activities." Another relative told us, "At first there were not many activities but [there are] more now." The provider told us they plan to recruit a staff member to increase activities for people.

People were supported to eat healthy diets.

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.

People’s care plans did not always reflect their current needs. For example, when there were changes to medication. Daily notes completed by staff were not always completed contemporaneously, therefore it was unclear how people's needs were effectively and accurately monitored. Since the assessment, the provider has implemented processes to support accurate contemporaneous record keeping.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

Processes regarding consent were not robust. Although staff had completed relevant training, principles of the MCA, 2005 had not been followed. For example, assessments were not always decision specific; people, relatives and professionals were not always involved when decisions had to be made in people’s best interests. Staff failed to demonstrate an understanding of the MCA, 2005, such as assuming capacity in the first instance.