Archived: Beeches Care Home (Nottingham)

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 remained 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 legal regulation in relation to safe care and treatment and requirements relating to mental capacity.

This service scored 58 (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 did not contain consistent information throughout and were not detailed enough to guide staff on how to support people with their needs in a personalised and effective way. For example, where someone’s identified need was around getting frustrated plans just stated “engage in activities they enjoy” but did not explain what these were; or “look for early signs of frustration” but did not detail what this looked like for individuals. This meant people may not have always received effective care and support.

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

People and their families we spoke with told us they had little or no involvement with care plans or reviews, and felt communication was limited. They said, “They don’t tell us anything,” and “I’ve not seen it (care plan). I raise questions, they’ll listen and address things but there seems to be no methodology.”

People were supported with their eating and drinking and we saw evidence of input from relevant professionals. However, we did find that some dietary requirements were not consistently recorded throughout care plans and shared with kitchen staff. A professional fed back to us their concerns around the knowledge of dietary requirements and as a consequence the impact this can have on individuals.

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

There appeared to be a lack of joined up working between staff and teams within the home, there was not a holistic approach to care planning and our observed care delivery demonstrated that staff were not always aware of vital information to support people safely. People did not all have emergency information packs available as the home had recently introduced a new electronic care planning system.

However, feedback we received with external healthcare professionals was positive with regards communication. For example, they told us, “Overall the service has improved greatly over the last few months, for example communications inhouse, with the surgery, proxy ordering. The new management team are having a very positive impact overall.”

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.

People told us they were supported with their health and wellbeing needs. For example, a person told us, “The GP comes along once a week. I had both the dentist and optician when I came here. I get my feet done once a month and the hairdresser is here every Tuesday.” We saw evidence of appropriate referrals being made and a healthcare professional confirmed, “Staff generally escalate concerns appropriately and in a timely manner.”

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.

The provider held a clinical risk register which detailed people’s individual needs to establish areas which required extra monitoring. For example, where people were identified to be at risk of malnutrition, we saw that monitoring of people’s weights was taking place.

Staff understood when to escalate concerns and to whom. A healthcare professional told us, “We receive suitable referrals, and if a resident’s condition deteriorates while on our waiting list, the care home often contacts us directly to inform us of any changes.”

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

We found there was inconsistent recording of people’s ability to consent in their care plans. Where people were identified as lacking capacity to consent to areas of their care and treatment best interest documentation was not always in place to ensure people’s rights were being upheld.

People told us they were asked their consent before staff supported them and were supported with their independence and choices.